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How to talk about the HPV vaccine

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As I recently reported, public health experts remain frustrated by chronically low rates of vaccination against a sexually transmitted infection that can cause cervical and other genital cancers.

Now, experts have another reason to push the HPV shot: Since it was introduced a decade ago, the shot has cut the rate of human papilloma virus - the most common sexually transmitted infection - by about two-thirds among young women ages 14 to 19, according to a report published in Pediatrics this week.

That’s an impressive feat, given that nationwide only about 40 percent of 13- to 17-year-old girls have received three or more doses of the HPV vaccine, according to a 2014 CDC survey. Boys weren't included in the Pediatrics study, but the CDC found that only 22 percent of 13- to 17-year-old boys were fully vaccinated.

So the question for public health experts is, how can doctors and parents work together to boost vaccination rates and ensure more young people are protected against HPV and the serious health problems it can cause?

Results 'somewhat surprising'

First, a little more about these new findings: Federal researchers compared HPV prevalence among women ages 14 to 34 before the vaccine was introduced, between 2003 and 2006, and afterwards, between 2009 and 2012.

Between those two periods, they found that HPV prevalence decreased 64 percent among 14- to 19-year-old females; there was a 34 percent drop among young women ages 20 to 24.

Brandon Brown, an assistant professor at the UC Riverside School of Medicine, says he found it "somewhat surprising" that the researchers found a significant decline in HPV prevalence, given that vaccination rates remain stubbornly low.

"If we can see an impact on HPV prevalence just with this low vaccine uptake, then hopefully we can see an even bigger impact with cancer later on, if we get more people vaccinated," he says.

'Like any other vaccine'

Brown says doctors can play a big role in increasing uptake of the HPV vaccine.

But the way they discuss it is crucial, he adds.

Some providers inadvertently give parents a reason to skip vaccinating their kids by noting that the shot "prevents genital warts and cancers, and you can get HPV by having sex with someone who has HPV," says Brown. 

The best approach "is to treat this vaccine like any other recommended vaccine," he says.

That means administering it along with other adolescent shots, like the pertussis booster, and simply saying, "today you're going to get your HPV vaccine and this prevents cancer," says Brown.

He says other doctors - especially pediatricians - shy away from bringing up HPV because they're squeamish about discussing sex; others might worry that by recommending the shot, they're insinuating that a child is sexually active.

If parents say their kids are too young to get a shot that prevents an STD, Brown recommends doctors reassure them that the vaccine is actually most effective if kids get it before they start having sex.

"If they say that it’s too early, I might say this is the perfect time for them to get it, especially since the parent is saying they’re not sexually active," says Brown. "This will provide optimal protection against cancer throughout the lifetime of the child."

Daniel Kegel, of Santa Monica, says he expected his son's pediatrician to recommend the 11-year-old get the HPV vaccine. When she didn't, Kegel asked her why.

Her response, he recalls, was, "I don't like to give 'the talk' that early." He adds, "I didn't go into it any further because I was kind of uncomfortable pushing it."

Looking back, he says, there was no reason for the pediatrician to feel the need to talk about sexual activity before giving his son the vaccine.

"For some reason, she thought she had to talk about that aspect of it, but you know, you really don't," he says. "Just say, 'look, there are these vaccines, they're recommended, you're going to get them. Any questions?"

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