Dear Dr Mitchell,
Upon the advice of her father, I rejected the Human Papilloma Virus (HPV) vaccine from the school when my daughter was 13 and in grade 7. I did the same in grade 8, but now I think I made a mistake, as unfortunately, now in grade 9, and at 15, the school says she can't get it. I can't afford to get it done privately, and I've been doing a lot of reading about cervical cancer and I'm scared. My daughter has a boyfriend and she's not sexually active yet, but I fear for her future. What can I do? Is it worth it to save up and have it done privately?
The HPV vaccine is best given to boys and girls when they are aged nine to 10, and certainly before age 15. The vaccine when given at this age has been proven to be extremely effective in ensuring that they get the level of protection that is necessary when they are older and become sexually active. If given at a young age it is extremely effective in preventing cancer of the cervix, penis, throat, anus, vulva and vagina. The idea is to give the vaccine prior to any exposure to the Human Papilloma Virus.
However, young people under 30 years old have a good immune system and tend to clear themselves of the Human Papilloma Virus even if they become exposed to it. Cancer tends to be rarely found in the young population but can definitely occur.
The usual dosing schedule is two vaccinations given six months apart in boys and girls under 15 years old. In those above 15 years old, the dose is three vaccines. The first dose is given, followed by the second dose one to two months later, and the third is given six months later.
The vaccine that is currently being used in Jamaica is Cervarix. It is unfortunate that you did not seize the opportunity to have your daughter receive the vaccine for free when it was offered in school. It is extremely important for you to save and pay to have your daughter vaccinated by your gynaecologist or family doctor. She will need three doses. You should also get vaccinated if you have not already done so.
The vaccine is effective and is recommended to be given in all women up to age 65. Women throughout their sexually active life and beyond are at risk and will benefit from vaccination even if they have had HPV infections or genital warts in the past. Having the infection does not provide any lasting immunity and so vaccination is necessary to prevent reinfection from re-exposure, thus reducing the risk of cervical cancer. The Human Papilloma Virus infection is extremely common, and is present in at least 80 per cent of women even after one act of sexual activity.
The risk for cervical cancer persists even if you do not continue be sexually active. As you get older your ability to get rid of the virus decreases significantly because of a weaker immune system, hence the importance of the vaccine to protect you.
You should have a serious talk with your daughter since she has a boyfriend at age 15. The risk of human immunodeficiency virus (HIV) and other sexually transmitted infections such as syphilis, gonorrhoea and chlamydia are also significant. Remind her that she is too young to be in any serious relationship and should focus on her school work. It is also against the law in Jamaica to be sexually active under the age of 16 years, so the relationship should not be encouraged.
You should make an appointment for yourself and your daughter to see your gynaecologist who will do a proper physical examination and Pap smear for you, and advise you further about getting the HPV vaccine for you both.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to firstname.lastname@example.org; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 876-968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.