HPV vaccine

The response from my teenage daughter was pretty much what I expected when I announced that I was making a doctor’s appointment for her to receive yet another vaccination. “I’m not a kid anymore, I’ve had my shots, leave me alone,” she retorted. It certainly didn’t make the conversation any less awkward when I told her that it was crucial that she get the shots now, before she started having sexual relationships.

I explained that she needed to be vaccinated against human papilloma virus (HPV), one of the most common sexually transmitted infections. After being infected with the virus, most people eliminate it before it does any damage, but in many others significant medical problems develop such as genital warts or cancer of the cervix, vagina, penis or anus.

In addition there has been an alarming increase in oral and throat cancers caused by the virus, presumably spread by oral sex. The actor Michael Douglas, who has cancer, made headlines when he discussed this issue during an interview last year.

It is now recommend that both males and females be routinely vaccinated against HPV when 11 to 12 years old.

If there’s an effective vaccine available, what’s the problem? Actually there are several.

The vaccine requires three separate injections given over six months and the cost of the vaccines alone is over $400.

Another problem is that there are actually two vaccines available — Gardasil and Ceravix — which are not identical. The issue is that there are many different “types” of HPV, and the vaccines differ in which of the types they cover, with neither vaccine providing perfect coverage against all relevant types. Gardasil is approved for females and males while Ceravix is only approved for females. Your health care provider should help you determine which is most appropriate for you or your teenagers.

The thorniest issue for most parents is that the vaccine should be given before any intimate sexual contact occurs. The vaccine is probably of little value if given after the patient already has the virus.

As I can testify, as a parent it can be more than a bit unsettling to know you are having your child vaccinated in preparation for the day when they will start having sex. On the other hand, I imagine it would be a whole lot more painful to see your child suffer with a disease such as cervical cancer that could have been easily prevented.

Dr. Stephen Picca of Massapequa is Board Certified in both Internal Medicine and Anesthesiology. He is retired from practice. Questions and comments can be sent to Dr. Picca at health@newsday.com.

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