A new study finds that when kids start their HPV vaccine series at age 9 or 10, as opposed to age 11 or 12 (when it is usually recommended), it provides more protection. Not only because it means that kids are more likely to complete the two-shot series, as the study shows, but also because preteens produce more antibodies after vaccination than older teens—their immune systems are more robust, says family physician Beth Oller, MD, FAAFP.
Human papillomavirus, or HPV, is an omnipresent sexually transmitted infection (STI)—one that nearly everyone will come into contact with at some point. “It is so common that 80% of women will get at least one type of HPV at some point in their lifetime,” says Dr. Oller. “Three out of every four adults will have at least one HPV infection before age 30.”
And though most HPV infections go away by themselves within two years, HPV is not always harmless. “Each year in this country, more than 36,000 people, men and women, have a cancer caused by HPV, including penile, vaginal, vulvar, anal and head and neck cancers. Over 7,000 die per year, and this is exactly why it is so important to get this vaccine for our children,” Dr. Oller explains. “We don’t have any other vaccine that prevents cancer.”
The first dose of the HPV vaccine is currently recommended for all kids ages 11 and 12—but can be started as young as ages 9 and 10, with the second dose offered 6 to 12 months later. Yet more than 40% of teens haven’t completed their HPV vaccine series, according to the Centers for Disease Control and Prevention (CDC), even though vaccination could prevent more than 90% of HPV-caused cancers from developing.
Starting HPV vaccine early equals more protection
In the first-of-its-kind national study, published in “Pediatrics”, researchers explored if kids who begin their HPV vaccine series at ages 9 or 10 were more likely to complete the full two-shot series. They found that doing so is associated with increased completion of the HPV vaccine series, thanks to the opportunity for more provider-patient touchpoints.
Previous state-based studies have shown that when started at ages 9 to 10, the rate of completion of the HPV series was higher compared to starting at 11 to 12, Dr. Oller notes.
“As a physician, I want to do anything I can to improve vaccination rates, especially with this important vaccine, as HPV is the most common sexually transmitted infection in the U.S. for both men and women,” she says. She recommends that children begin the HPV series as soon as they are eligible to, at age 9.
The benefits of starting the series early, at age 9 or 10, are two-pronged. For one, the HPV vaccine series is most effective when given before a person is exposed to the virus, which is spread through intimate skin-to-skin contact, the CDC notes.
“The longer the immune system has to incorporate this immunity into itself before it encounters the virus, the better,” explains Dr. Oller. “If the series is completed before age 15, only 2 doses are needed as opposed to 3—which is a good selling point to the child.”
Second, if more teens complete their series by age 13, there’s a public health benefit, too: more vaccinated teens means more coverage and potentially fewer instances of HPV infection.
Some parents are hesitant to get their kids vaccinated against HPV
But some parents are reluctant to vaccinate their pre-teens and tweens, mainly because it means grappling with the fact that they’ll soon become sexually active. As a parent, that can be a tough pill to swallow.
“The reason I hear parents say no is because they feel like ‘my child doesn’t need that yet.’ It’s the idea that if your child isn’t yet having sex, then they don’t need the vaccine,” says Dr. Oller.
But given what we know about immunity, that argument doesn’t hold up. Getting the vaccine early—well before your child becomes sexually active—gives your child a better chance to build up immunity against the virus. And remember, the HPV vaccine is cancer prevention, Dr. Oller reminds.
“I also discuss with parents that, as pervasive as HPV is, someone can contract HPV even if they have only had one sexual partner. As parents, we all want to prevent as much suffering and illness in our children as possible, which is why this vaccine is so important.”
The vaccines have a high efficacy rate and a high safety profile. Side effects are mild and may include pain at the injection site, dizziness, nausea, headache. But the benefits greatly outweigh the risk of possible side effects.
“We know that these vaccines work, and work well. HPV infections and cervical precancers have dropped since 2006, when HPV vaccines were first introduced in the U.S. Among teen girls, infections with HPV types that cause most HPV cancers and genital warts have dropped 88%. Among young adult women, these infections have dropped 81%,” says Dr. Oller.
Some adults should get the HPV vaccine, too
If you didn’t get the HPV vaccine in your teens, Dr. Oller recommends checking with your primary care physician to see if you might need it now.
The CDC recommends that adults up to age 26 who have never received an HPV vaccination should do so as soon as possible, but adults up to age 45 may also be eligible.
“If my patients have new sexual partners then I strongly encourage it up to age 45, and also if there is any woman who comes in with positive HPV changes on a Pap, I recommend vaccination,” notes Dr. Oller.
“There are many caveats, however, so I recommend for all adults who are unsure if they have been vaccinated or if they should be vaccinated against HPV to talk to their family physician about what the recommendation is for them.” Vaccination after age 26 carries less benefit, however, as more adults in the 27 to 45 age range were likely already exposed to the virus. If you have questions about the HPV vaccine for you or your child, be sure to reach out to your healthcare provider. It’s a small step—with big benefits.