HPV Vaccine Q&A
A panel from the Centers for Disease Control and Prevention (CDC) has made the recommendation that boys and young men should be vaccinated against human papillomavirus, or HPV. Read the CDC's Press Briefing Transcript for further information on the recommendation.
The recommendation has received a significant amount of media coverage and has left people, especially parents, with many questions. Wake Forest Baptist researcher, Scott Duane Rhodes, Ph.D., is answering those questions submitted by people via the Wake Forest Baptist Health Facebook page, Twitter account, and email. Dr. Rhodes is a professor and researcher in the Division of Public Health Science in the Department of Social Sciences & Health Policy. His research focuses on community-based approaches to health promotion and disease prevention – specifically around infectious diseases.
Q: What is HPV and how is it transmitted?
A: There has been a lot in the news about the human papillomavirus (HPV) recently. There are more than 40 HPV types that can infect the genital areas of males and females. These HPV types can also infect the mouth and throat.
HPV transmission typically occurs through direct skin-to-skin contact, including genital-to-genital contact. In fact, the virus is spread easily between sexual partners, making it one of the most common sexually transmitted infections (STIs). And because there are often no signs or symptoms, most infected people are unaware that HPV transmission has occurred.
HPV infection can cause genital warts, cervical cancer and other cancers like cervical cancer that do not have signs or symptoms until they are advanced and are difficult to treat. These include cancers of the vulva, vagina, penis and anus. HPV infection also can cause cancer of the throat, tongue and tonsils.
[Video: Dr. Rhodes explains HPV.]
Q: What is the purpose of vaccination? What exactly are we vaccinating against?
A: The vaccines are to prevent HPV infection. HPV infection can lead to genital warts and cancer, as I previously mentioned. There are 2 approved vaccines. These vaccines can protect males and females against some of the most common types of HPV that can lead to disease and cancer. These vaccines are given in 3 shots, and it is important to get all 3 doses to get the best protection.
It is important to remember that there are no treatments for HPV, the virus, itself. We can only treat the diseases associated with infection; the problem is, often diseases like cervical cancer are discovered when they are advanced and more life-threatening.
Q: What are the side effects associated with the vaccine? Can the vaccine cause mental retardation?
A: Side effects do not last long and go away on their own. Side effects include pain from the needle injection and temporary redness at the injection site, which is typically the arm. A mild fever, headache, muscle or joint pain can occur. Nausea, diarrhea or fainting sometimes may occur. Allergic reactions from vaccines may occur but are very rare. If they do occur, they would occur within a few minutes to a few hours of vaccination.
Both vaccines are very safe. There is no medical evidence that vaccination against HPV causes mental retardation. Vaccination against HPV is not even remotely associated with mental retardation.
Q: Does having this vaccine encourage sexual behavior in adolescents?
A: This vaccine does not encourage sex among adolescents. We do not want adolescents to engage in sex, and this vaccine offers protection against HPV should they ever be exposed to HPV. However, to be effective, the vaccine must be taken early; the body must have time to develop the antibodies to fight HPV if they are ever exposed.
I tell parents to think of the vaccine as we do tetanus immunization. We immunize against tetanus, but no one would say that we have given permission to play with rusty needles.
Q: Is HPV only a concern for homosexual males?
A: HPV is a concern for everyone. It is the most common sexually transmitted infection in the US. By vaccinating boys, we are preventing them from infection and the risks of getting genital warts and certain types of cancer in later life. We also are preventing them from giving HPV to women. Women who get HPV are at increased risk for cervical cancer, and cervical cancer strikes about 12,000 American women each year and kills about 4,000.
[Video: Dr. Rhodes explains why the HPV vaccine is recommended for men.]
Q: What does this CDC recommendation mean in terms of cost of the vaccine for the patient?
A: Now that the CDC Advisory Committee on Immunization Practices recommends vaccination for boys, most private insurers will likely pay for vaccination as they do for girls. The 3 doses cost over $300.
There are programs that help uninsured and underinsured girls and young women pay for HPV vaccination and these programs may include boys and young men in time. Options include the Merck Vaccine Patient Assistance Program, Vaccines for Children Program, Planned Parenthood, some college and university medical clinics, and some local health departments.
Q: Will this CDC recommendation mean that the government will make the vaccine mandatory?
A: This seems unlikely, at least for the foreseeable future. Vaccination requirements tend to be determined at the state level, as opposed to the federal level. In NC, the State Board of Health would have to require vaccination and the NC legislature would have to provide funding. In NC, only information about HPV and the vaccine is required to be distributed to parents of children in grades 5-12.
Q: This immunization is widely advertised to the young population, but would it also be recommended that unmarried sexually active adults seek this treatment toward prevention?
A: Individuals should get the vaccine before they become sexually active and exposed to HPV. Those who are sexually active may benefit from the vaccine, but they may get less benefit from it. This is because they may have already gotten one or more of the common HPV types targeted by the vaccines.