The HPV vaccine protects against infection by certain strains of the human papilloma virus (HPV).
HPV can cause cervical cancer and genital warts.
The HPV virus has also been linked to other kinds of cancers, including vaginal, vulvar, penile, anal, mouth and throat cancers.
Thomas J. Murwin, MD is here to discuss the HPV Vaccine, who should get it and what else to think about when you consider getting the vaccine.
Selected Podcast
The HPV Vaccine
Featured Speaker:
Thomas Murwin, MD
Thomas J. Murwin, MD joined Dean Clinic in 1994. His specialty is Pediatric Medicine. Transcription:
The HPV Vaccine
Melanie Cole (Host): Human Papillomavirus Virus can cause cancers of the cervix, vagina and vulva in women, cancer of the penis in men and cancers of the anus and or the mouth or throat in both men and women. There are about 26,000 of these cancers each year and most could be prevented with the HPV vaccine. My guest today is Dr. Thomas Murwin. He’s a pediatrician with Stoughton - Dean Clinic. Welcome to the show, Dr. Murwin. Tell us about the advent about the HPV vaccine and really the most important bit of information you want listeners to know when they question this vaccine.
Dr. Thomas Murwin (Guest): The most important information about HPV vaccine is if you get three does into a female before she gets infected with the HPV virus, you will reduce her risk with the current vaccine of cervical cancer by 90% in her lifetime and you will reduce the risk of head and neck cancers in males by 55% in their lifetime. So, this vaccine is an anti-cancer vaccine. It’s related to sexual activity. It’s estimated that over 80% of people at some point in their lifetime will be sexually active. So, if your children are like you and will eventually become sexually active, you should get this vaccine into them before they get infected. We know that probably 1/3 of high schoolers by the time they are done with high school will participate in an activity that places them at risk for getting HPV virus. So, get the vaccine in during middle school before they start participating in said activities.
Melanie: What age should we get that first shot? When you say “participating in said activities,” we’re not just talking about intercourse here, are we?
Dr. Murwin: We are talking about any anal sex, oral sex or the usual sexual intercourse that everybody thinks about. They are all potentially related to transmission of the HPV virus. As you get older, the percentage of people in that age group that has HPV goes up. It’s estimated that within two years of starting sexual activity, males, about 60% will be infected with HPV and females, almost 50% will be infected with HPV. So, if you wait until they do it, it’s too late to get the use, to get the benefit of this vaccine. Our recommendation is get that first dose in sometime between 11 and 13. The doses are supposed to be three doses within a six month period of time. So, the earlier they start it, the earlier they finish it and get the full protection of the vaccine. Once they are infected with HPV, the vaccine doesn’t do anything to clear that infection.
Melanie: Is the response to the vaccine better at this younger age than it is if say they waited until they were in their late teens?
Dr. Murwin: Yes. When you look at antibody levels in 11 to 13-year-olds, it’s much higher than 18- to 25-year-olds. So, yes. We believe we get better protection the earlier we get it in.
Melanie: Dr. Murwin, what do you say to parents that say, “I’m not sure about this vaccine because then it’s going to encourage my child to go out and engage in sexual activity”?
Dr. Murwin: There is no evidence to say that that is happening. We have our kids wear seatbelts and that doesn’t allow them to go out and drive crazy. We wear seatbelts because we want to decrease their risk of bad things happening to them or ourselves while we are driving. We are not always in control of when we get in an accident. Same with HPV. We are not always in control of when we get exposed to HPV. We don’t know who’s infected and who isn’t. So, it’s better to get them protected and talk to them about why you think they shouldn’t have sex or whatever your values are around that topic.
Melanie: I think it does encourage that discussion and start that communication. Don’t you think?
Dr. Murwin: Yes, I do. Fifty percent of high schoolers say they’ve never had a talk about sex with their parents. So, that would be another issue that we can get parents to start talking about. It’s just an uncomfortable issue.
Melanie: This used to be just recommended for girls and now it is recommended for boys, correct? What changed?
Dr. Murwin: Our understanding of how much HPV causes head in neck cancers in males. Right now there’s about 10,000 cases of cervical cancer every year and about 7,000 cases of head and neck cancers per year in males. So, we know that 50% of that 7,000 can be prevented with the current vaccine. Fifty-five if you want to be specific. As we understood more about HPV through our studies, we found that instead of 1,000 cases a year, it’s more like 7,000 cases a year which makes it a lot more prevalent. The effectiveness of the vaccine can prevent more cancers.
Melanie: Is it ever too late to get this vaccine? Is there an age when you would say, “Well, if you missed that mark then it’s not worth getting that vaccine”?
Dr. Murwin: It’s recommended up until 25 years of age for catch up for men and women. If you’re over 25, it’s not FDA approved so you cannot get the vaccine. Otherwise, no. It’s better to give the vaccine even if they’re infected with one of the types in the vaccine. The new vaccine has nine types in it and they may get protection from the other eight types. So, instead of being 90% protective against cervical cancer, it may be less so but it’s still going to be protective against other types of HPV that can cause cervical cancer.
Melanie: Is there anything parents should look for after getting the vaccine? Any complications or side effects?
Dr. Murwin: The biggest thing is that it hurts and some kids faint. People get worried about that but I would say that’s been happening for many decades. I was a fainter when I got vaccines. We did not have the HPV vaccine. When someone gets something painful done to them, some of them faint. In our clinic we have them wait 15 minutes after the vaccine so that if they experience that side effect, it happens now and we can take care of it.
Melanie: Dr. Murwin, even though this is a little bit off topic of HPV itself, give your best advice about vaccines in general and what do you say to parents? There is so much in the media today about anti-vaccinations and states are making new regulations. What do you tell parents about the importance of getting their vaccinations on schedule?
Dr. Murwin: I say it’s as important as wearing a seatbelt. You don’t know when these diseases are coming. It’s scientifically based evidence that says vaccines are probably, from a cost effective standpoint, the best thing we do in healthcare. If you get your kids vaccines, you will reduce their risks of having bad things happen to them all the way from hospitalization to death. Using the car analogy, it’s the same reason we wear seatbelts. We wear seatbelts so that if we get in a car accident, we are more likely to have less bad injuries and less death happen.
Melanie: When parents question just even the safety of all of the vaccines that we have available today, what do you say to them?
Dr. Murwin: I say to them that if you look at the science, you will probably come to the same conclusions I do. These are safe, they have been tested on millions unlike drugs that get tested on tens of thousands or hundreds of thousands. The tests that they do on vaccines are done on millions of kids because they are looking for these rare side effects that they don’t want to miss. There is science backing every one of our vaccines, including HPV. People say, “I don’t want to give my child the HPV vaccine because I don’t believe it.” Well, we know that there are almost 20,000 cases of cancer that can be prevented every year with a single vaccine. If I had a breast cancer vaccine that was 90% effective in reducing breast cancer in a female, people would be clamoring for it but because the HPV vaccine is related to sexual activity they don’t. They say, “Well, my 12-year-old isn’t sexually active. I don’t’ need it.” No, you need it so that when they become sexually active, they are protected and aren’t going to get the bad types of HPV.
Melanie: How do you tell parents to start that discussion? If their child says, as children do when they start to get more curious and a little older, “What is this vaccine and why am I getting it?” Is that a discussion we leave to you pediatricians or do we as parents do this?
Dr. Murwin: No, no no. Educate yourself. Go to cdc.gov and learn about HPV and they have great information on that site as well on how to talk to your kids about sex. So, educate yourself. It’s an uncomfortable topic for some people but getting your values on a lot of adult type issues is not always easy on how you discover that in yourself. You just have to talk to your kids about what your values are and what’s out there.
Melanie: So, in the last just minute or so give us your best advice for parents considering giving this vaccine to their children, the discussions that they might have surrounding it and why they should come to Stoughton Hospital - Dean Clinic for their care.
Dr. Murwin: Because I’m a firm believer in vaccines. I give them to my children. They’re safe; they will prevent death; they will prevent cancers and cancer hurts a lot more than a poke or two pokes or three pokes. Vaccines are scientifically based. That’s what we do in medicine is develop science and test our theories and build on them over the years and we’ve built a very strong base that says vaccines are the best thing that we can do for our children to protect them and allow them to grow up healthy, young adults.
Melanie: Beautifully put, Dr. Murwin. Thank you so much for such great information. You’re listening to Stoughton Hospital Health Talk and for more information you can go to stoughtonhospital.com. That’s stoughtonhospital.com. This is Melanie Cole. Thanks so much for listening.
The HPV Vaccine
Melanie Cole (Host): Human Papillomavirus Virus can cause cancers of the cervix, vagina and vulva in women, cancer of the penis in men and cancers of the anus and or the mouth or throat in both men and women. There are about 26,000 of these cancers each year and most could be prevented with the HPV vaccine. My guest today is Dr. Thomas Murwin. He’s a pediatrician with Stoughton - Dean Clinic. Welcome to the show, Dr. Murwin. Tell us about the advent about the HPV vaccine and really the most important bit of information you want listeners to know when they question this vaccine.
Dr. Thomas Murwin (Guest): The most important information about HPV vaccine is if you get three does into a female before she gets infected with the HPV virus, you will reduce her risk with the current vaccine of cervical cancer by 90% in her lifetime and you will reduce the risk of head and neck cancers in males by 55% in their lifetime. So, this vaccine is an anti-cancer vaccine. It’s related to sexual activity. It’s estimated that over 80% of people at some point in their lifetime will be sexually active. So, if your children are like you and will eventually become sexually active, you should get this vaccine into them before they get infected. We know that probably 1/3 of high schoolers by the time they are done with high school will participate in an activity that places them at risk for getting HPV virus. So, get the vaccine in during middle school before they start participating in said activities.
Melanie: What age should we get that first shot? When you say “participating in said activities,” we’re not just talking about intercourse here, are we?
Dr. Murwin: We are talking about any anal sex, oral sex or the usual sexual intercourse that everybody thinks about. They are all potentially related to transmission of the HPV virus. As you get older, the percentage of people in that age group that has HPV goes up. It’s estimated that within two years of starting sexual activity, males, about 60% will be infected with HPV and females, almost 50% will be infected with HPV. So, if you wait until they do it, it’s too late to get the use, to get the benefit of this vaccine. Our recommendation is get that first dose in sometime between 11 and 13. The doses are supposed to be three doses within a six month period of time. So, the earlier they start it, the earlier they finish it and get the full protection of the vaccine. Once they are infected with HPV, the vaccine doesn’t do anything to clear that infection.
Melanie: Is the response to the vaccine better at this younger age than it is if say they waited until they were in their late teens?
Dr. Murwin: Yes. When you look at antibody levels in 11 to 13-year-olds, it’s much higher than 18- to 25-year-olds. So, yes. We believe we get better protection the earlier we get it in.
Melanie: Dr. Murwin, what do you say to parents that say, “I’m not sure about this vaccine because then it’s going to encourage my child to go out and engage in sexual activity”?
Dr. Murwin: There is no evidence to say that that is happening. We have our kids wear seatbelts and that doesn’t allow them to go out and drive crazy. We wear seatbelts because we want to decrease their risk of bad things happening to them or ourselves while we are driving. We are not always in control of when we get in an accident. Same with HPV. We are not always in control of when we get exposed to HPV. We don’t know who’s infected and who isn’t. So, it’s better to get them protected and talk to them about why you think they shouldn’t have sex or whatever your values are around that topic.
Melanie: I think it does encourage that discussion and start that communication. Don’t you think?
Dr. Murwin: Yes, I do. Fifty percent of high schoolers say they’ve never had a talk about sex with their parents. So, that would be another issue that we can get parents to start talking about. It’s just an uncomfortable issue.
Melanie: This used to be just recommended for girls and now it is recommended for boys, correct? What changed?
Dr. Murwin: Our understanding of how much HPV causes head in neck cancers in males. Right now there’s about 10,000 cases of cervical cancer every year and about 7,000 cases of head and neck cancers per year in males. So, we know that 50% of that 7,000 can be prevented with the current vaccine. Fifty-five if you want to be specific. As we understood more about HPV through our studies, we found that instead of 1,000 cases a year, it’s more like 7,000 cases a year which makes it a lot more prevalent. The effectiveness of the vaccine can prevent more cancers.
Melanie: Is it ever too late to get this vaccine? Is there an age when you would say, “Well, if you missed that mark then it’s not worth getting that vaccine”?
Dr. Murwin: It’s recommended up until 25 years of age for catch up for men and women. If you’re over 25, it’s not FDA approved so you cannot get the vaccine. Otherwise, no. It’s better to give the vaccine even if they’re infected with one of the types in the vaccine. The new vaccine has nine types in it and they may get protection from the other eight types. So, instead of being 90% protective against cervical cancer, it may be less so but it’s still going to be protective against other types of HPV that can cause cervical cancer.
Melanie: Is there anything parents should look for after getting the vaccine? Any complications or side effects?
Dr. Murwin: The biggest thing is that it hurts and some kids faint. People get worried about that but I would say that’s been happening for many decades. I was a fainter when I got vaccines. We did not have the HPV vaccine. When someone gets something painful done to them, some of them faint. In our clinic we have them wait 15 minutes after the vaccine so that if they experience that side effect, it happens now and we can take care of it.
Melanie: Dr. Murwin, even though this is a little bit off topic of HPV itself, give your best advice about vaccines in general and what do you say to parents? There is so much in the media today about anti-vaccinations and states are making new regulations. What do you tell parents about the importance of getting their vaccinations on schedule?
Dr. Murwin: I say it’s as important as wearing a seatbelt. You don’t know when these diseases are coming. It’s scientifically based evidence that says vaccines are probably, from a cost effective standpoint, the best thing we do in healthcare. If you get your kids vaccines, you will reduce their risks of having bad things happen to them all the way from hospitalization to death. Using the car analogy, it’s the same reason we wear seatbelts. We wear seatbelts so that if we get in a car accident, we are more likely to have less bad injuries and less death happen.
Melanie: When parents question just even the safety of all of the vaccines that we have available today, what do you say to them?
Dr. Murwin: I say to them that if you look at the science, you will probably come to the same conclusions I do. These are safe, they have been tested on millions unlike drugs that get tested on tens of thousands or hundreds of thousands. The tests that they do on vaccines are done on millions of kids because they are looking for these rare side effects that they don’t want to miss. There is science backing every one of our vaccines, including HPV. People say, “I don’t want to give my child the HPV vaccine because I don’t believe it.” Well, we know that there are almost 20,000 cases of cancer that can be prevented every year with a single vaccine. If I had a breast cancer vaccine that was 90% effective in reducing breast cancer in a female, people would be clamoring for it but because the HPV vaccine is related to sexual activity they don’t. They say, “Well, my 12-year-old isn’t sexually active. I don’t’ need it.” No, you need it so that when they become sexually active, they are protected and aren’t going to get the bad types of HPV.
Melanie: How do you tell parents to start that discussion? If their child says, as children do when they start to get more curious and a little older, “What is this vaccine and why am I getting it?” Is that a discussion we leave to you pediatricians or do we as parents do this?
Dr. Murwin: No, no no. Educate yourself. Go to cdc.gov and learn about HPV and they have great information on that site as well on how to talk to your kids about sex. So, educate yourself. It’s an uncomfortable topic for some people but getting your values on a lot of adult type issues is not always easy on how you discover that in yourself. You just have to talk to your kids about what your values are and what’s out there.
Melanie: So, in the last just minute or so give us your best advice for parents considering giving this vaccine to their children, the discussions that they might have surrounding it and why they should come to Stoughton Hospital - Dean Clinic for their care.
Dr. Murwin: Because I’m a firm believer in vaccines. I give them to my children. They’re safe; they will prevent death; they will prevent cancers and cancer hurts a lot more than a poke or two pokes or three pokes. Vaccines are scientifically based. That’s what we do in medicine is develop science and test our theories and build on them over the years and we’ve built a very strong base that says vaccines are the best thing that we can do for our children to protect them and allow them to grow up healthy, young adults.
Melanie: Beautifully put, Dr. Murwin. Thank you so much for such great information. You’re listening to Stoughton Hospital Health Talk and for more information you can go to stoughtonhospital.com. That’s stoughtonhospital.com. This is Melanie Cole. Thanks so much for listening.