There is a lot of buzz about the importance of the human papilloma virus (HPV) vaccine for preteens, especially for girls. What often gets missed is that boys need the vaccine, too. First, it's important to know that HPV is unfortunately very common. Almost 80 million Americans have been infected, and almost 15 million new infections happen every year. HPV is linked with certain types of cancer and the development of genital warts.
The good news is that the HPV vaccine can significantly reduce the likelihood of developing cancer and warts. The bad news is that the number of people receiving the vaccine in the United States is too low.
Listen in as Ella Hamilton, CNP discusses the importance of the HPV vaccine.
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HPV and Teens: Start the Discussion
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Learn more about Ella Hamilton, CNP
Ella Hamilton, - CNP, Coon Rapids clinic
Ella Hamilton, CNP is a board-certified nurse practitioner specializing in pediatrics. She has professional interests in adolescent health, mental health and health promotion. She became a nurse practitioner because: she wanted to help children as they grow through different ages and stages. she saw a pediatric provider when she was little who had a great impact on me. She has six younger siblings and from an early age she took care of their scrapes and cuts; that’s when she knew she wanted to become a provider.Learn more about Ella Hamilton, CNP
Transcription:
Melanie Cole (Host): Human Papillomavirus is the most common sexually transmitted infection in the United States. My guest today is Ella Hamilton. She's a Certified Nurse Practitioner in pediatrics at Allina Health Coon Rapids Clinic. Welcome to the show, Ella. Tell us, what is HPV? Everyone hears about it in the media. What is human papillomavirus?
Ella Hamilton (Guest): Human papillomavirus is a virus, and there are actually a hundred different strains of the virus and it's the most common cause of genital warts and cervical cancer and other kinds of cancers in boys, as well, such as penile and anal cancers, actually.
Melanie: So, now we're hearing from the American Academy of Pediatrics recommendations for this vaccine for this vaccine to be given. First of all, is it to be given both to boys and girls?
Ella: Yes. It should be given to both boys and girls.
Melanie: And what ages?
Ella: We recommend that the series be started at the age of 11.
Melanie: Is there a reason for this?
Ella: There is, actually. There are several reasons. We start the series at 11 because there's a more robust immune response if we start the series early and then, starting at 11, 12, 13, those ages, kids are coming into the clinic more frequently. They are usually come in yearly and in the later teenage years, we don't' tend to see kids quite as often, so we try and get the series started as soon as possible.
Melanie: So, I'm going to jump right into the heart of this. At eleven years old, some parents say, and you just mentioned there's a robust immune response, which is such an important factor to note for parents, but parent say "Well, if this is a sexually-transmitted infection, I don't need to give it at eleven. My kids are not doing anything like that, then."
Ella: Right. Yes. And my response to parents is always, "I know it's really hard to think about your kid being sexually active, but at some point they probably will be, so it's best to give the vaccine when we think it's going to protect them the most," and that's really starting at that age, eleven.
Melanie: Are there some risk factors with not receiving the vaccine?
Ella: Well, if you don't receive the vaccine, all people who are sexually active really have a very high risk of coming in contact with HPV. I think up to 80 or 90% of sexually active teens and adults come into contact with some strain of HPV. So, it's not an "if" they come in contact with it. It’s more likely a "when". So, if they don't get the vaccine and they were to come into contact with one of the strains that can cause cancer or genital warts, they would be at risk for getting those conditions.
Melanie: How is the vaccine administered?
Ella: So, we give it in a three-dose series. We give one at the first visit, and then we give the second dose two months later, and the third dose four months after the second dose, or at least six months in between the first dose and the third dose. And it's given as an IM injection, usually in the arm.
Melanie: What if you're somebody who is over the age of 26? You've missed out. Is it too late, then, to get the vaccine? What is the age range of being able to get this vaccine?
Ella: Up to 26 for girls and then, young men can get vaccinated through age 21. Yes. And then, you know, for men who are sexually active with other men, they can get it through age 26.
Melanie: [CROSS-TALK]
Ella: Excuse me?
Melanie: We're going to start again, we'll just edit that out.
Ella: Oh, okay.
Melanie: So, after that age, the vaccine would not work for somebody?
Ella: Well, it's not necessarily that it wouldn't work for somebody, but that's the ages that they've tested the vaccine through and that we can make sure that they're safest through. I always encourage all of my patients, and I see kids up to 21, but anybody should be practicing safe sex practices with condoms all the time to protect them from sexually-transmitted infections, as well.
Melanie: How do you start this conversation with your teen? What do you recommend, Ella, that parents say to begin? Because some parents are going to say "Well, if I discuss this, my children are going to think it's safe now to have sex."
Ella: Yes and it’s a very good question. I always start out with parents that the conversation about sex really should be an open one. I always want my teens to be able to talk to their parents about sex because if they can't talk to their parents, then they're going to talk to their friends and that often leads to misinformation. So, a developmentally-appropriate conversation--and I think keeping it simple that this is a vaccine that's going to protect you from things we don't want you to get, just like any other vaccine would.
Melanie: So, just really keeping it simple and starting that conversation is so important for parents?
Ella: Absolutely.
Melanie: What about questions for parents such as they might ask you if it affects fertility later on in life or if there are any other side effects.
Ella: Yes. So, the most common side effect to this vaccine is the same one to any other vaccine, the most common side effects are a little bit of redness or injection site pain from where we actually give the shot. There's no evidence to support the claim that this impacts fertility for men or women. What I always tell parents, too, is that the risk of getting HPV, that for sure impacts fertility because you have HPV that ends up leading to genital warts or cervical cancer. That will definitely cause fertility problems.
Melanie: So, what if a teen didn't get it, Ella, and then they decide before they go to college, "You know what? I should really get this vaccine," or their parents decide. Do they need to be tested for HPV first before they get the vaccine if they get it late?
Ella: No, they do not. They do not to be tested. We'd be happy to have them to come into the clinic and we'd get the series started then.
Melanie: What if they already have HPV?
Ella: It won't get rid of HPV but it will protect them from having consequences from getting one of the strains of HPV that we vaccinate them against.
Melanie: That's an interesting vaccine and such a great adjunct for parents now. Kind of wrap it up for us. Tell the parents what you want them to know about HPV and their teen, what you tell them every day about this vaccine.
Ella: Yes. You know, I think, thinking about myself, though. I'm a new parent. I have a 6-month son, and what I think is that it's really so important to start vaccinating these kids as soon as they're eligible to have the vaccine. So, when my son turns 11, I plan on starting the series with him right at that time. It's a controversial vaccine. You know, the media kind of makes it controversial, but it's really a very safe and highly effective vaccine that we give kids.
Melanie: Thank you so much for being with us today, Ella. It's such great information for parents. You're listening to the WELLCast with Allina Health, and for more information you can go to allinahealth.org. That's allinahealth.org. This is Melanie Cole. Thanks so much for listening.
Melanie Cole (Host): Human Papillomavirus is the most common sexually transmitted infection in the United States. My guest today is Ella Hamilton. She's a Certified Nurse Practitioner in pediatrics at Allina Health Coon Rapids Clinic. Welcome to the show, Ella. Tell us, what is HPV? Everyone hears about it in the media. What is human papillomavirus?
Ella Hamilton (Guest): Human papillomavirus is a virus, and there are actually a hundred different strains of the virus and it's the most common cause of genital warts and cervical cancer and other kinds of cancers in boys, as well, such as penile and anal cancers, actually.
Melanie: So, now we're hearing from the American Academy of Pediatrics recommendations for this vaccine for this vaccine to be given. First of all, is it to be given both to boys and girls?
Ella: Yes. It should be given to both boys and girls.
Melanie: And what ages?
Ella: We recommend that the series be started at the age of 11.
Melanie: Is there a reason for this?
Ella: There is, actually. There are several reasons. We start the series at 11 because there's a more robust immune response if we start the series early and then, starting at 11, 12, 13, those ages, kids are coming into the clinic more frequently. They are usually come in yearly and in the later teenage years, we don't' tend to see kids quite as often, so we try and get the series started as soon as possible.
Melanie: So, I'm going to jump right into the heart of this. At eleven years old, some parents say, and you just mentioned there's a robust immune response, which is such an important factor to note for parents, but parent say "Well, if this is a sexually-transmitted infection, I don't need to give it at eleven. My kids are not doing anything like that, then."
Ella: Right. Yes. And my response to parents is always, "I know it's really hard to think about your kid being sexually active, but at some point they probably will be, so it's best to give the vaccine when we think it's going to protect them the most," and that's really starting at that age, eleven.
Melanie: Are there some risk factors with not receiving the vaccine?
Ella: Well, if you don't receive the vaccine, all people who are sexually active really have a very high risk of coming in contact with HPV. I think up to 80 or 90% of sexually active teens and adults come into contact with some strain of HPV. So, it's not an "if" they come in contact with it. It’s more likely a "when". So, if they don't get the vaccine and they were to come into contact with one of the strains that can cause cancer or genital warts, they would be at risk for getting those conditions.
Melanie: How is the vaccine administered?
Ella: So, we give it in a three-dose series. We give one at the first visit, and then we give the second dose two months later, and the third dose four months after the second dose, or at least six months in between the first dose and the third dose. And it's given as an IM injection, usually in the arm.
Melanie: What if you're somebody who is over the age of 26? You've missed out. Is it too late, then, to get the vaccine? What is the age range of being able to get this vaccine?
Ella: Up to 26 for girls and then, young men can get vaccinated through age 21. Yes. And then, you know, for men who are sexually active with other men, they can get it through age 26.
Melanie: [CROSS-TALK]
Ella: Excuse me?
Melanie: We're going to start again, we'll just edit that out.
Ella: Oh, okay.
Melanie: So, after that age, the vaccine would not work for somebody?
Ella: Well, it's not necessarily that it wouldn't work for somebody, but that's the ages that they've tested the vaccine through and that we can make sure that they're safest through. I always encourage all of my patients, and I see kids up to 21, but anybody should be practicing safe sex practices with condoms all the time to protect them from sexually-transmitted infections, as well.
Melanie: How do you start this conversation with your teen? What do you recommend, Ella, that parents say to begin? Because some parents are going to say "Well, if I discuss this, my children are going to think it's safe now to have sex."
Ella: Yes and it’s a very good question. I always start out with parents that the conversation about sex really should be an open one. I always want my teens to be able to talk to their parents about sex because if they can't talk to their parents, then they're going to talk to their friends and that often leads to misinformation. So, a developmentally-appropriate conversation--and I think keeping it simple that this is a vaccine that's going to protect you from things we don't want you to get, just like any other vaccine would.
Melanie: So, just really keeping it simple and starting that conversation is so important for parents?
Ella: Absolutely.
Melanie: What about questions for parents such as they might ask you if it affects fertility later on in life or if there are any other side effects.
Ella: Yes. So, the most common side effect to this vaccine is the same one to any other vaccine, the most common side effects are a little bit of redness or injection site pain from where we actually give the shot. There's no evidence to support the claim that this impacts fertility for men or women. What I always tell parents, too, is that the risk of getting HPV, that for sure impacts fertility because you have HPV that ends up leading to genital warts or cervical cancer. That will definitely cause fertility problems.
Melanie: So, what if a teen didn't get it, Ella, and then they decide before they go to college, "You know what? I should really get this vaccine," or their parents decide. Do they need to be tested for HPV first before they get the vaccine if they get it late?
Ella: No, they do not. They do not to be tested. We'd be happy to have them to come into the clinic and we'd get the series started then.
Melanie: What if they already have HPV?
Ella: It won't get rid of HPV but it will protect them from having consequences from getting one of the strains of HPV that we vaccinate them against.
Melanie: That's an interesting vaccine and such a great adjunct for parents now. Kind of wrap it up for us. Tell the parents what you want them to know about HPV and their teen, what you tell them every day about this vaccine.
Ella: Yes. You know, I think, thinking about myself, though. I'm a new parent. I have a 6-month son, and what I think is that it's really so important to start vaccinating these kids as soon as they're eligible to have the vaccine. So, when my son turns 11, I plan on starting the series with him right at that time. It's a controversial vaccine. You know, the media kind of makes it controversial, but it's really a very safe and highly effective vaccine that we give kids.
Melanie: Thank you so much for being with us today, Ella. It's such great information for parents. You're listening to the WELLCast with Allina Health, and for more information you can go to allinahealth.org. That's allinahealth.org. This is Melanie Cole. Thanks so much for listening.