Parents may be concerned that giving their daughters the human papillomavirus (HPV) vaccine will lead to an increase in sex and sexually transmitted infections (STIs).
However, a new study concludes that the shot is not linked to higher levels of STIs.
An article in JAMA Internal Medicine reports that about one-quarter of American girls between the ages of 14 and 19 are infected with HPV. The infection also affects 45 percent of women between the ages of 20 and 24.
The vaccine can block certain high-risk strains of HPV, which can cause cervical, vulvar, and vaginal cancers, along with genital warts. Nonetheless, vaccination rates in the United States are quite low.
At the end of 2006, 2.5 percent of young women had received the HPV vaccine. That went up to 27 percent by the end of 2010.
In 2013, 57 percent of 13- to 17-year-old girls had received at least one dose of the vaccine, while 38 percent had received all three recommended doses.
In the new study, Dr. Anupam B. Jena of Harvard Medical School in Boston and her colleagues looked at data from an insurance database. The database included information from 2005 to 2010 on 21,610 12- to 18-year-old girls who received the vaccine and 186,501 of the same age who were unvaccinated.
Vaccine Not Linked to Higher STI Rates
Jena’s team found that vaccinated women had higher rates of STIs both before and after vaccination compared with those who did not get the vaccine. In the year before getting vaccinated, the STI rate among HPV-vaccinated girls was 4.3 per 1,000. For unvaccinated girls, the rate was 2.8 per 1,000.
In the year after getting vaccinated, the STI rate for vaccinated girls rose to 6.8 per 1,000. For unvaccinated girls, it increased to 4.2 per 1,000.
The study authors said the increase in STIs in both groups implies that the HPV vaccine was not associated with a rise in infections. If the vaccine did encourage girls to have riskier sex, one would expect the infection rate in the vaccinated group to increase much more quickly than in the unvaccinated group.
“We found no evidence that HPV vaccination leads to higher rates of STIs,” the study concluded. “Given low rates of HPV vaccination among adolescent females in the United States, our findings should be reassuring to physicians, parents, and policy makers that HPV vaccination is unlikely to promote unsafe sexual activity.”
A 2012 study published in Pediatrics also showed that sexual activity did not increase in girls who received the HPV vaccine.
Should All Kids Get Vaccinated?
Dr. Robert A. Bednarczyk, an assistant professor at Emory University, said HPV vaccinations have been a concern for parents of younger children who are not yet sexually active.
He said doctors have been less willing to recommend the HPV vaccine compared to other vaccines because doing so brings up a discussion about sex.
Bednarczyk, who wrote an editorial published alongside the study, asked if providers worry about discussing how pertussis or whooping cough is transmitted when they give kids a Tdap booster shot.
“If not, then why is HPV vaccine treated so differently?” he asked.
The CDC recommends the HPV vaccine for all children — boys and girls — when they are 11 to 12 years of age.
Vaccines work best when the child had not yet been exposed to the virus, so if an 11- or 12-year-old is not yet having sex, it’s still a good idea to administer the vaccine, Bednarczyk said.
“We do not wait until we have been in the sun, on the beach, for an hour or two before applying sunscreen. We use sunscreen before this exposure to the sun,” he noted. “Why can we not treat HPV vaccine in the same manner?”
Bednarczyk hopes the current study reassures doctors about the HPV vaccine’s safety and efficacy. He also hopes it will encourage them to endorse the vaccine.
“Without this strong recommendation for HPV vaccine, we cannot fully achieve the benefits of HPV vaccination in preventing cancer,” he added.