Risks and Benefits of the HPV Vaccine

THE World Immunisation Week is observed from April 24-30. Since 2012, the World Health Organization (WHO) has been endorsing it with the participation of 180 countries. The programme aims to increase immunisation rates against vaccine preventable diseases around the world.

This year’s theme of the World Immunisation Week is “Close the Immunisation Gap”. The WHO estimates that immunisation averts two to three million deaths annually.

It seeks to highlight that an additional 1.5 million deaths can be avoided – about one in five children worldwide – are still missing routine immunisation for preventable diseases.

Immunisation can protect against 25 different infectious agents from infancy to old age, including diphtheria, measles, pertussis, polio and tetanus.

Inadequate immunisation coverage often results from limited resources, competing health priorities, poor management of health systems and inadequate follow up.

The WHO campaign hopes to support people in various parts of the world, especially in the developing nations, to enhance immunisation coverage and save lives.

The six goals of the Global Vaccine Plan Action Plan looks at eradicating measles, diphtheria, tetanus, rubella and polio, and building the immunity in neonates, children and pregnant mothers.

The final goal of the plan is to enhance the use of new or underutilised vaccines.

As the developing world is working closer to seeing complete elimination of the “old diseases”, the new world is also struggling to “accept” the vaccination of “new pathogens” such as cancer and sexually induced infections.

The father of psychoanalysis Sigmund Freud once said: “I cannot think of any need in childhood as strong as the need for a father’s protection.”

With this in mind, we address a reader’s plight:

Dear Dr G,

My name is Heng. I am a father of two children. My daughter is 13 and my son is 15 years old.

My children’s school recently wrote to me and asked whether my children could participate in the vaccination of HPV (Human papillomavirus).

I was rather alarmed when I realised the vaccine is for sexually transmitted virus.

I have done plenty of research and realised that the vaccine predominantly aims at eliminating cervical cancer in women.

The treatment is also for the prevention of genital warts.

I am confused. On one hand, I understand the importance of prevention of cervical cancer. On the other hand, this is related to sexual activities and genital warts.

I would like to think that good family upbringing alone would stop my children from getting the disease. Can you tell me the risks and benefits of the vaccine?

Heng

HPV can be considered the most common sexually transmitted infection in many countries, including the United States (US).

Twenty million people in the US are already infected, and about six million get infected every year. The only mode of transmission of HPV is through sexual contact.

Although most HPV infections are dormant and remain symptomless, the important implication of HPV is the correlation with cancer, especially cervical cancer.

Cervical cancer is the second leading cause of deaths among women. As more than 50% of sexually active men and women are infected with HPV at sometime in their lives, the final aim of the vaccine is to eliminate the cancer.

There are at least 40 subtypes of HPV. These include two types that cause about 70% of cervical cancer and two types that cause about 90% of genital warts.

Therefore, the HPV vaccine can prevent most cases of genital warts, cervical cancer and a vast majority of genital warts.

HPV vaccine is routinely recommended for girls 11 to 12 years of age. Such timing is important, as the prevention is more effective when the girls have not been exposed to sexual contacts.

Currently, with the protection from four subtypes of HPV targeted vaccine, the cancer prevention is near 100%.

The interesting observation made recently is that more and more parents are not vaccinating their girls or not completing the course, citing “safety concerns”.

In a comparative study, 4.5% of parents have safety concerns with the intervention, which increased to 16% in 2010, when asked about the reasons of dropping out.

This is compared with 1% of safety concerns when it comes to non-sexually related disease protection such as tetanus and diphtheria.

The bad press for the HPV has been rather unjust, and there has been a spade of unreliable information online.

Despite the “hysteria”, the several millions of doses of vaccines had induced minimal “adversity” including pain, itchiness and redness at the injection areas.

This may follow by transient mild fever that occurs in one in 10 people. Although like any medicine, there is no zero risk for the vaccine, but most experts would agree that the benefits outweighs the risks.