Should my daughter get the HPV vaccine?
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content provided by Healthwise
Introduction
This information will help you understand your choices, whether you share in the decision-making process or rely on your doctor's recommendation.
Key points in making your decision
HPV stands for human papillomavirus. The HPV vaccine can help protect your daughter from getting the types of HPV that cause most cases of genital warts and cervical cancer. Consider the following when making your decision:
The U.S. Advisory Committee on Immunization Practices (ACIP) recommends the vaccine for girls 11 to 12 years old, and the vaccine is approved for girls starting at age 9. It is also recommended for females ages 13 to 26 who did not receive it when they were younger.
The vaccine protects against four types of HPV: two that cause cervical cancer and two that cause genital warts. There are other types of HPV virus that cause cervical cancer and genital warts, but these four types are some of the most common.
The best time for your daughter to get the vaccine is before she becomes sexually active. This is because the vaccine works best before there is any chance of infection with HPV. Girls who get the HPV vaccine before they are sexually active are almost totally safe from infection by the four types of HPV the vaccine guards against.
The vaccine is safe. It was tested on 11,000 women before it was approved. You can't get HPV from the vaccine, and it doesn't contain mercury.
Medical Information
How do you get HPV?
HPV stands for human papillomavirus. It is spread by having sex with someone who has the virus. Infection with HPV is common, especially among young people. Half of all sexually active people in the United States will get HPV.1 But most women never know they have the virus, because it usually goes away on its own and may not cause any symptoms.
There are more than 100 types of human papillomavirus. But only some types of HPV lead to cervical cancer or genital warts.
Cervical cancer happens when HPV causes abnormal cells in the cervix, which then grow out of control. HPV can stay in your body for a long time. It can take 10 years or more for a woman to get cancer from an HPV infection. While cervical cancer in the United States is not as common as it used to be, about 10,000 women get it each year and 3,700 die from the disease.2
Genital warts may or may not cause symptoms. Even if you treat visible warts or if the warts go away without treatment, the HPV infection can stay in the body's cells. It is possible to spread genital warts to a sex partner even if there are no signs of them.
What is the HPV vaccine?
The HPV vaccine is a series of three shots that can protect your daughter from being infected with some of the most common types of the virus.3 4 The vaccine guards against four types of HPV: two that cause 70 out of 100 cases of cervical cancer and two that cause 90 out of 100 cases of genital warts.
The vaccine protects against the four types of HPV for at least 5 years. Studies are under way to see how long the vaccine will last and if a booster shot is needed after 5 years.1 A booster shot is another dose of the vaccine given after the first series of shots.
For the vaccine to work, it is very important that your daughter receive all three shots. The second shot is given 2 months after the first shot. The last shot is given 4 months after the second shot.
The vaccine is not useful for treating an HPV infection.5 But if your daughter already has one type of the virus when she gets the vaccine, the vaccine can protect against the three other types of HPV that cause most cases of cervical cancer or genital warts.
Health insurance may cover all or part of the cost of the vaccine. But if you don't have health insurance, check with your local health department, clinic, or hospital to see if you can get the vaccine for a low cost or even for free.
Studies are under way to see if the vaccine helps prevent HPV in men.1
When should your daughter get the vaccine?
The U.S. Advisory Committee on Immunization Practices (ACIP) recommends the vaccine for girls 11 to 12 years old and the vaccine is approved for girls starting at age 9. It is also recommended for females ages 13 to 26 who did not receive it when they were younger. The best time for your daughter to get the vaccine is before she becomes sexually active. This is because the vaccine works best before there is any chance of infection with HPV. In this case, the vaccine can prevent almost all infection by the four types of HPV the vaccine guards against.2
How do you talk to your daughter about the HPV vaccine?
Some parents may worry about talking to their young daughters about the HPV vaccine because they think it means they have to have the "sex talk." But you don't have to talk to your daughter about sex if you are not ready. Your daughter may have other vaccines between ages 10 and 12, such as a meningitis shot or a tetanus booster shot. You may want to start the HPV vaccine series when she receives these other shots. You can tell your daughter that these vaccines can help keep her healthy and prevent cancer later in her life.
If you do decide to talk to your daughter about HPV and the vaccine, it doesn't mean you are giving your child permission to have sex. It is a chance to teach your daughter about safe sex and sexually transmitted diseases (STDs). This information will be very important for her when she is older and making her own choices about sex.
Is the HPV vaccine safe, and how long does it last?
The vaccine is safe. It was tested on 11,000 women before it was approved by the U.S. Food and Drug Administration (FDA).6 You can't get HPV from the vaccine, and it doesn't contain mercury. There are no serious side effects from the vaccine. Some people may have mild side effects such as a low-grade fever and soreness in the arm where the shot was given. But neither lasts long.
Does your daughter need to be tested for cervical cancer after getting the HPV vaccine?
Even though the HPV vaccine protects against most cervical cancers, your daughter still needs to get regular Pap tests to check for cervical cancer, starting within 3 years after she becomes sexually active. This is because there are some types of HPV that the vaccine doesn't prevent. Pap tests look for cells that may be, or can lead to, cervical cancer. If these cells are found early and treated, you may prevent cervical cancer.
If your daughter gets the vaccine before she is sexually active, she does not need to be tested for cervical cancer before she gets the HPV vaccine.
If you need more information, see the topic Immunizations.
Your Information
Your choices are:
Have your daughter get the HPV vaccine.
Do not have your daughter get the HPV vaccine.
The decision whether to have your daughter get the HPV vaccine takes into account your personal feelings and the medical facts.
Deciding about the HPV vaccine Reasons to have your daughter get the HPV vaccine
Reasons to not have your daughter get the HPV vaccine
The vaccine is recommended for girls 11 to 12 years old and is approved for girls starting at age 9. The vaccine is also recommended for females ages 13 to 26 who did not receive it when they were younger.
You want to protect your daughter against cervical cancer and genital warts later in life.
The vaccine is safe and has no serious side effects.
You want your daughter to be protected against HPV before she becomes sexually active.
Are there other reasons you might want your daughter to get the vaccine?
The vaccine is very new, and you want to wait to see if there are any problems from it over time.
You don't believe in vaccines.
Are there other reasons you might not want your daughter to get the HPV vaccine?
These personal stories may help you make your decision.
Wise Health Decision
Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about your daughter getting the HPV vaccine. Discuss the worksheet with your doctor.
Circle the answer that best applies to you.
I am comfortable talking to my daughter about a vaccine that may prevent cervical cancer in the future. Yes No Unsure
I worry that if my daughter gets the HPV vaccine, she will become sexually active. Yes No Unsure
I want to do everything I can to keep my daughter healthy, both as a child and as an adult. Yes No Unsure
I want to follow the recommendations of experts and have my daughter vaccinated. Yes No Unsure
I know women who have had HPV or cervical cancer. It is very important to me to take steps to prevent this from happening to my daughter. Yes No Unsure
I don't have health insurance, and I am worried about the cost of the vaccine. Yes No NA*
*NA=Not applicable
Use the following space to list any other important concerns you have about this decision.
What is your overall impression?
Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to have or not have your daughter get the HPV vaccine.
Check the box below that represents your overall impression about your decision.
Leaning toward having my daughter get the HPV vaccine
Leaning toward NOT having my daughter get the HPV vaccine
Immunizations
Cervical Cancer
Genital Warts (Human Papillomavirus)
References
Citations
U.S. Department of Health and Human Services (2007). HPV Vaccine: Questions and Answers. Available online:
http://www.cdc.gov/vaccines/vpd-vac/hpv/vac-faqs.htm. Centers for Disease Control and Prevention (2007). HPV (human papillomavirus) vaccine: What you need to know. Vaccine Information Statement. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases (2/2/07). Available online:
http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-hpv.pdf.FUTURE II Study group (2007). Quadrivalent vaccine against human papillomavirus to prevent high-grade cervical lesions. New England Journal of Medicine, 356(19): 1915–1927.
Garland SM, et al. (2007). Quadrivalent vaccine against human papillomavirus to prevent anogenital diseases. New England Journal of Medicine, 356(19): 1928–1943.
Hildesheim A, et al. (2007). Effect of human papillomavirus 16/18 L1 viruslike particle vaccine among young women with preexisting infection. JAMA, 298(7): 743–753.
U.S. Department of Health and Human Services (2007). Human Papillomavirus: HPV information for Clinicians. Available online:
http://www.cdc.gov/std/hpv/hpv-clinicians-brochure.htm. 
