Every year, a similar situation arises in parents' WhatsApp groups: a teacher informs about the vaccination of girls against the human papillomavirus (HPV), and the discussion begins to gain momentum. Many mothers are wary of this vaccine, considering it a "Western influence."
To understand how justified these fears are, we turned to gynecologist and endocrinologist Cholpon Abdilova for a comment.
— What are the characteristics of the human papillomavirus and its dangers?
— The virus is transmitted through contact and sexually. According to WHO data, most people encounter it during their lifetime. In 90% of cases, the body copes with the virus on its own within 1-2 years. However, in some individuals, it can cause cellular changes that subsequently lead to dysplasia or cervical cancer. The danger lies in the fact that the disease can develop for a long time without symptoms. A person may not suspect the presence of the virus. There are various types of HPV, and the oncogenic forms pose the greatest threat.
— Why has vaccination against this virus only recently become common practice?
— Previously, medical professionals did not realize that HPV is the main cause of cervical cancer and a number of other serious diseases. The link between HPV and oncology was established only in the 1980s and 1990s. Mass vaccination began later, when safe and effective vaccines were developed to protect against the most dangerous types of the virus.
Additionally, the introduction of any vaccine requires time for obtaining approvals, integration into national programs, organizing supplies, and conducting educational work with the population.
— What scares parents the most — the side effects of the vaccine or its possible future consequences?
— Most often, the concern arises not so much from the vaccine itself, but from the topic it is associated with. Many have associations with morality and adolescent behavior. While vaccination is aimed at preventing diseases that can develop over the years and manifest in adulthood. Parents often perceive that vaccination may encourage early sexual activity, although this is not the case. We explain that the vaccine is given now, and the protection will be effective in the future — even after 20 years.
— What arguments do parents most often cite when refusing vaccination?
— The main reasons are a lack of information, fears, and biases. Parents sometimes say: "I am against vaccinations in general," or refuse for religious reasons. Some prefer to postpone vaccination until the age of 18, not realizing that the effectiveness of the vaccine is higher at a younger age.
— Do you think parents' reactions would change if the vaccine were called "cervical cancer vaccine" instead of "HPV vaccine"?
— Perhaps. The word "cancer" carries more responsibility, rather than shame, as in the case with HPV. The paradox is that the papillomavirus is one of the main causes of cervical cancer, but it is the name and associations that prevent parents from making the decision to vaccinate and protect their children. My daughter is vaccinated against HPV, and the daughters of my relatives have also received complete and reliable information.
— Do you often encounter the consequences of HPV in your practice?
— Almost daily. Recently, a 35-year-old woman came for a routine check-up. Tests showed severe dysplasia and the presence of a high-risk oncogenic virus. In another case, a 43-year-old patient, who had not seen a gynecologist for several years, believed that "if there is no pain, there are no problems." When she experienced bleeding, an examination revealed significant changes in the cervix. Most oncological processes develop painlessly, so cervical cancer often goes unnoticed for a long time.
— Why is vaccination recommended for ages 9 to 14?
— At this age, the immune response is most pronounced. The vaccine creates a protective barrier before infection with the virus. This approach to prevention implies that protection comes first, and then the risk. Additionally, children require only two doses of the vaccine with a six-month interval, while adults need three.
In many countries, HPV vaccination is part of national programs.
For example, Australia was one of the first to start mass vaccination of adolescents and has already recorded a decrease in cases of dysplasia and precancerous changes in young women.
It is worth noting that vaccination is recommended not only for girls but also for boys. HPV is also dangerous for men, as it can cause cancer of the anal canal, penis, as well as anogenital warts. Men can be both carriers and affected individuals.
— If a girl is already 16 years old and she did not enter the free program, is it possible to get vaccinated for a fee?
— Yes, vaccination is available at any age, preferably before the onset of sexual activity. In private clinics, the cost starts from $250-300 per dose. There are different types of vaccines that differ in the number of virus types they protect against.
For example, "Gardasil-4" protects against the most common types of HPV — 6 and 11 (low risk, causing warts) and 16 and 18 (high risk, leading to cancer). Its cost is about 17,000 soms per dose.
"Gardasil-9" protects against nine types of the virus, including additional high-oncogenic types, and costs about 25,000 soms per dose. There are also other types of HPV (1, 2, 3, 4, 5) that cause skin growths but do not lead to tumors.
— Are there any side effects of the vaccine?
— The vaccine has been thoroughly studied and is considered safe. Side effects are more often related not to the drug itself but to the injection: pain at the injection site, redness, weakness, headache, and sometimes a slight increase in temperature.
— How should one communicate with parents who doubt the necessity of vaccination?
— First of all, it is important to provide them with reliable information. Fear is a natural reaction when it comes to a child's health. It is necessary to explain that vaccination against HPV is not a matter of early sexual behavior, but a method of prevention, and at the moment it is the most effective method.
It is important to remember that many countries around the world have been using this vaccine for many years, its safety is confirmed by large studies and the experience of millions of vaccinated adolescents.
Cholpon Abdilova
It should also be taken into account that it is impossible to fully control the future circumstances of a child's life. Even if you are confident in your upbringing and values, you cannot predict what partner a person will encounter in adulthood. HPV can be transmitted even in marriage, and the presence of the virus is not related to a person's moral qualities.
When vaccination begins, many parents come to me for consultation. I urge them not to be afraid and to trust medicine, explaining that the vaccine is a great investment in the health of their daughters.
