Parents Skip HPV Vaccination In Teenage Daughters Due To Safety, Side Effect Concerns
March 18, 2013

Parents Skip HPV Vaccination In Teenage Daughters Due To Safety, Side Effect Concerns

Lawrence LeBlond for - Your Universe Online

Concerns about safety and side effects of receiving the human papillomavirus (HPV) vaccine have left many parents guarded about offering the option to their teenage daughters, even with increased recommendations by health experts.

Paul Darden, MD, of the University of Oklahoma Health Sciences Center, and colleagues have found that more than 40 percent of parents reported in 2010 that they did not plan to vaccinate their teen daughters against HPV. They reported their findings in the April issue of Pediatrics. The study also included research by the Mayo Clinic.

Furthermore, Darden and his colleagues found that 16 percent of parents cited fears as the main reason for not getting their female children vaccinated in 2010, up from 5 percent in 2008. The total percentage of parents opting not to vaccinate their daughters grew to 44 percent in 2010 from 40 percent in 2008, according to the authors.

For the study, the researchers looked at three vaccines routinely recommended for US teens: one for sexually-transmitted HPV; Tdap, for tetanus, diphtheria and acellular pertussis; and the meningococcal conjugate vaccine (MCV4). The authors found that immunization rates rose for all three vaccines, except for the proportion of girls immunized against HPV.

Senior study author Robert Jacobson, MD, a pediatrician with the Mayo Clinic Children´s Center, said the HPV vaccination rate in girls is going in “the opposite direction.”

As opposed to HPV, only 1 percent of parents fear safety and side effects from their teen daughters receiving the Tdap vaccine.

"You'd expect as people get more familiar with a vaccine that they would actually become more comfortable with it," said Darden. However, “that doesn't seem to be the case with HPV.”

The findings suggest that additional approaches may be needed to improve HPV immunization rates in this subset. Detailed discussions about the vaccine and its effectiveness should be maintained between the pediatrician and both the parent and child, he noted.

However, according to William Schaffner, MD, of Vanderbilt University, other reports have shown that “provider hesitancy” could still be playing a role.

He told MedPage Today in an interview that some doctors may be delaying their discussions about the HPV vaccine with parents until their children are older.

"Pediatricians are letting it go in the early teens years [sic] and bringing it up only later," he said. "Then we're missing some teens because they tend not to see the doctor as frequently in the late teens as they do around 11, 12, and 13."

"Pediatricians really do need to continue to be vaccine advocates," he added.

This is especially true when it comes to HPV, a family of sexually transmitted viruses linked to tumors of the cervix, head and neck and organs. The virus is passed through genital contact, most often during vaginal and anal sex, but also through oral sex.

Data from the US Centers for Disease Control and Prevention (CDC) state that HPV vaccines offer the best protection to both girls and boys who receive it before becoming sexually active, allowing them to develop an immune response. The longer parents wait to vaccinate their teens, the longer it will take to build up immunity, and the less safe their children are if they have a sexual encounter.

For the study, the researchers analyzed data for teens ages 13 to 17 in the 2008-10 National Immunization Survey of Teens. They discovered that as of 2010, 80 percent of teens had the Tdap and 63 percent had the MCV4 vaccine. While the researchers found that immunization rates rose overall for HPV vaccination, only a third of teen girls had received the vaccine.

Parents failed to have their children vaccinated due to a number of reasons: Nine percent said it was not recommended by their child´s pediatrician; some had lack of knowledge; 17 percent believed the vaccine was unnecessary; and 16 percent worried about the safety/side effects of the immunization. Also, 11 percent of parents said that their child was not sexually active.

"HPV causes essentially 100 percent of cervical cancer and 50 percent of all Americans get infected at least once with HPV. It's a silent infection. You cannot tell when you've been exposed or when you have it," said Jacobson. "While most HPV infections clear, a percentage linger and start the process of cancerous changes. The HPV vaccine is an anti-cancer vaccine."

Despite reasons that parents give for not vaccinating their teen daughters, there is little evidence that the HPV vaccine has dangerous side effects.

The first HPV vaccine was licensed in 2006, and even then “there was very strong evidence that it was safe,” Jessica Kahn, professor of pediatrics at Cincinnati Children's Hospital Medical Center, told USA Today´s Michelle Healy.

That evidence "only continues to increase as tens of millions of doses have been administered and no evidence of safety concerns has emerged," said Kahn, who was not involved in the new study.

The study does have some limitations, report the authors. The cross-sectional survey compared three distinct cohorts across multiple years, and the survey focused mainly on self-reporting from parents without verifying vaccination status through providers.