Courtesy of Tribune News Service

Opinion: HPV vaccinations should be mandatory for school enrollment

If there was a disease that caused 30,000 new cases of cancer every year and had no cure, wouldn’t you want to be vaccinated against it? What about if you knew that a quarter of all men and a fifth of all women already have it? Or that many people have it but don’t know it

Well, you’d be in luck, we have a vaccine and we’ve had one since 2006. The only problem? Many people don’t get it. In fact, only 27 percent of adolescents and 13 percent of adults in South Carolina receive it. 

This disease, in case you hadn’t figured it out yet, is human papillomavirus, HPV.

HPV is the most common sexually transmitted infection, STI, in the United States, with over 14 million new cases every year. Adolescents make up nearly half of these new cases, roughly 7 million a year. Luckily, we have a vaccine for it. Unfortunately, not nearly enough people get it.

You may be wondering though, why get it? After all, 30,000 new cases of cancer for 14 million new infections sounds low. However, the total number of new infections doesn’t accurately inform you of the risk. 

HPV is not one virus, but many. There are more than 40 types of HPV that can be sexually transmitted and “15 are considered to be cancer-causing.” Of these 15, two, “HPV-16 and HPV-18, cause about 70% of cervical cancers worldwide.” Certain HPV types can cause other cancers as well, such as “anal, oropharyngeal, penile, vulvar, and vaginal.” 

These “high-risk” types aren’t exactly uncommon either. As mentioned earlier, a quarter of all men and a fifth of all women already have it. With that in mind, why not vaccinate? After all, the vaccine, Gardasil 9, has been found to be highly effective in blocking a significant number of complications related to a variety of different cancerous strains.

The answer, unfortunately, isn’t as clear as with other incidents of parents forgoing vaccinating their kids. In fact, while the rate of early childhood vaccinations in South Carolina follows the U.S. average, the HPV vaccination rate is far below it and one of the lowest in the nation. This, if anything, indicates that there is a significant difference in perception between the two vaccination regimens.

Experts have pointed out the fact that some pediatricians are uncomfortable talking to parents about the vaccine and why it’s needed. It is a conversation regarding their child’s long-term sexual health – not the easiest thing to do. 

Other experts have also noted that pediatricians may not push for boys to get the vaccination either, all despite the fact that it protects boys from a variety of cancers as well. These problems are not the hardest to solve, it simply requires more training and guidelines for pediatricians. The perception of the vaccine by parents, on the other hand, may be the hardest part of the equation. 

Some parents who don’t vaccinate their kids against HPV do so because of perception that since their child isn’t having sex or isn’t going to have sex for some time, they don’t need them to be vaccinated against a virus that is purely sexually transmitted. Other parents even believe that vaccinating their kids against HPV will somehow make them more sexually active. These points are both patently false.

The first objection relies on the idea that parents have some sort of idea of when their child is likely to become sexually active. I don’t know about you, but I don’t think many parents have conversations with their kid about when they started having sex. More than that, many parents may be surprised (or perhaps not) about when most children are likely to become sexually active. 

According to research from the CDC, adolescents tend to become sexually active at age 17 – though this is merely the average, significant numbers of adolescents become sexually active earlier and later than 17. Also worth considering is the fact that parents really don’t have any control of whether or not and, in particular, when their child becomes sexually active. 

Furthermore, even if your kid does stay abstinent until marriage, it’s not like parents have any control on whether or not their future partner has also stayed abstinent. Given all these things, wouldn’t it make sense to err on the side of safety and vaccinate your kids?

The second objection is laughable up until you realize people actually believe it. The fact is, the data simply doesn’t back it up. Studies have found that not only does the HPV vaccination not result in increased sexual activity, it also doesn’t result in an increase of riskier sexual behavior (not using a condom, for example). 

More than data though, parents who believe this really must not know how the teenage brain functions – I don’t think any teenager really believes that they should start having sex because they they’ve been vaccinated. Ask virtually any teenager if you don’t believe me – I’m sure they’ll come to same conclusion.

So, if both of these perceptions are false, then why does debunking them matter? I’ll give you a hint, it comes down to vaccine coverage.

When looking at coverage rates, you’ll find that “teens living in major metropolitan areas were far more likely to get the vaccine than those living in rural areas, which may be more socially conservative.” Sounds a lot like South Carolina, doesn’t it? 

Perception is a particularly challenging problem. Luckily, there’s a fairly simple solution – make HPV vaccinations mandatory for enrollment in high school and college.

This isn’t some off the wall, insane idea either, this is already the law in Washington D.C., Rhode Island and Virginia. Those states now have some of the highest HPV vaccination rates in the entire U.S., drastically decreasing the risk of their citizens acquiring a number of debilitating and deadly cancers down the road. 

A similar law in South Carolina could cut down on nearly a 100 deaths per year and save the state millions of dollars in healthcare expenditures. And this is just the impact on cervical cancer – HPV related cancers as a whole result in 580 new cancer cases a year. If we take this path, we could one day even reach the level of Australia, where cervical cancer is predicted to be virtually eliminated by 2028 in large part due to extraordinarily high vaccination coverage. So many lives that could be saved by this vaccine, why not make it mandatory?

Like it or not, adolescents will have sex and many of them will become infected with HPV. But we can prevent the nastier side effects that come with it. We shouldn’t let an uncomfortable reality trump a rational solution to a pressing problem. Parents should do what’s best for their kids and lawmakers should do what’s best for their citizens – make the vaccine mandatory. 


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