Should my son and daughter receive the HPV Vaccine?
We have had a number of questions lately about the Human Papillomavirus (HPV) Vaccine. I realized that I needed a refresher on the topic, especially when a mother recently asked about the vaccine for her son.
What is HPV?
HPV is a virus that causes cervical cancer and genital warts and is also a risk factor for some less common cancers such as vaginal, vulvar, anal and penile cancers. There are estimated to be 150 strains of HPV, 40 of which are linked to cervical cancer. HPV types 6 and II cause genital warts and these do not cause cancer. HPV is spread by skin to skin contact, including sexual intercourse, oral sex, anal sex, or other contact involving the genital area (hand to genital area). The virus is very common and it is estimated that 75-80% of sexually active adults will acquire HPV infection before the age of 50. The majority of men and women become infected between the ages of 15-25 years. Most people infected have no symptoms and in most cases, the infection goes away within two years without treatment. However, in approximately 10-20% of women, the infection persists. In these cases, the virus increases the risk of developing cervical cancer. This however, takes 20-25 years to develop.
Cervical cancer is the third leading woman’s cancer and 100% of cervical cancers are thought to be caused by HPV. This is probably the biggest reason why we recommend vaccination
Does the vaccine really work?
Results from vaccine studies show that the HPV vaccine in women is very effective in preventing HPV infections and cervical pre-cancers caused by HPV. HPV vaccination in women has been shown to reduce the risk of genital warts in their male sexual partners.
What are the current recommendations for the HPV Vaccine? Should boys be vaccinated?
The primary age group recommended for vaccination according to NACI was females aged 9 to 13. HPV is a sexually transmitted infection, and ideally, the vaccine should be administered to females before they become sexually active in order to ensure maximum benefit. NACI also recommends the vaccine for females 14 to 26 years of age as there still is the potential for benefit regardless of the previous history of sexual activity, pap abnormalities, cervical cancer, anogenital warts or a known HPV infection.
Studies also show that the HPV vaccine in men reduces the risk of developing genital warts and persistent HPV infection which may in turn decrease the spread of HPV to sexual partners. The vaccine Gardisil® is indicated for both girls and boys. Oral cancer related to HPV is on the rise and can have can have devastating outcomes. Of all HPV mediated tumours, a recent study in NS showed that 74% of these were oral cancers, a 50% rise in from when the previous study was done a decade ago. Anal cancer, although globally rare, is growing in incidence in the United States; 88% of anal cancers are attributed to HPV.
NACI has determined that there is good evidence to recommend the use of Gardasil® in males between 9 to 26 years of age, again as with females, receipt of Gardasil® between 9 and 13 years of age prior to the onset of sexual activity is recommended to maximize the efficacy of the vaccine.
What is the recommended vaccination schedule?
Currently, the HPV vaccine is administered to girls and boys in grade 7 as part of the publically funded immunization program. They receive 2 doses to healthy girls; 3 doses if 15 years of age and older (months 0, 2, and 6) The vaccine for boys has only recently been added to the New Brunswick schedule and is only covered for boys born after 2005. However, you physician or pharmacist can still prescribe this if your family member missed the cut-off.
One in 148 women will develop cervical cancer in their lifetime. Other cancers such as vaginal, vulvar, throat, anal and penile are less common but no less devastating. We know that HPV-related throat cancers are on the rise in men and women. We now have a vaccine that can prevent a virus that we know causes cancer. For more information go to:
Dr. Jennifer Ryan, BSc. Pharm, Pharm D, ACPR, FCSHP
Jennifer received her Bachelor of Pharmacy in 1999 from Dalhousie University, Halifax, Nova Scotia and completed the Canadian Hospital Pharmacy Residency Program at the Hospital for Sick Children in Toronto, Ontario in 2000. She received her Doctor of Pharmacy in 2006 from the University of Florida.
From 2001-2014 held several positions as a hospital pharmacist including: Pharmacy Research and Education Coordinator, Clinical Manager, Pharmacy Residency Coordinator and Pharmacy Practice Leader in Nephrology. She has held an adjunct faculty position with Dalhousie University since 2005. Jennifer’s research interests have included areas of disease prevention, medication adherence and pharmacy education. Jennifer has presented nationally and internationally.
Jennifer and husband Cory own and operate the Medicine Shoppe Pharmacy, in Grand Bay-Westfield where they live and raise their three children. They have a strong sense of community responsibility and are committed to improving healthcare access for their clients and neighbors.