Discussing human papilloma virus vaccination

A mother and her 15 year old daughter come to your clinic. The mother’s other daughter, who is 12 years old, recently received the human papilloma virus (HPV) vaccine at school. The mother wants to know whether her 15 year old daughter who missed her HPV vaccination should receive it now.

HPV is sexually transmitted. Infection is often asymptomatic. In some people, however, HPV infection persists and over time leads to genital warts or cancer, mainly cervical, but also anal, penile, oral, and throat cancers (fig 1⇓). The HPV types 16 and 18 together cause 70% of cervical cancers.1234

Prophylactic vaccines against HPV are offered as part of the national immunisation programme in many countries including in the UK.1 These vaccines generate HPV-specific antibodies that bind to the virus and prevent cervical infection. Table 1⇓ shows the three types of vaccines available.

Vaccination coverage globally has been variable. Surveys among parents find that the most common reasons for not vaccinating their child include lack of knowledge about the vaccine, a belief that it is not needed, their child is not sexually active, and concerns about safety.678 A healthcare provider’s recommendation is an important factor in parents’ …