Ask a Doc: Gardasil

March 06, 2017

Tara Gellasch, MD, answers this Ask a Doc regarding the Gardasil vaccine.

Question: I heard on the news that there have been some changes to the Gardasil vaccine.  My 12 year old daughter is schedule for her routine physical exam next month.  What do I need to know about these changes?  Also I have a 10 year old son, does he need to be vaccinated as well?

           

While three different vaccines for Human Papillomavirus (HPV) were initially developed Gardasil 9 is the most commonly used.  This protects against 9 different strands of HPV including seven that combine to cause 90% of cervical cancers.  These strands of the virus are also linked to the majority of vulvar, vaginal, penile and anal cancers.  Additionally, Gardasil 9 protects against two strands causing the majority of genital warts.  An increasing number of oral cancers are linked to HPV as well.

According to the CDC over 14 million people become infected with HPV annually.  HPV is transmitted with sexually contact.  While condoms can reduce transmission given the prevalence of the virus this does not eliminate the risk.  In the United States there are 13,000 new cervical cancers and 11,000 men diagnosed with HPV related cancers each year. 

The Gardasil vaccine is extremely effective.  Studies suggest that if all 12 year old girls in the US were vaccinated more than 200,000 HPV infections, 100,000 abnormal PAP smears and 3300 cases of cervical cancers would be prevented annually.  Further declines in new HPV related cancers can be expected if boys receive the vaccine as well.

In 2016 The United States Advisory Committee on Immunization Practice (ACIP) announced changes in the dosing of the Gardasil vaccine.  The new recommendations are for a two dose series for children under the age of 15.  Doses should be given six months apart instead of the previous 3 dose regimen. The vaccine is most effective in men and women if it is given before the person has been exposed to HPV.  Typically the vaccine is offered to girls and boys at age 11 or 12 but it can be offered as early as age 9.   In children/adults between the age of 15 and 26 the vaccine should be given in three doses ideally over a 6 month period.

Despite the clear success of this vaccine in reducing HPV related precancers and cancers, only 45% of girls are currently receiving the vaccine.  For boys the rates are half that with only 20-25% receiving this potentially lifesaving vaccine.  Unless we can improve these vaccination rates we can expect 2,000 children every year to grow up and develop a cancer that could have been prevented.

The most common side effects from the vaccine are mild including pain or bruising at the injection side, fever, dizziness or nausea  .  Serious side effects are extremely rare.  It is important to tell your child’s doctor if he or she has any allergies. 

It is wonderful that you are committed to protecting your children from HPV.  Your daughter should be able to get her first vaccine at her upcoming visit.  Your son can receive his first vaccine at age 11 or 12.