Number of HPV infections significantly down, but many parents still opt out

MONROE — Sonia Ohlde said she had no doubts about her decision. Both of her daughters would get the HPV vaccine.

The series of three shots is effective in preventing cervical cancer in woman — the same type of cancer that killed her grandmother, Julia Morris, when she was 81 years old.

“That’s why I don’t mind talking about it,” Ohlde said. “She was otherwise perfectly healthy.”

Cervical cancer causes about 4,000 deaths in women each year in the United States.

It’s typically caused by the human papillomavirus, a sexually transmitted disease so common that more than half of sexually active men and women will be infected during their lifetimes.

The danger isn’t just to women. Men can face various types of cancer from the virus themselves, including throat and anal cancer. Both men and women can get genital warts from the virus.

Shannon Munn, of Gold Bar, recently decided to have her 12-year-old son, Benjamin, get the first of the three HPV shots last week. Their oldest son, now 13, got the shots last year.

“We figured it was a good idea for their own health and well-being and their future wives,” Munn said. “I would rather for them to just be safe.”

Since the vaccine was introduced in 2006, there’s been a significant decrease in the types of HPV infections that can be prevented with the shots. The vaccine is less effective after childhood.

A study of teen girls found the infections had dropped by 56 percent, according to the federal Centers for Disease Control and Prevention.

“We are amazed and so pleased to see that,” said Michele Roberts, who works in the immunization program for the state Department of Health. “It really shows the power of this vaccine to prevent cancer.”

Even with this success, nationally only about one-third of 13- to 17-year-old girls have been fully vaccinated, according to the federal health agency.

To be most effective, the vaccine has to be administered before the first sexual encounter. For both boys and girls, the series of three shots is recommended to start at about age 11 or 12, younger than many parents want to think that their son or daughter is interested in sex.

Some parents worry that getting the vaccine is sending an unintended message: Sex at that preteen age is OK.

“It’s a sensitive subject,” said Dr. James Troutman, an Everett Clinic pediatrician. Parents often respond: “Oh, I don’t think we’ll do that one today.”

Lynette Wachholz, a pediatric nurse practitioner for The Everett Clinic, said some parents just don’t see the urgency in beginning the shots before their children hit their teen years.

“They look at their young-looking daughter and think she will never have sex,” Wachholz said.

Ohlde said she didn’t think having her 12- and 16-year-old daughters get the shots was sending any subtle messages about sex.

“I feel like this is a totally separate issue,” she said. Ohlde said she told her girls that the shots help prevent the disease that killed their great-grandmother.

“It’s just preparing them for life,” she said. “At some point they’re going to have boyfriends and fiancées. They’re going to grow up. You might as well be prepared and plan ahead.”

When the HPV vaccine, called Gardasil, was introduced in 2006, it initially was considered a vaccine for girls, protecting against four strains of HPV, including two that cause cancer.

In 2011, that changed. It was offered to boys to protect against genital warts, anal, throat and penile cancer, and against spreading the disease to women.

In Washington, about two-thirds of girls 13 to 17 have gotten the first shot, but only about 40 percent had gotten all three shots, according to national vaccination data.

The number of boys getting the shots was far less, with about 9 percent of boys having at least one shot.

Wachholz, the pediatric nurse practitioner for The Everett Clinic, said she sees the difference in boy-girl vaccination rates narrowing, but thinks there’s still a significant gap for boys to catch up.

When the vaccine is first offered as their kids are going into sixth grade, about half of parents initially decline, said Dr. Deborah Nalty, a family practice physician for Providence Medical Group. Many more are ready for their sons and daughters to begin the shots when they’re about 14, she said.

Three doses are required for full protection. The suggested timing is for the shots to be given during a six-month period, but patients don’t have to start over if they don’t complete the series in that period, Wachholz said.

The shots are included in the state’s Vaccine For Children Program. That allows them to get the shots until they reach age 19, typically for an administration charge of about $20.

Making sure they complete the three-shot series can be challenging.

“We call it catch them when you can,” Troutman said. “Sometimes they’re coming in for an ingrown toenail and you’re telling them you need an HPV shot and they’re not too happy about it.”

Their main concern isn’t whether the shots will provide protection, Wachholz said. “If they’re healthy 11-years-olds, they ‘eeeyew’ about sex. They just care about, ‘Is it going to hurt? and ‘Do I have to do it today?’ “

Nalty said she understands it can be a tough decision for some parents, especially those who object based on personal moral or faith beliefs.

“What we hope for all our children is they have one sexual partner,” Nalty said. “I may say ‘Your girl or boy may fall in love with someone who’s had multiple sexual partners.’”

Several studies have found nearly half of college women have the virus, she said. By the time those who aren’t vaccinated have three sexual partners, they have a 70 percent chance of getting the virus, Nalty said.

“It’s just rampant,” she said. “We want to get kids’ immunity built up.”

Sharon Salyer: 425-339-3486; salyer@heraldnet.com.

The HPV vaccine

The HPV vaccine protects against the most common types of the human papillomavirus and can prevent most cases of cervical cancer in women, if given before they’re exposed to the virus. It also protects against other health issues in boys and girls.

The vaccine is recommended for children when they are 11 or 12 years old. Three doses are required. It’s important to get the shots before sexual contact occurs.

Source: Centers for Disease Control and Prevention

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