National vaccination coverage statistics for adolescents (13-17 years old) were recently published by the Centers for Disease Control and Prevention (CDC).  Wait, wasn’t this supposed to be a cancer blog?  Oh, it is–the human papillomavirus (HPV) vaccine prevents infection by the HPV strains that cause cancer.

In 2015, 56% of adolescents had at least 1 dose of HPV vaccine, 45% had 2 doses, and 35% had all 3 doses required for maximal protection.  In comparison for the same adolescent population, 87% had a Tdap vaccine and 81% had a meningococcal vaccine.

So why the low HPV vaccination rates?

Choice.

I hate to say that.  I don’t really care much for big government, for restrictions, for rules, but when choice results in pediatricians stating, “your 11-year old is going to get the meningococcal and Tdap vaccines today, but we also have this other vaccine if you’re interested. It’s for a sexually transmitted disease.”  What parent wouldn’t question that choice for their 11-year old?

Vaccines  stimulate your immune system and trick it into thinking you’ve been infected with the pathogen.  That way, if you are ever exposed to the microbe, those immune cells are primed and ready to get rid of it.  So they work best when you get them before you’ve been introduced to the microscopic disease.

The thing is, if you make it through life without measles, mumps, rubella, polio, pneumococcus, etc. those vaccines might have worked for you.  I state it this way because in reality, you may have never in your entire life come in contact with these pathogens.  Don’t get me wrong, the vaccines worked–globally–to reduce the amount of circulating infectious disease that allowed you to go about your life without being exposed, but they didn’t need to work individually for you.

This is absolutely and unequivocally not the case for HPV.

HPV is one of the most prevalent infectious diseases.  About 80 million people in the U.S. are currently infected. That’s 1 in 4 people!  25% of our population at any given time is walking around with HPV.  And HPV is the #1 most common sexually transmitted disease in the world.  Because of this, just a single unprotected sexual encounter (in any form–vaginal, anal, oral) is risk for infection.  To make matters worse, you’ve likely had multiple HPV infections yourself and never known it and an infected person does not need to have symptoms (ie. warts) to transmit the virus to a partner.

Sometimes HPV will go away on its own (whether you knew it was there or not), but sometimes it sticks around and has the ability to cause cancer later in life.  We have no real way to distinguish these outcomes, so preventing infection by vaccination before any sexual encounter is our best weapon to prevent the cervical, vaginal, penile, anal, and oropharyngeal (mouth) cancers that HPV sets in motion.

Studies have shown that HPV vaccination does not result in increased sexual activity or risky sexual behaviors in teenagers.  If you’re worried about telling your child they are getting a vaccine for a sexually transmitted disease, discuss with them how vaccines work.  Tell them that the vaccine will help protect them from cancer when they’re older, but only if they get the vaccine before they ever have sex.

HPV vaccination at age 11 will protect your child whether he/she starts having sex at the very young age of 13 or a more mature 22.  As a parent, you have little-to-no control over when your child makes this decision, but you do have the ability to prevent the cancers HPV can cause.

Rhode Island is the only state in the U.S. that currently requires HPV vaccination for all kids going into 7th grade.  Unsurprisingly, Rhode Island has the highest HPV vaccination rates in the country–68% of female and 58% of male adolescents received all 3 doses.  These rates are still not up to the target of 80%, but are far better than the lowest (24% of females in Mississippi and 16% of males in Tennessee).

Like the microscopic bugs vaccines prevent, I think we can all learn something from our smallest state.

To read more:
Boston Globe
CDC adolescent vaccination rates 2015
CDC HPV information
Vaccine hesitancy among pediatricians
HPV vaccination unlikely to promote risky sexual behaviors