HPV vaccine rethink

When her 11-year-old daughter brought home a permission slip for the human papillomavirus vaccine two years ago, Andrea deBolster* left it blank, confident her children wouldn’t need the optional shot. 

“Why on earth would we vaccinate them against something they could only get from a lifestyle that we don’t condone?” asks the Vancouver-area mother, who didn’t know a lot about the HPV vaccine but bristled at its assumption of promiscuity. “To me, it wasn’t a whole lot different than telling us to make sure kids have condoms when they go to parties, just in case.”

In a letter stapled to the permission form, the British Columbia Christian school deBolster’s daughter attends rushed to explain its decision to offer the controversial vaccine, which targets sexually-transmitted types of HPV that cause cancers of the cervix, penis, anus, mouth and throat.

With 35 percent of Grade 6 girls missing out on the vaccine in the 2015-2016 school year in British Columbia – closer to 40 percent in Ontario – it’s clear deBolster isn’t the only parent with reservations. 

Dr. Dan Reilly has heard it all. 

	Dr. Dan Reilly encourages parents to rethink their hesitations about the HPV vaccination.

The obstetrician and gynecologist often confronts misinformation at his Fergus, Ont. practice when patients bring up something they’ve read online. 

Reilly debunks the three most-oft heard objections to the HPV vaccine, suggesting some Christian parents may want to rethink their hard-line stance. 

Is the HPV vaccine safe? 
To get Health Canada approval, vaccines undergo a rigorous licensing process requiring scientific and clinical evidence showing they are safe and effective, and are monitored once in use. 

The risks are small, says Reilly. Some people end up with a bruised arm, while others feel faint. “We have data on millions of people who’ve received the HPV vaccine. It’s incredibly safe.” 

There is a small chance of developing a rare autoimmune disorder that causes paralysis called Guillain-Barré Syndrome, a risk any time the immune system is activated, says Reilly.  

But it is not more common in vaccinated people and a cold or a scraped knee is more likely to trigger the syndrome, he says. “Any time you activate the immune system, there is a one in a million chance something could go wrong.” 

By comparison, HPV is a greater risk: If not immunized, the Canadian Cancer Society estimates three of four sexually-active Canadians will have an HPV infection in their lifetime. 

Only one partner  
Conversations about the vaccine often assume multiple sexual partners, which can be off-putting for those hoping their children will stick to one, concedes Reilly. 

Parents should be hopeful, but the only way to avoid HPV exposure is lifelong abstinence or having only one partner who has also had only one partner – unusual in our culture, he says.  

“Their son or daughter may make different choices than they hope. They should also be aware that even if they only have one partner, that partner may not have. Unfortunately, in our society sometimes sexual activity is also not by choice.”

Encouraged to have sex earlier?
Many Christian parents worry that a vaccine designed to prevent a sexually-transmitted infection sends a permissive message that sex is a free-for-all. 

But studies comparing vaccinated and unvaccinated adolescents found no evidence the vaccine influences decision-making, says Reilly. Both groups had the same number of partners, average age of onset of sexual activity and incidence of sexually-transmitted infections. 

The best way for parents to get the right message across is talking about their faith community’s beliefs. 

“We know education is the most powerful way to influence the decisions children make. Not talking about something is a poor strategy,” says Reilly, adding that the sex talk should have begun well before the vaccine is on the radar. “If the first time you’re talking about human sexuality is in Grade 7 in the context of the HPV vaccine, I’d be concerned you haven’t prepared them as well as you can for the world they face.” 

Think about it like teaching a first-time driver to wear a seatbelt, Reilly suggests. 

“We encourage teens to wear seatbelts when they drive with the understanding that’s it’s not permission to drive faster. Even if he or she is a safe driver, that doesn’t mean everyone else is,” he says. “We do a lot of things to protect our children against dangers they’re unlikely to encounter.” 

If you have doubts about the vaccine based on something you heard second-hand or read online, dig deeper, says Reilly. He advocates tracking down the references to fear-mongering articles online – most don’t check out. “If you come across someone online making a truth claim, pursue the evidence behind it.” 

DeBolster has started to do just that. 

If the HPV vaccine was offered again, she wouldn’t hesitate this time to sign the permission form for her now 13-year-old-daughter and her two younger sons that are eligible for the publicly-funded vaccine as of this year. 

“Not all kids go down the path we want them to and they do make mistakes. If this vaccine is available and can save them a lifetime of medical problems, why wouldn’t we do it?”  

*Names have been changed.