“You will be among the handful of women who have walked into my clinic to vaccinate their daughter for HPV (Human Papillomavirus)”, says my gynecologist Dr Nandini Devi. I realised that this conversation would stretch beyond the scheduled appointment time. We resume our conversation on a quiet Saturday afternoon.
Nandini is one among the leading gynecologists in Bangalore, and has been administering this vaccine from the time it was introduced in India. “I first vaccinated my daughters and to this day I can finger count the number of parents, who have stepped into my clinic to vaccinate their pre-teens,” she shares.
The American Academy of Pediatrics and Center for Disease Control and Prevention recommends the HPV vaccine for pre-teen boys and girls at the age of 11. However, it can be administered from the age of nine. The immune response to this vaccine is better in pre-teens. This just means better protection for our children before they are sexually active. This is not a sign that our pre-teens are ready to have sex. IT IS JUST THE OPPOSITE. It is important to get your child protected before you or your children have to think about this.
HPV is a group of viruses. HPV type is a number given to each HPV virus in this large group. “Though it is classified as STD (Sexually Transmitted Disease), it can also be transmitted through intimate skin contact between an infected and non-infected person – not just through sexual contact” clarifies Nandini.
HPV is the most common sexually transmitted infection (STI). HPV is a virus that can cause warts on any area of skin or mucous membrane – including the mouth or genital area. HPV that causes warts is not the same as the one that causes cancer. Having vaginal, anal or oral sex with an infected person spreads the virus. Anyone who is sexually active can get HPV. HPV can be transmitted even when the infected person has no symptoms.
The body fights most HPV infections naturally but some damage the cells in the infected area leading to genital warts or cancer. There is no routine screening for most HPV- related cancers for men and women. In women, regular Pap smears can detect the virus early. Early detection is important to prevent cervical cancer in women. That is why a vaccine that prevents most of these types of cancers is so important.
HPV vaccines are given as a series of three shots over six months to protect against HPV infection. HPV vaccination of boys and young men is also likely to benefit females by reducing the spread of HPV viruses.
I am intrigued as to why there is such great ignorance about this vaccine. “There is a three-fold reason for this. Our government still refuses to talk about cancer on media. Cancer caused by cigarettes and tobacco is an exception to this. Unless we speak more about the causes and symptoms, information about the vaccine will never reach the masses. Second, the disease burden reduces only to the next generation. Administering the vaccine to a 10-year-old will only reflect benefits in his/her late teens and early twenties. With a change in the leadership every five years, no ruling or non-ruling party want to invest the time and effort. Lastly, media is also responsible for the unawareness. They simply do not want to speak about an issue that has no bearings on the TRPs. Amitabh Bachchan did wonders to the Pulse Polio movement. We need the same effect and energy towards spreading the awareness of this vaccine” shares Nandini.
Most of Nandini’s patients have been women who were informed enough to ask for the vaccine or women who were counseled by her. “Every gynecologist has a social responsibility to inform her patients of preventive care available to them and their children. It is my responsibility to educate them about the benefits of this vaccine” she shares.
Nandini is honest to admit that most doctors do not want to invest the time. “Majority of my patients are unaware about the virus. When I educate them about the virus, the causes, the symptoms and the vaccine, they have too many questions. They are also apprehensive about the side effects. The vaccine is also expensive. I have to spend that extra time patiently answering their queries. Not many doctors are willing to spend that time,” she adds.
I ask her if social stigma associated to the nature of the virus was a reason that many women do not vaccinate themselves or their children. “Ignorance is the key factor. I find most of my patients making the choice to vaccinate against HPV, once they are informed about its benefits,” she shares.
Nandini however has a note of caution. “HPV vaccine needs to be stored under perfect conditions at the prescribed temperature. I ensure that the vaccines are refrigerated and there is a backup generator if there is a power outage. Most druggists shut their refrigeration at night thus making the vaccine unsafe and ineffective. Thus it is important you source your vaccine from your trusted doctor.”
‘It prevents cancer’ is a great opening line to start the conversation with your preteen. However, they do need to understand the entire gamut of the purpose of this vaccination. Young women and men are making progressive choices about intimacy early on, in life. It is the responsibility of parents to educate them about safe practices. We have to provide a comfortable platform and an open forum so our children have the confidence to approach us when they face questions about intimacy choices. This vaccination is the safety net. There is no better time to start than now.
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