HPV vaccinations still low among teens; doctors, National Cancer Institute urge action

Merck's Gardasil 9 is approved by the FDA and has been shown to protect against HPV strains that can cause genital cancers for up to 10 years (follow-ups ongoing).

Photo/Merck

Merck's Gardasil 9 is approved by the FDA and has been shown to protect against HPV strains that can cause genital cancers for up to 10 years (follow-ups ongoing).

GRAND CANYON, Ariz. — A recent study by the Centers for Disease Control and Prevention (CDC) indicates that cases of cancers associated with human papillomavirus (HPV) are on the rise — approximately 39,000 new cases are reported annually in the United States.

HPV vaccines can prevent most cases of genital cancers (cervical, anal and penile) caused by the virus, but vaccination rates among American teens and young adults remain low, with 41 percent of girls and 28 percent of boys receiving the recommended series of shots.

Guidelines for administering Gardasil 9, an HPV vaccine approved by the Food and Drug Administration (FDA) in 2006, have recently changed: the CDC now recommends teens under 14 receive two doses of the vaccine six months apart, the first for the initial protection and the second as a booster to keep the production of antibodies going. Teens and young adults over the age of 14 should continue to receive the vaccine in three doses over a six-month period.

According to the CDC, most sexually active teens and adults will be infected with HPV at least once in their lives. The virus is passed via skin-to-skin contact during sexual activity, and most infections are eliminated by the body’s immune system without ever causing symptoms. Some variations of the virus, however, can cause infections that are not easily eliminated by the body and can go on to cause genital warts and cancers in both women and men. Of the 39,000 cases of reported HPV-associated cancers each year, around 12,000 are cervical cancer, and about one-third of the women diagnosed (4,000) will die from the disease.

April Alvarez-Corona, a pediatrician for North Country HealthCare in Winslow and Flagstaff, said that she recommends to parents that they vaccinate their children around 11 years of age. She said parent education is a very important part of the process, so she begins the conversation as early as age 9 to prepare both the parents and the children.

“Initially, there may be a misunderstanding about the vaccine and sexual activity,” she said. “Some parents feel that it will give their children free-reign to be sexually active without consequences. I can’t change their minds, but I stress to them that the HPV vaccine is mainly an important cancer prevention method.”

Alvarez-Corona said Gardasil 9 can be administered as early as nine years of age under special circumstances.

The CDC notes that Gardasil 9 does not protect against other sexually transmitted infections like chlamydia, gonorrhea, herpes or HIV/AIDS. Ideally, the CDC recommends pre-teens and teens be vaccinated before they engage in sexual activity, ensuring that they haven’t already been in contact with one or more of the HPV strains the vaccine is formulated to prevent. Although the vaccine has been shown to be most effective before the age of 14, when antibody development is strongest, the CDC indicates that teens and young adults up to age 26 can still benefit from the vaccine because it is unlikely they have been exposed to all of the HPV strains targeted by the vaccine. Gardasil 9 is not recommended for pregnant women.

The CDC also said that women who have been vaccinated for HPV should not stop getting annual PAP smears or cancer screenings, since some forms of cervical cancers are not caused by HPV.

“Parents should be aware of the situation and realize that this is a way to protect their children against life-threatening infections,” Corona said. “The first 10 years or so after the vaccine came out, we were seeing some resistance, but it’s less and less now. It’s gotten better over the last five or six years.”

Although Gardasil 9 is aimed at pre-teen and teen girls, boys of the same age will also benefit from the vaccine, since HPV can cause penile and oral cancers.

A spokesperson for the Grand Canyon Clinic, which is managed by North Country HealthCare in Flagstaff, said Gardasil 9 can be administered on-site at a routine clinic visit.

More information about Gardasil 9, or the vaccination process, is available by visiting www.cdc.gov/hpv/parents/questions-answers.html.

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