I am all for parents making informed decisions about their
children’s healthcare and not just being passive bystanders. The key to that is
that they need to have accurate information on which to base their decisions.
One subject on which there seems to be a lot of confusion is
the HPV vaccine. This vaccine was introduced in 2006 to decrease the risk of
contracting the Human Papilloma Virus which can lead to cancer of the cervix,
penis, and mouth. One of the early concerns was that by giving young people a vaccine
against a sexually-transmitted disease, this would give them license to have
sex. This reasoning never made sense to me. I doubt that when young people are
contemplating having sex they spend much time considering the risk of cervical
dysplasia years in the future. A study in the journal Pediatrics in 2012 found no increase in sexual activity in teens
who had had the vaccine when compared to those who did not.
More recently, the concern has been about side effects of
the vaccine. Parents sometimes cite “horror stories” they have heard but they
often cannot remember exactly what they heard. They often just have a vague
unease about the vaccine. In other situations, parents have concerns about
specific side effects. When these arise, I have tried to trace their concerns
to the original incident in question. When I have done this, I have either run
into a dead end because there does not appear to be any actual evidence to
support the concern or have found that the circumstances of the alleged side
effect were very different from the headlines that end up on the internet.
One concern that has been raised was that the vaccine could
cause premature ovarian failure in young women. Premature ovarian failure is
when the ovaries stop functioning at an early age, essentially menopause
happening at the wrong time. A parent gave me something they had printed from
the internet about this. I investigated it as far as I could go and didn’t find
anything concerning. In case I was missing something, I asked around and no
other physicians I talked to were aware of any evidence of this. Because
gynecologists would be the ones likely to hear if there was an increase in this
problem in young women since the vaccine went into use, I contacted several
gynecologists I know and they also were unaware of any evidence to support this
link.
Prior to the introduction of the vaccine, the incidence of
premature ovarian failure was reported to be around one in ten thousand women
by age 20 and one in a thousand women by age 30. In the first nine years after
the vaccine was introduced, six cases were reported in girls who had received
the vaccine. During that time around 170 million doses of the vaccine had been
given which means the rate was lower
than the rate reported prior to the introduction of the vaccine.
Prior to licensure of the HPV vaccine, its safety was
studied in 30,000 persons over seven years with no significant adverse effects
noted. Since licensing, more than a
million more patients have been studied. In the past seven years, our practice
has given almost 9000 doses of HPV vaccine with no significant side effects.
As physicians, we have all taken the Hippocratic Oath which
states in part, primum non nocere, “First,
do harm.” While we are humans who
make mistakes, we would never do anything which we thought would harm a
patient. If you have concerns about the vaccine, by all means have that
discussion with your child’s doctor. You may even reach a different conclusion
than the doctor. Just make sure the decisions being made are based on accurate
information.
