A current study in Pediatrics say: ivdruguseNo.

The argument that the HPV vaccine will somehow encourage teens to have risky sex has always seemed strange to me. It brings to mind a teen thinking, “I wanted to wait, it’s what my family, my religion, and my personal values tell me… but now I have a much lower risk of getting cancer in a few decades, so I might as well just start having sex.” Or alternately, a teen who’s not thinking, in a passionate situation with a romantic partner, suddenly remembering the possibility of an increased cancer risk in middle to late life, and stopping everything.

Teens don’t think this way.

To me, the people who make this argument are both overestimating and underestimating teens. They are overestimating a teen’s ability to make long-term plans for possible negative outcomes. Teens have enough trouble making rational decisions when a bad outcome is staring them in the face, much less when it’s decades away.

At the same time, they are underestimating a teen’s ability to understand that there are multiple sexually transmitted infections out there, and a vaccine for one doesn’t mean they are STI-free for life. Also, most teens can recognize that giving a vaccination against a sexually transmitted infection does not mean that they should go out and have sex right now. Particularly since the vaccine is recommended for girls and boys at age 11-12.

An interesting article in the Journal of School Health discussed common objections to the HPV vaccine. I wanted to discuss some of the other reasons people are against the HPV vaccine (apart from concerns about the safety of the vaccine, which we’ve addressed in a few different posts.)

  • Sending mixed messages: Some parents and policymakers have stated that they feel vaccinating their child against HPV goes against the message that they should be sexually abstinent. This confuses me because, at some point, most parents want their children to get married and engage in sexual relations with their spouse. There is no way to guarantee an STI-negative spouse. People have sex before marriage, people lie about having had sex before marriage, people have oral and/ or anal sex before marriage because it “doesn’t count”, and people are sexually assaulted. HPV is so transmissible it can be caught from hand-to-genital contact. HPV can be tested for, but not cured. Lots of people have HPV, and your child might fall in love with one of them someday.
  • If teens are responsible and use protection, they won’t catch HPV: No method of STI protection is foolproof, but this is particularly true for HPV. Condoms certainly help, but HPV is can be transmitted from skin not covered by condoms.
  • HPV isn’t a high-risk disease. HPV carries a different type of risk than many other vaccine-preventable diseases. The tetanus vaccine, for example, prevents against a rapidly lethal infection. The HPV vaccine protects against strains of a virus that might lead to cancer someday, when one’s child is in their forties or older, which can seem like lifetimes away. Vaccinating an 11-12 year old girl may seem like jumping the gun; and yet this is exactly the time when protection needs to be put into place.
  • The real solution to HPV is for teens to abstain from sex. I have no problem with teens abstaining from sex- but thinking that all teens are going to abstain from sex 100% of the time is unrealistic. Some families are okay with teens being sexually active under certain conditions. Some teens feel ready to have a healthy sexual relationship, and will make the decision for themselves. Teens choose to have sex for a huge variety of reasons, but what has been constant throughout history is that some teens will have sex.

For parents concerned that HPV vaccination might encourage their child to have sex earlier or with more people, this study supplies good data. However, I think the best way to address this is to have a discussion with your teen about what the HPV vaccination is, what’s it’s not, and what your family values and expectations are around teen sexual activity. Encourage your teen to have a discussion with their health care provider about sex and STIs, too.