One of my main roles as a pediatrician is disease and injury prevention. I spend time at every well visit talking to parents about pool safety, car seats, helmets and child proofing. I talk to teens about safe driving, seat belts, drugs and alcohol. I try to get parents to stop smoking and counsel teens to never start. But our most successful area of prevention has been in the vaccinations we give our patients. For decades we have been preventing polio, tetanus, whooping cough, diphtheria, measles, mumps and rubella. Since I graduated from medical school 18 years ago, we have added vaccines for chicken pox, rotavirus, hepatitis B, and certain types of meningitis and pneumonia. And now, amazingly, we have a vaccine that prevents cancer: the HPV vaccine. Given the pediatrician’s huge focus on disease prevention, it is extremely disheartening to me when parents refuse to vaccinate their child. And this happens most commonly with the HPV vaccine. It is difficult for me to understand why parents would not want to protect their child against cervical cancer, mouth and throat cancers, penile and anal cancers, and genital warts. Unfortunately, there is misinformation in the media and on the Internet about the safety of the HPV vaccine, and misperceptions from parents that giving the vaccine to their children encourages sexual activity. Some parents also falsely believe that children shouldn’t get the vaccine until they are sexually active.
Florida has the lowest HPV vaccination rate in the country, and not surprisingly, one of the highest rates of cervical cancer. Parents need to make getting their preteens and teens this important vaccine a priority and certainly not refuse to give it to them. To address the safety concerns, the CDC’s Morbidity and Mortality Weekly Report published the week of July 25 supported that there have been no serious safety concerns linked to the HPV vaccine. In the United States, doctors have been giving the HPV vaccine for eight years and have given 67 million doses. As far as seeing the vaccine as permission for teens to be sexually active or waiting until they are sexually active to give it, the CDC recommends that we give the vaccine at the 11- to 12-year-old well visit, but it can be given to patients as young as 9. Studies have found that getting the HPV vaccine does not make kids more likely to be sexually active or to start having sex at a younger age. The vaccine provides children with the best protection when given at 11 to 12 years old, before the initiation of sexual activity. I recommend that rather than discussing with an 11-year-old that HPV is a sexually transmitted disease, just let them know it is one more disease that we are protecting them from. I have few parents who refuse the Hepatitis B vaccine, which is a three-shot series given in the first year of a baby’s life and also protects against a sexually transmitted disease. Another fact that I think parents don’t realize is that HPV is so common that almost everyone who is not vaccinated will be infected at some point. Most infections are without symptoms, and it is estimated that 79 million Americans are infected with HPV. So waiting until kids are sexually active to give them a vaccine that takes six months to complete for an extremely common disease is not a good plan to protect them. I made sure my daughter got all three of her HPV vaccines when she was 12, three years ago. I hope that parents will work together with me to help protect their children against cancers that are now preventable, and to get Florida off the bottom of the list for HPV vaccination rates. Marcy Solomon Baker, MD, is assistant medical director for pediatrics, BayCare Medical Group.