January 14, 2019

Making Decisions with Your Child Now to Help Protect Against HPV Later

making tough decisions about health now to protect against HPV laterBy Stephen Kimmel, MD

Elizabeth Stone famously wrote, “Making the decision to have a child – it is momentous. It is to decide forever to have your heart go walking around outside your body.” As parents we are tasked with nurturing our young ones, protecting them and preparing them to live full lives.

Some things are easy: encouraging the use of helmets and seatbelts, supporting performance in school. And some things are more complicated – when do you buy them a cellphone? When can they have a Facebook account? Is she still allowed to live in my house if her uncle convinces her to pull for State over Chapel Hill?

As a pediatric provider, I am a resource for parents and children making difficult decisions, and one of them can be whether or not to get the HPV vaccine, which prevents the acquisition (catching) of the human papillomavirus (HPV).

This vaccine is complicated for families because we offer it starting at 11 years old to protect against HPV, which is normally contracted during intimate (or romantic) contact. As a father with a conservative background, I fully recognize how dissonant and off putting that sounds, but as a doctor, I also know some things that put this recommendation into perspective.

One – HPV is common, really common.

During 2013-2014, prevalence of HPV for adults aged 18-59 was around 40 percent, which is almost half. It is also insidious (sneaky). Most people who have HPV do not know they have an infection.

Two – HPV causes damage.

HPV infects cells of the mucus membranes (mouth, penis, vagina and anus). It can start a chain reaction that causes those cells to divide out of control and become cancers. I take care of patients with cancer, and I am passionate about cancer prevention.

Three – The HPV vaccine can prevent catching the HPV virus and prevent over 90 percent of the cancers associated with this infection.

This means that if we immunize children before they are exposed to the virus, we can protect a generation of people against cancers that develop at the site of mucus membranes (mouth, penis, vagina and anus).

This is still hard for parents to understand. In particular, parents with a strong religious conviction about sexual activity before marriage. Something that helps me think this through with parents is that it is possible that their child will be a virgin on their wedding night; it is also possible that their new spouse who does not have any symptoms of infection, could unknowingly give them a viral illness that could – even many years later – lead to a life-impacting cancer. That is no fun to think about, but it is one reason doctors recommend the HPV vaccine.

Vaccines work by decreasing the prevalence (amount of people with a disease) in a population. This means that the more people get protected, the more everyone benefits.

Sometimes I get home late at night or up early in the morning, and I am the only one awake in my home. I always pray for my daughters, and sometimes for their future partners, because I am a dad living with my heart outside my chest. I also make sure my children have helmets that fit, use their seatbelt in the car and, when my girls turn 11, I will be thankful for a simple series of shots that can prevent cancer.


Stephen Kimmel, MD, is a family medicine provider at the Blue Ridge Medical Center – Yancey Campus.

To find a provider in your area, visit missionhealth.org.