Should my daughter get the HPV vaccine?

Decision Points focus on key medical care decisions that are important to many health problems.

Introduction

This information will help you understand your choices, whether you share in the decision-making process or rely on your doctor's recommendation.

Key points in making your decision

HPV stands for human papillomavirus. The HPV vaccine can help protect your daughter from getting the types of HPV that cause most cases of genital warts and cervical cancer. Consider the following when making your decision:

  • The National Advisory Committee on Immunization (NACI) and Health Canada recommend the vaccine for girls 9 to 13 years old, before they become sexually active. It is also recommended for females ages 14 to 26, even if they are already sexually active, have had an abnormal Pap test, or have had an HPV infection.
  • The vaccine protects against four types of HPV: two that cause cervical cancer and two that cause genital warts. There are other types of HPV virus that cause cervical cancer and genital warts, but these four types are some of the most common.
  • The best time for your daughter to get the vaccine is before she becomes sexually active. This is because the vaccine works best before there is any chance of infection with HPV. Girls who get the HPV vaccine before they are sexually active are almost totally safe from infection by the four types of HPV the vaccine guards against.
  • Having your daughter vaccinated against HPV doesn't mean that you have to talk to your daughter about sex if you are not ready. You may want to tell your daughter that this vaccine may help prevent cancer later in her life.
  • The vaccine is safe. You can't get HPV from the vaccine, and it doesn't contain mercury.

Decision Point logo - Medical Information section presents medical information in question-and-answer format. Medical Information

How do you get HPV?

HPV stands for human papillomavirus. It is spread by having sex with someone who has the virus. Infection with HPV is common, especially among young people. It is estimated that more than half of all sexually active people will get HPV.1, 2 But most women never know they have the virus, because it usually goes away on its own and may not cause any symptoms.

There are more than 100 types of human papillomavirus. But only some types of HPV lead to cervical cancer or genital warts.

  • Cervical cancer happens when HPV causes abnormal cells in the cervix, which then grow out of control. HPV can stay in your body for a long time. It can take 10 years or more for a woman to get cancer from an HPV infection. While cervical cancer in Canada is not as common as it used to be, about 1,350 Canadian women get it each year and 390 die from the disease.3
  • Genital warts may or may not cause symptoms. Even if you treat visible warts or if the warts go away without treatment, the HPV infection can stay in the body's cells. It is possible to spread genital warts to a sex partner even if there are no signs of them.

What is the HPV vaccine?

The HPV vaccine is a series of three shots that can protect your daughter from being infected with some of the most common types of the virus. The vaccine guards against four types of HPV: two that cause 70 out of 100 cases of cervical cancer and two that cause 90 out of 100 cases of genital warts.

The vaccine protects against the four types of HPV for at least 5 years. Studies are under way to see how long the vaccine will last and if a booster shot is needed after 5 years.2 A booster shot is another dose of the vaccine given after the first series of shots.

Health Canada recommends that your daughter receive all three shots. The second shot is given 2 months after the first shot. The last shot is given 4 months after the second shot.

Even if your daughter already has one type of the virus when she gets the vaccine, the vaccine should protect against the three other types of HPV that cause most cases of cervical cancer or genital warts.

Your provincial or territorial health ministry may not yet cover the cost of the HPV vaccine. You may have to pay for the vaccine yourself. The cost is about $500. Some provinces pay for the vaccine through health programs in the schools. Check with your provincial or territorial public health ministry for more information.

Studies are under way to see if the vaccine helps prevent HPV in men.2

When should your daughter get the vaccine?

The National Advisory Committee on Immunization (NACI) recommends the vaccine for girls 9 to 13 years old, before they become sexually active . It is also recommended for females age 14 to 26, even if they are already sexually active, have had an abnormal Pap test, or have had an HPV infection. The best time for your daughter to get the vaccine is before she becomes sexually active. This is because the vaccine works best before there is any chance of infection with HPV. In this case, the vaccine can prevent almost all infection by the four types of HPV the vaccine guards against.1

How do you talk to your daughter about the HPV vaccine?

Some parents may worry about talking to their young daughters about the HPV vaccine because they think it means they have to have the "sex talk." But you don't have to talk to your daughter about sex if you are not ready. Your daughter may have other vaccines between ages 10 and 12, such as a meningitis shot or a tetanus booster shot. You may want to start the HPV vaccine series when she receives these other shots. You can tell your daughter that these vaccines can help keep her healthy and prevent cancer later in her life.

If you do decide to talk to your daughter about HPV and the vaccine, it doesn't mean you are giving your child permission to have sex. It is a chance to teach your daughter about safe sex and sexually transmitted infections (STIs). This information will be very important for her when she is older and making her own choices about sex.

Is the HPV vaccine safe, and how long does it last?

The vaccine is safe. You can't get HPV from the vaccine, and it doesn't contain mercury. There are no serious side effects from the vaccine. Some people may have mild side effects such as a low-grade fever and soreness in the arm where the shot was given. But neither lasts long.

Does your daughter need to be tested for cervical cancer after getting the HPV vaccine?

Even though the HPV vaccine protects against most cervical cancers, your daughter still needs to get regular Pap tests to check for cervical cancer, starting about the time she becomes sexually active. This is because there are some types of HPV that the vaccine doesn't prevent. Pap tests look for cells that may be, or can lead to, cervical cancer. If these cells are found early and treated, you may prevent cervical cancer.

If your daughter gets the vaccine before she is sexually active, she does not need to be tested for cervical cancer before she gets the HPV vaccine.

If you need more information, see the topic Immunizations.

Decision Point logo - Your Information section helps you decide about your personal comfort level and preferences about the decision. Your Information

Your choices are:

  • Have your daughter get the HPV vaccine.
  • Do not have your daughter get the HPV vaccine.

The decision whether to have your daughter get the HPV vaccine takes into account your personal feelings and the medical facts.

Deciding about the HPV vaccine

Reasons to have your daughter get the HPV vaccine

Reasons to not have your daughter get the HPV vaccine

  • The vaccine is recommended for girls 9 to 13 years old . The vaccine is also recommended for females ages 14 to 26, even if they are already sexually active, have had an abnormal Pap test, or have had an HPV infection.
  • You want to protect your daughter against cervical cancer and genital warts later in life.
  • The vaccine is safe and has no serious side effects.
  • You want your daughter to be protected against HPV before she becomes sexually active.

Are there other reasons you might want your daughter to get the vaccine?

  • The vaccine is very new, and you want to wait to see if there are any problems from it over time.
  • You don't believe in vaccines.

Are there other reasons you might not want your daughter to get the HPV vaccine?

These personal stories may help you make your decision.

Decision Point logo - Wise Health Decision section helps you understand how you are feeling about the decision. Wise Health Decision

Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about your daughter getting the HPV vaccine. Discuss the worksheet with your doctor.

Circle the answer that best applies to you.

I am comfortable talking to my daughter about a vaccine that may prevent cervical cancer in the future.YesNo Unsure
I worry that if my daughter gets the HPV vaccine, she will become sexually active. YesNoUnsure
I want to do everything I can to keep my daughter healthy, both as a child and as an adult.YesNoUnsure
I want to follow the recommendations of experts and have my daughter vaccinated.YesNoUnsure
I know women who have had HPV or cervical cancer. It is very important to me to take steps to prevent this from happening to my daughter. YesNoUnsure
I am worried about the cost of the vaccine.YesNoNA*

*NA=Not applicable

Use the following space to list any other important concerns you have about this decision.

 

 

 

 

 

What is your overall impression?

Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to have or not have your daughter get the HPV vaccine.

Check the box below that represents your overall impression about your decision.

Leaning toward having my daughter get the HPV vaccine

 

Leaning toward NOT having my daughter get the HPV vaccine

     

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Author: Carrie Henley
Robin Parks, MS
Last Updated: August 14, 2007
Medical Review: Joy Melnikow, MD, MPH - Family Medicine
Tom Bailey, MD - Family Medicine
Jeanne Marrazzo, MD, MPH - Infectious Disease

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