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HPV Hang-Ups: Why Are Teenagers Still Not Getting Vaccinated?

The Human Papillomavirus (HPV) is the most common STI in the United States. While it is most often linked to cervical cancers and genital warts, the virus is also connected to a range of cancers that affect all genders. The HPV vaccine, first made available in 2006, currently protects against nine strains of the virus. But even though the vaccine is safe and dramatically reduces cervical cancer rates, relatively few teenagers are getting vaccinated. We talked to Research Program Director Dr. Anthony Salandy, who is overseeing the Mount Sinai Adolescent Health Center’s own HPV research, and Research Coordinator Sarah Pickering, who is on the ground with our HPV research participants every day, about common misconceptions surrounding the vaccine, and why usage rates remain low.

The HPV vaccine is recommended through age 26. If you live in the NYC area and are 10-24 years old, you can call the Mount Sinai Adolescent Health Center and make an appointment to receive the HPV vaccine for free. The vaccine is a three dose series given over six months.

Q: So, basics first. What is HPV?

Sarah Pickering: HPV is the Human Papillomavirus and is the most common STI in the United States. It’s transmitted through genital skin-to-skin contact which can be as simple as touching someone’s genitals and then touching your own. There are about 14 million new infections each year. HPV is a virus, but it can lead to cervical cancers, penile cancer, anal cancers, and cancers of the throat, tongue and tonsils.

Q: Why is the vaccine important?

SP: Because it’s highly effective, it’s a very safe vaccine, and it’s a cancer prevention tool. People who get the vaccine are less likely to get cancers related to HPV.

Q: As of 2014, only 40% of girls and 21% of boys in the recommended age range had received all three doses of the HPV vaccine.  Why are so few people getting vaccinated?

SP: The biggest factor is the misconception that vaccinating adolescents will encourage them to have riskier sex. The thinking goes that if teenagers feel that they’re protected by the vaccine, they may think that they don’t need to use condoms, for example. That theory has been disproved.

Also, the vaccine is recommended starting when the immune response is stronger, in young children starting around age 9. Some parents don’t think the HPV vaccine is relevant to their kids at that age because of the sexual transmission piece of it.

Dr. Anthony Salandy:  Another major issue is access. It would be interesting to see what the rate of HPV vaccination is among minority adolescents in rural areas, which often have inadequate school health systems and a low density of community services that offer the vaccination.  There’s also a racial component. The incidence rate of cervical cancer in African Americans is 11.4%, and in Latinas it is 13.4%, compared to whites at 8.5%. Death rates related to cervical cancer for African Americans are double that of whites. There’s a clear health disparity there.

In addition, there is the anti-vaccination bandwagon.  Of course, there is no actual link between vaccinations and autism, but some very high-profile individuals have made uninformed arguments, and a lot of others look to them.

SP: Part of the access piece is that each vaccine is very expensive—I think it’s around $100 per dose. It’s covered by insurance, but if you don’t have insurance it’s a huge access issue.  Another issue for young people is that parents have to consent to vaccines in most places, although not in New York City.

Q: Are there any other major misconceptions about the vaccine that we haven’t talked about?

SP: Online, there’s a big network of HPV vaccine horror stories. It’s not hard science, but people are still exposed to them and it is very scary. For some people those horror stories are more real than cancer prevention 30 years from now. In reality, while there is a little bit of pain and burning when you get the shot, there are no other side effects.

Q: Are pediatricians talking with their patients about the vaccine?

SP: Not enough. That’s one of the biggest barriers. Pediatricians feel it is not within their purview because it’s related to sexual health and they’re mostly working with kids. I read something that all doctors have a pretty limited amount of time with their patients and this might not be top of their list because it’s a point of contention with parents, and again because they consider it outside of their purview. That’s definitely a huge issue.

Q: Is there anything you’d like to add?

AS: I think it’s really important for parents to understand that you have a responsibility to do the right thing for your children. When you give your child a car you say, “Wear your seat belt.” When your children get to a certain age, you say, “Don’t smoke.  Don’t drink.”  We always focus on the bad things and rarely do we say, “You need to get vaccinated because the HPV vaccine can protect you against HPV that is linked to cervical cancer.” To me, that’s a gift. And it’s a gift that can save your child’s life.

The Mount Sinai Adolescent Health Center is located in New York City. It provides comprehensive, confidential, judgment free health care at no charge to over 10,000 young people every year. This column is not intended to provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual, only general information for education purposes only.

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