As a family doc some parents have told me that they do not want their child to get the HPV (human papillomavirus) vaccine. Some parents fear that their child may have a dangerous reaction to the vaccine, or that the vaccine is not necessary as their child is not sexually active. Worldwide, over half a million women are diagnosed with threatening cervical cancer and about 260,000 women die from cervical cancer every year. It is the 4th most common cancer in women.

As a mother, I can understand the reluctance that a parent may have after hearing “horror stories” about a childhood vaccination or children getting injured after HPV vaccination. However, as a health professional, I know that benefits of vaccination outweigh the risks of not vaccinating. My daughter Madi will be getting the HPV vaccine to help protect her from cancers in adulthood. 

What Exactly is Human Papillomavirus or HPV?

HPV is a virus that only infects humans and is the most common sexually transmitted infection. There are over 100 types of HPV, only some of them are sexually transmitted and can cause genital warts or cancers of the cervix (a part of the woman’s anatomy situated at the top of the vagina) and cancers of the penis. The virus itself is spread through sexual intercourse or contact of genitals or the infected area and infects both men and women. 70% of precancerous lesions and revival cancers are caused by two types of HPV (16 and 18), however other “strains” of HPV are associated with illnesses like genital warts.

What are the Signs and Symptoms of HPV Infection?

The majority of infections do not cause any symptoms. It can lead to genital and non-genital warts. Persistent infection may cause precancerous lesions and potentially cervical cancer

What Can Happen When Your Body Does Not Clear an HPV Infection? 

The majority of HPV infections go away on their own and do not cause health problems, but some do not. For women who obtain regular Pap-Smears, these may detect low-grade changes of the cells on the cervix. These cellular changes can be transient and may not necessarily develop into a full blown cancer, but it is important to have proper follow-up because HPV related cancers can be life-threatening.

What Type of Cancers is HPV Linked To?

  • Cervical Cancer: Virtually all cases of cervical cancer are attributable to HPV infection.
  • Penile Cancer
  • Cancers of the anus
  • Vulvar and Vaginal Cancer 
  • Cancers of the head and neck – HPV can result in changes in tissues within the mouth and throat. 

Who is At Risk For HPV Infection? 

Genital HPV infections are most often transmitted through sexual contact (genital-genital, or anal-genital). The strongest predictor of genital HPV infection is sexual activity, therefore anybody who is sexually active could be at risk for HPV infection. This is why vaccination as well as regular cancer screening with your family doctor is important. The biggest risk factors for HPV include:

  • Having more sexual partners increases the likelihood of HPV infection
  • Early first sexual intercourse
  • Use of tobacco and smoking 
  • Being immunosuppression (for example: having HIV) 

The HPV Vaccine is Important because it protects against up to 9 strains of Human Papillomavirus and Can Protect You from Developing an HPV Infection

There are currently 3 vaccines available – cervarix, gardasil and gardasil 9. In Canada and the US only gardasil 9 is available.

Gardasil 9 protects against 9 different strains of HPV. HPV strains 16 and 18 are responsible for about 70% of cervical cancers worldwide. Gardisil 9 also covers 7 other strains of HPV that put men and women at risk of anal and genital cancers.

These gardasil vaccine is 3 doses given over 6 months (at 0, 2, and 6 months).  

Who should get the HPV Vaccination?

HPV vaccination is recommended for both females and males. It works best when it is given before a person gets infected with HPV so therefore before somebody starts having sexual intercourse. The Advisory Committee on Immunization Practices (ACIP) in the United States recommends the following:

  • For young boys and girls: The HPV vaccination is recommended for boys and girls aged 11 to 12 years old. The vaccine can be safely administered to young boys and girls as early as 9 years old. 
  • The HPV vaccine is recommended to everyone 9-45 years old
  • For females aged 13-26, and males aged 13-21 that missed the vaccination of did not get all the shots they needed, they can “catch-up” on the vaccination.

This post was co-authored by Stephanie Liu, MD, MSc, CCFP, BHSc and Suzanne Black, MD, BSc.

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