What Parents Should Know About the HPV, or Cervical Cancer, Vaccine

Does your daughter need the HPV vaccine to help protect against cervical cancer? Get the latest medical information on the HPV vaccine here.

From the WebMD Archives

You've probably heard that a new HPV vaccine can protect women against cervical cancer. In fact, the vaccine may be most effective when given to girls and young women. Is the HPV vaccine something you should consider for your daughter? Is this vaccine safe? When should girls receive the shots, and are there any drawbacks

Learn more about how this major medical breakthrough can benefit your daughter.

What Is HPV?

HPV refers to a group of viruses called human papillomavirus. Genital HPV is the most common sexually transmitted infection in the United States. Just how widespread is this virus? Take a look at these infection rates for U.S. females:

  • Ages 14-19: 25% have been infected with HPV.
  • Ages 20-24: 45% have been infected with HPV.

Data from the 2003-2004 National Health and Nutrition Examination Survey (NHANES) show that one in four female adolescents in the U.S. has at least one of the most common sexually transmitted infections. According to the CDC, the most common STD was HPV (18%), followed by chlamydia (4%). Among the teen girls that had an STD, 15% had more than one.

How Is HPV Spread?

HPV is transmitted during genital skin-to-skin sexual contact. This includes vaginal or anal sex and possibly oral sex. A person can get HPV even if years have passed since he or she had sex.

The Connection between HPV and Cervical Cancer

There are many types or strains of HPV. Most types do not cause cervical cancer. However, certain strains of HPV are more likely to lead to the disease.

For example, one study found four cervical cancer-causing HPV types in 3.4% of women studied. If that rate of infection is true for all women in the United States, then about 3.1 million U.S. females may now be infected with these four HPV types. These women are at risk of developing cervical cancer.

In 2007, the United States will have about 11,150 new cases of cervical cancer, and 3,670 women will die from this cancer, the American Cancer Society estimates.

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What Are the Benefits of the HPV Vaccine?

The main benefit of the vaccine is protection from cervical cancer.

Two HPV vaccines are currently on the market: Gardasil and Cervarix. In 2006, the FDA licensed Gardasil, the first cervical cancer vaccine. In 2007 Cervarix was approved. However, they don't protect against all types of cancer-causing HPV. Vaccines protect against these four types of HPV:

  • HPV 6
  • HPV 11
  • HPV 16
  • HPV 18

These types are responsible for 70% of cervical cancers and 90% of genital warts.

Has your daughter already been infected with one of these HPV strains? If so, receiving the vaccine won't prevent disease from that particular type. However, the HPV vaccine will protect against infection from the other HPV strains included in the shot.

Why Should Girls Receive the HPV Vaccine?

Full benefit of the HPV vaccine occurs only if you receive it before you're infected with any of the HPV strains included in the vaccine. That's why the CDC recommends vaccinating girls between ages 11 and 12. Ideally, this is before they become sexually active. The HPV vaccine can also be given to girls as young as 9 and to girls from age 13 to 26 who have not received it earlier.

You may question whether 11 or 12 is too early to vaccinate. Your daughter may not become sexually active for several more years. Some pediatricians counter that vaccinating preteens helps to take the guesswork out of figuring out when your daughter has become sexually active. The vaccine also has been shown to be more effective in immunizing against HPV when it is given to younger girls who have never been infected with the dangerous HPV strains.

How Is the HPV Vaccine Given?

The HPV vaccine is given in three injections over a six-month period. So far, scientists know that the vaccine is effective for at least five years. It shows no decreasing immunity during that time. Protection may last even longer. Researchers are still studying long-term effectiveness and whether a booster vaccine will be needed.

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What Concerns Do Parents Have about the HPV Vaccine?

What are some objections to the vaccine? Here are some concerns you may have, along with responses to these concerns.

  • The HPV vaccine does not have a long track record of safety and effectiveness. Over time, unintended problems may emerge.

Researchers have tested the vaccines in more than 11,000 females, ages 9 to 26, around the world. They've concluded that the vaccines are safe and cause no serious side effects. The FDA has reviewed the studies and agrees. The main side effect of the HPV vaccine was mild pain at the injection site. The vaccine contains no mercury or thimerosal.

  • Many states now require the vaccine for middle-school girls, which may infringe on parental rights.

If states do make the HPV vaccine mandatory, you may have a choice to opt out by reading the vaccine literature and signing a form.

  • The vaccine may give girls a false sense of security, or it may subtly encourage sexual activity.

You can explain that the HPV vaccine is a cervical cancer vaccine. It only protects against some types of HPV that lead to cancer. It offers no protection against HIV, gonorrhea, chlamydia, syphilis, herpes, and other STDs (sexually transmitted diseases).

You can also discuss factors that increase or decrease risk of HPV infection. According to the American Cancer Society, these factors increase HPV risk:

  • Having sex at an early age.
  • Having many sexual partners.
  • Having a partner who has had many sexual partners.

The CDC recommends that girls and women, even after vaccination, continue to practice "protective sexual behaviors:"

  • Abstinence.
  • Monogamy.
  • Limiting the number of sexual partners.
  • Using condoms, which offer some, but not complete, protection against HPV, HIV, and other sexually transmitted infections.

Remember that although your daughter may lower her risk through abstinence and monogamy, she could still get HPV after a sexual assault or from an infected spouse. Infection can result after even one sexual encounter.

Regular Pap Smears: Another Way to Fight Cervical Cancer

Whether or not you give your daughter the HPV vaccine, one thing is clear: Regular Pap smears remain crucial for fighting cervical cancer. Even girls and women who receive the HPV vaccine aren't protected from all cancer-causing HPVs. Pap smears find early changes in the cervix that can lead to cancer. Catching problems early provides the chance for more effective treatment.

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The American College of Obstetricians and Gynecologists recommends starting Pap screening in girls and young women as follows:

  • Within 3 years of becoming sexually active.
  • By age 21.

Most girls taking the vaccine will probably need fewer Pap smears taken at longer intervals over their lifetimes.

WebMD Feature Reviewed by Brunilda Nazario, MD on May 05, 2008

Sources

SOURCES: American College of Obstetrics and Gynecology: "New Cervical Cancer Screening Guidelines." News Release: "HPV Infection Common Among Females in U.S.," Journal of the American Medical Association. American Cancer Society: "Detailed Guide: Cervical Cancer: What Are the Risk Factors for Cervical Cancer?" "Frequently Asked Questions About HPV Vaccines," and "What Are the Key Statistics About Cervical Cancer?" CDC: "HPV and HPV Vaccine: Information for Healthcare Providers." Richard Pan, MD, associate professor of pediatrics, University of California, Davis. Michael Brady, MD, American Academy of Pediatrics spokesman. Associated Press: "Virginia to Require Vaccine for Girls." News-Medical.Net: "Merck Lobbying States to Mandate Gardasil for School Girls."

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