By Guest Blogger Betsy Armentrout, MD, Wake Forest Baptist Health – Ford, Simpson, Lively and Rice Pediatrics

Just before I sat down to write this article, I read an email briefing from the American Academy of Pediatrics that Pinterest is changing its search engine feature to help more accurate information come to the top when people search on vaccine safety. This is great news, but also eye-opening to me that Pinterest is used as a source of vaccine information. Like most people, I also turn to the internet when I need information about nearly any subject. We all recognize that there is really good information out there, and mostly all recognize that there is also really bad or misleading information. I encounter this often when I talk with adolescents and their parents about vaccines, especially the HPV vaccine (also known as Gardasil or Cervarix).

To start with some background information, the Gardasil vaccine was approved for use in the US in 2006. HPV is the most common sexually transmitted infection in the United States and is most often acquired soon after initiating sexual activity. Currently about 79 million Americans are infected with HPV and there are more than 14 million new infections annually. Every year, approximately 34,000 women and men are affected by cancers caused by HPV. Because HPV-related cancers usually develop over many years, it will be in the next several decades that we will see the greatest impact of the vaccine on the reduction in HPV-related cancers. We already have research involving nearly 74,000 women that shows a decline in cervical precancer from 164 in 10,000 unvaccinated women to only 2 in 10,000 vaccinated women. (Cochrane Database of Systemic Reviews, 2018, Issue 5)

So what makes people hesitant when it comes to HPV vaccine? I’m not always sure, but I have some ideas.

  • HPV is a sexually transmitted infection. As parents of young adolescents, we aren’t very comfortable thinking about them becoming sexually active. This puts us in a place of unease and perhaps less receptive to the information about this vaccine.
  • Some parents fear that a teen who receives the HPV vaccine is more likely to initiate sexual activity or have unsafe practices. Fortunately, this has been well-studied and is simply not true.
  • The HPV vaccine is a series, which means that a young person receives the vaccine 2-3 times (depending on age of first shot) over about a year’s time. Any event that occurs around the time of that vaccine, such as a fever, a rash, a new onset of diabetes, a car accident, etc., may seem associated with the vaccine. A tetanus shot occurs once every 10 years so the chance of associating a potentially unrelated event with that shot is much lower.

When a patient or parent reports a health problem that occurs near the time of a vaccine, it is reported as an “adverse event.” We are fortunate to have a well-established Vaccine Adverse Event Reporting System ( to track and monitor these events from the millions of vaccines that are administered yearly. Serious and life-threatening reactions to vaccines do rarely occur and fortunately the rate is less than 1 in one million vaccines. I will never argue that a vaccine has absolutely no risk, but I feel strongly that our vaccines are safe and save lives.

I have been practicing pediatrics for nearly 20 years. I’m not sure that I’ll ever be an expert, but I do have expertise in some areas. I hope that parents and patients will ask me questions about what they read and hear about vaccine safety so they can make well-informed decisions. I hope they will be open to my recommendations on good websites and sources of information that are based on rigorous studies. My favorite question regarding the HPV vaccine is, “what did you do with your children?” My answer is that both of my sons received the HPV vaccine series at the recommended age of 11-12. Every pediatrician in my office with teen-aged children has the same answer.

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