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A Very Awkward Conversation (HPV)


20 years from now - 

Adult Child, late 30s: Mom, Dad I have throat cancer.

Parent:  How could this happen?  You are so healthy.  What can we do?

Adult Child:  The doctors told me the cancer was caused by the HPV virus that I got from dating.

Parent:  But you were a “good kid”, you only dated a few people in high school and you have been married now for 10 years.  This shouldn’t have happened to you.

Adult Child:  They told me most people with HPV don’t know they have it, and it can be transmitted through saliva and close contact.  They also said it is very common, so most adults are exposed at some point.  

Parent: Ohh

Adult Child:  They also asked me if I ever had my HPV vaccines?  They said those vaccines would have reduced my risk of getting this type of cancer by over 80%, maybe even 90%.  Did I ever get that shot?

Parent: No, we didn’t believe in it.

Adult Child:  Wait, what? They had a shot that could stop me from getting a horrible form of cancer from a virus, a virus I could catch by doing normal social activities, and you said no?  I have a good chance of dying because you didn’t want to listen to the doctors that were trying to save future lives.  Why?


I know this conversation will happen in the future between some of my patients and their parents.  Even thinking of it breaks my heart, because I know when this conversation happens that somehow, I failed these kids by not being able to convince their parents to do something so easy, so low risk, so strongly backed by science, that it should have been a no brainer.  But why do I have a difficult time convincing a small percentage of my patients to get this vaccine?  Parents will come in to get their child’s “sixth grade shots” and tell me they are fine getting the meningitis vaccine and the tetanus/pertussis/diptheria shots that are required by the school, but not the HPV one.


What does having the school require it, make it more acceptable to a parent than when it isn’t required?  The school's requirements help prevent disease outbreaks that can happen while your child is still in school.  If a measles or meningitis outbreak happens at the school, we will know immediately how it started.  But what about an outbreak of HPV that spreads through the upperclassman, and luckily most of the students clear the virus but 1-2 develop cancer 20 years later?  Doesn’t that still matter?


Let's look at how many deaths in the US yearly from the illnesses that the “sixth grade shots” prevent.

Diphtheria        0 deaths in the US in 2022

Tetanus    7 deaths in the US in 2019

Pertussis 10 deaths in the US in 2019

Meningitis 210 cases in the US in 2021, 10% of those died


Why are these numbers so low?  Because our vaccines are so effective.  But we haven’t had this level of success yet with HPV because parents are more reluctant to get it, for reasons that are unproven, and usually from their “research on google” where anyone can write anything, much of which is completely false.  HPV vaccine doesn’t cause infertility, it doesn’t stunt your child’s growth, it doesn’t cause your child to have sex at an early age, etc.


What are the facts about HPV?

CDC reports estimates that 42 million Americans currently have HPV

From the CDC website (https://www.cdc.gov/cancer/hpv/statistics/index.htm)  “In general, HPV is thought to be responsible for more than 90% of anal and cervical cancers, about 70% of vaginal and vulvar cancers, and more than 60% of penile cancers. Oropharyngeal cancers traditionally have been caused by tobacco and alcohol, but recent studies show that about 70% of cancers of the oropharynx may be linked to HPV.”


So how many of these cancers are caused by HPV per year?

Again, from the CDC website “Each year, about 47,199 new cases of cancer are found in parts of the body where human papillomavirus (HPV) is often found. HPV causes about 37,300 of these cancers.”


How many of these cancers can be prevented with the HPV vaccine?

92% according to the CDC, but only 51% of our teens are protected.  So the awkward conversation I started this article with will be a common occurrence in about 10 years when these cancers start happening routinely, in a generation of adults that could have been protected.  That is a tragedy, and as a parent, something I don’t want to be responsible for my kids.  


This article wasn’t as fun as others, and I apologize.  But, if it convinces one of you to protect your child and they don’t get a cancer that shortens their life significantly, it will have been well worth it!


Until next time, good luck parenting, 

Dr. William Fisher, MD


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