When the answer to vaccines is “No”

SIDEBAR
Human papillomavirus vaccine: Patient-friendly talking points

• Human papillomavirus (HPV) causes genital warts and cancer of the cervix, vagina, vulva, anus, rectum, penis, and oropharynx.
• The HPV vaccine is a cancer prevention vaccine. The 9-valent vaccine is active against 2 genital wart-causing strains and 7 cancer-causing strains of HPV.  
• HPV is highly prevalent; 79 million Americans are currently infected, nearly 14 million people become newly infected each year, and nearly all of us will be exposed at some point in our sexual lives.⁴⁰
• There are often no outward signs of infection, so it is a difficult infection to avoid.
• It takes no high-risk sexual activity to be exposed to the HPV virus.
• The HPV vaccine is recommended for both boys and girls usually around age 11 to 12 years (but as early as 9 years and as late as 26 years is acceptable). If the first vaccine is administered before 15 years of age, only 2 injections are needed 6 to 12 months apart. If the first vaccine is administered after 15 years of age, 3 injections are needed at 0, 2 months, and 6 months.⁴¹
• Completing the series before sexual activity begins is the best way to protect our children because the vaccine is a preventive measure, not a treatment.
• The HPV vaccine is highly effective with >90% efficacy against high-risk cancer-causing strains.⁴²
• The HPV vaccine offers long-term protection. The vaccine has been on the market since 2006, and immunity has not yet diminished. Further monitoring is ongoing.⁴³
• The HPV vaccine is covered under the Vaccines For Children program until age 19 years. Then it is up to individual insurance plans to cover it.
• The HPV vaccine does not cause infertility.⁴⁴ HPV infection, on the other hand, can lead to fertility problems if, for example, treatment for cervical precancer or cancer requires partial removal of the cervix or a hysterectomy.
• The HPV vaccine does not cause autoimmune diseases.^45,46 Studies show no difference between vaccinated and unvaccinated groups in rates of autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis, type 1 diabetes mellitus, multiple sclerosis, Hashimoto's thyroiditis, Graves' disease, and others.
• The HPV vaccine does not encourage earlier sexual activity. There was no earlier incidence of outcomes related to sexual activity (pregnancy, sexually transmitted infection testing or diagnosis, or contraceptive counseling) in vaccinated vs unvaccinated patients studied.⁴⁷