Survey: More Parents Oppose HPV Vaccine

Parents' resistance to the human papilloma virus (HPV) vaccine for their daughters has increased over time, surveys suggest. And there's been a big jump in the number who cite safety concerns with the vaccine. The HPV vaccine protects against virus types that cause most cases of cervical cancer. It also prevents some cases of genital warts. The study was based on two national surveys. Parents' answers on the 2010 survey showed about 25% of teen girls had received all 3 doses of the HPV vaccine. That was up from 16% in 2008. But the percentage of parents who said they did not intend to get the vaccine for their daughters increased from 40% to 44%. Some said that it wasn't needed or that their daughters were not sexually active. About 16% cited safety concerns, up from 4.5% in 2008. That puzzled researchers, who said the vaccine is very safe and side effects are mild. The vaccine is recommended at age 11 or 12 because it works best if given before girls have sex. It is now recommended for boys, too. The journal Pediatrics published the study. HealthDay News and Reuters Health news service wrote about it March 18.

By Henry H. Bernstein, D.O.
Harvard Medical School

What Is the Doctor's Reaction?

Once a child starts school, he may think he is all done with vaccines. Guess again! Vaccines are not just for babies and young children.

Preteens and teens (and adults, for that matter) need several vaccines, too. Some teens are at higher risk for certain infections. One example is meningitis, an infection of the coverings of the brain. Plus, the protection teens got from some vaccines as youngsters may begin to wear off by the time they are teenagers.

Unfortunately, the number of teens who get all recommended vaccines is well below where it should be. Why are teenagers not receiving all the vaccines they need?

A recent study published in the journal Pediatrics helps provide an answer. Researchers looked at the 2008-2010 National Immunization Survey of Teens. They wanted to know the reasons parents gave for not having their teens vaccinated.

The survey asked parents if their child had received the following vaccines:

• Tetanus-diphtheria-acellular pertussis (Tdap) or tetanus-diphtheria (Td)
• Meningococcal conjugate (MCV4)
• Human papillomavirus (HPV), if the child was female

Parents of teens who were not up to date with these vaccines were asked why. Here are the main reasons parents gave:

• Their doctor did not recommend the vaccine.
• It was not needed.
• They did not know enough about it.
• They did not know why their child did not receive it.

For HPV vaccine, parents gave the same reasons above. They also listed these other concerns about HPV:

• My daughter is not sexually active.
• My daughter is not the right age.
• I'm worried about its safety or side effects.

The percentage of parents with concerns about the safety of the HPV vaccine grew from 5% to 16% between 2008 and 2010. So did the number of parents who said they did not plan to vaccinate their daughters against HPV.

This study did find that more doctors are recommending all of the teen vaccines. Yet many parents still refuse to vaccinate their teenagers against serious diseases, especially HPV.

HPV easily spreads by skin-to-skin contact during sex. More than half of sexually active people get this virus at some point in their lives. The HPV vaccine:

• Prevents cancer
• Protects against genital warts
• Stops the spread of the virus to sexual partners

What Changes Can I Make Now?

Vaccines are safe, and they protect against serious (and sometimes deadly) diseases. Make sure your teen is up to date with his or her vaccines. Discuss the recommended vaccines with your teen's doctor. It's often easiest to receive all vaccines needed at the same office visit.

The latest vaccine recommendations for all teens include:

• Tdap protects against tetanus, diphtheria and whooping cough (pertussis). The vaccines children get as infants may begin to wear off. Your child needs a booster dose of Tdap if she is:
  • 11 or 12 years old
  • 13 or older and has not yet had this new vaccine.
  • 7 to 10 and did not get all doses of pertussis-containing vaccines as an infant or preschooler
• MCV4 vaccine protects against meningococcal disease. Even with treatment, many people die or are disabled from this infection. Vaccination is the best way to keep children healthy. Your child should receive MCV4 based on age:
  • 11 or 12 years old -- Get 1 dose now and a booster at age 16.
  • 13 to 15 (and never had this vaccine): Get 1 dose now and a booster at age 16 to 18.
  • 16 or older (and never had this vaccine): Get 1 dose now, especially before college or joining the military.
• HPV vaccine protects against the types of HPV that cause cancer of the cervix, penis, anus, head and neck. It also can help protect against genital warts. HPV vaccine is now recommended for all girls and boys:
  • Children 11 or 12 years old get 3 doses over 6 months.
  • A teen age 13 or older who has never had any doses of this vaccine can still get it. Talk to your child's doctor.

  HPV vaccine prevents cervical cancer best when given before a young girl becomes sexually active. That is why teens need it when they turn 11 years old. HPV vaccine has been studied for many years in many children and young adults. It has proven to be safe and very effective.

• Influenza vaccine protects against the viruses predicted to cause the flu in the coming season. It is especially important for children with chronic medical conditions, such as asthma and diabetes. Your child needs flu vaccine every year beginning at 6 months of age.

What Can I Expect Looking to the Future?

Expect to hear more from your teen's doctor about vaccines. Every teen needs to be protected against these serious (and deadly) diseases. Your doctor can provide you with written information about the safety and effectiveness of these vaccines.

To learn more, visit the Centers for Disease Control and Prevention's teen vaccine web page.