Rosenblum: HPV vaccine worries understandable, but unfounded

It's good to hear that more of our kids are getting vaccinated against human papillomavirus (HPV), a sexually transmitted virus that causes cervical cancer.

But, as my colleague Jeremy Olson reported last week, the increase isn't enough to quell concerns of public health officials who wish that far more of our kids were getting protection against the disease that kills about 4,000 women annually in the United States.

I'm not surprised that putting "sex" and "shots" in the same sentence results in parental alarm bells ringing. That's a good thing. But it's important to make decisions based on facts.

Parents should know, for example, that potential side effects of HPV shots are minimal and are similar to those of many other childhood vaccinations. And, far from encouraging sexual activity, the vaccine, coupled with an age-appropriate conversation about healthy sexuality, will far more likely lead to the opposite result.

About a third of girls ages 13 to 17 received the full series of three doses of HPV vaccine in 2010, up from 18 percent in 2008. But doctors were hoping for a rate closer to 60 percent.

The vaccine now is being recommended for boys in that age group as well.

HPV is the most common sexually transmitted infection in the U.S. Nearly 80 percent of women and 50 percent of men will carry, then clear, the virus at some point in their lives without knowing it, said Amy Allina, program director of the National Women's Health Network in Washington, D.C.

Allina doesn't just understand parental skepticism. She praises it. One of her organization's missions is to "challenge drugs and devices" being brought to the marketplace to assure that they are based on good science.

Good science reveals that there are about 70 strains of HPV. The vaccine, which came on the market in 2007, licensed by the FDA and approved by the Centers for Disease Control and Prevention (CDC), protects against four strains; two of those strains cause 90 percent of genital warts cases and 70 percent of cervical cancer cases.

While the vaccine does not protect against all strains, Allina still calls it "one of the great public health successes in the U.S. We now know that there is no evidence that it is dangerous. And we get more data every year."

So, what about those side effects? Well, lots of girls (78 percent, according to one large CDC study) reported pain when receiving the vaccine, 17 percent reported bruising, 15 percent reported dizziness and 14 percent reported swelling. Just 1 percent of girls reported fainting.

The younger the girl, the more pain and dizziness she reported, according to the study. It's important to note, too, that many of these girls were getting other shots at the same time, including tetanus and meningitis.

Side-effect concerns aside, it's more likely that what's keeping parents from driving to the pediatrician's office is queasiness over having to have "the conversation" with girls who aren't even teenagers yet.

But talking to kids about sex doesn't lead kids to have sex.

Thirty years of research shows that conversations focused on healthy and safe sexuality, in fact, delay the onset of sexual activity. With accurate information, teens who are already sexually active have fewer partners and less frequent sex. And they're more likely to use contraception.

"With information, they learn about the consequences of being sexually active and make decisions based on that," said Migdalia Loyola, director of education and outreach for Planned Parenthood.

All 18 Planned Parenthood clinics in Minnesota provide the HPV vaccine, and Loyola welcomes the opportunity to talk with parents about how to engage their kids in age-appropriate conversations about the whys of getting the vaccine.

"It's a tough age," she said. "They're still young, yet they're asking a lot of questions. It's another opportunity for a family conversation."

Madi Driscoll remembers her own family's conversation around HPV. The 17-year-old senior at Central High School in St. Paul is a member of Planned Parenthood's Teen Council. When she was 12, she began the three-dose series, but the decision was hardly made lightly.

Madi's mom is a urologist who was concerned about side effects. The mom did research and, ultimately, was comfortable enough to get Madi vaccinated. She was also wise enough to ask Madi a question that the rest of us might ask our own kids more often:

"Is there anything that concerns you about this vaccine?"

"I've been really lucky," Madi said. "Both of my parents are really involved in my health. Don't be afraid to talk about sexual health with your kids, because otherwise you stigmatize it. It's an ongoing conversation. It's a serious thing."

gail.rosenblum@startribune.com

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