HPV vaccine is now recommended years earlier for kids with sexual abuse history, according to the updated childhood immunization schedule released on Monday by the U.S. Centers for Disease Control and Prevention.
HPV infection can cause cervical, mouth, throat and other cancers, and while it is the most prevalent sexually transmitted infection, it can also be communicated sans sexual contact.
The updated vaccine schedule recommends that the HPV vaccine be administered to children ages 9 and 10 with a history of sexual abuse. The HPV vaccine used to be recommended to girls and boys starting ages 11 to 12.
The recommendations favor the HPV-9 vaccine, which protects from nine strains of the virus.
Cody Meissner, a pediatrics professor who was part of the new schedule discussions, warned that more than 80 percent of the population will be infected with HPV at least once over their lifetime.
And sexual abuse is an important discussion in these talks, as studies estimate one in four girls — as well as one in 20 boys — will be subjected to this form of abuse before they reach 18.
Meissner said the perpetrators are usually close to and trusted by the child and their loved ones, making abuse a sensitive matter. "[B]ut we just have to get past the denial that these things don't happen to young children," he urged, adding that physicians need to be asking the appropriate sexual abuse screening questions during child visits.
These child victims have higher risk factors for STIs, due to being infected on the first assault or during continuing abuse. In addition, they are initiated into sex earlier than other kids their age.
There is also a tendency, added Meissner, for sexually abused children to have sex more frequently with a higher number of partners.
But although a third of child sexual abuse victims are younger than 9, the HPV vaccine license is for age 9 at the earliest.
Researcher Anna Giuliano, who led clinical trials for the vaccine, vouched for the staying power of the HPV vaccine based on more than 10 years of follow-up data from trials.
"When we look at how the antibodies have sustained, we anticipate the vaccine will protect out to 30 years or more post-vaccination," she said.
Yet there is a lag in vaccine uptake, partly due to some hesitation on doctors' part.
A study back in October found that many doctors passively discourage HPV vaccination.
Some factors at play include discomfort in discussing sexually transmitted disease, assumptions that parents deem the vaccine unimportant, and focusing on perceived high-risk groups instead of routinely suggesting the vaccine to everyone in the age group.
Photo: Steven Depolo | Flickr
