Australia's HPV Vaccine Program Could Eliminate Cervical Cancer. Why Can't the US Do the Same?

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Experts say unjustified fears over side effects and sexual activity are keeping some parents in the U.S. from getting their children vaccinated.

Experts say girls and boys should receive their first dose of HPV vaccine by age 12. Getty Images

Australia is on the verge of eliminating human papillomavirus (HPV) and, in turn, virtually eliminating cervical cancer cases.

This is not a platitude or a far-fetched goal. It’s happening.

In 2007, Australia began providing the HPV vaccine for free to girls ages 12 and 13. In 2013, they extended the program to boys.

As a result, the HPV rate among women ages 18 to 24 dropped from 22 percent to 1 percent between 2005 and 2015.

In the next two years, cases of HPV in Australia will be “rare” and “will gradually disappear altogether over the next 50 years,” predicted Dr. Ian Frazer, an immunologist and professor best known for co-inventing the base technology behind the HPV vaccines.

Frazer is confident that, if used globally, these vaccines (Cervarix, Gardasil, Gardasil 9) will “result in the total disappearance of HPV and HPV-associated diseases.”

HPV causes 99 percent of all cervical cancer cases. HPV can also precede oral, anal, or penile cancer.

In December, the Australian government introduced a new advanced screening test for cervical cancer.

This is leading to predictions that cervical cancer cases in Australia will drop to a mere handful in the coming decades.

So, given the seriousness of the disease and the success rate of the Australian vaccine program, why are only about two-thirds of teen girls and one-half of teens boys in the United States vaccinated?

Immunization is the main way to prevent HPV, but in the United States, parents have to pay for the shots. The vaccine is also optional, not mandatory.

Those factors, paired with the stigma around HPV vaccines, means many parents in the United States opt not to immunize their teens.

Frazer clears up the controversy around the safety of the HPV vaccines, stating the only known side effects are a mild fever or local pain for 24 to 48 hours. This affects 30 percent of vaccinated girls and boys.

“One in a million have an allergic reaction to the vaccine that requires treatment,” Frazer said.

“There are many people claiming that their child has developed a disease following vaccination,” he continued. “However, the studies show that these diseases are no more common now after vaccination than they were before the vaccine programs started.”

Dr. Nanette Santoro, a professor and chair of obstetrics and gynecology at the University of Colorado School of Medicine, agrees.

“There is a world of alternative facts coming from the anti-vaxxers who have promulgated false stories about harm from the vaccine that has been blown up way out of proportion and gets used as justification for parents not to vaccinate their kids,” she told Healthline.

But what’s the root of parents not wanting to vaccinate?

Santoro dives into another layer of stigma, unraveling the stories that hold the United States back in their efforts to eradicate HPV.

“Many [American] parents wrongly feel that giving their child the HPV vaccine is tantamount to giving them ‘permission’ to have sex,” she said. “Countries who are having great success with HPV vaccines are giving it to young girls as part of their pediatric vaccine series. No drama there.”

Santoro says in order for the United States to see similar success, “it requires acceptance by parents of young children that their adorable little girl (and now it is recommended for boys) is a sexual being. This seems to be much less of a problem for Europeans and Australians.”

In Frazer’s view, the United States could model Australia’s success, but “there would need to be agreement between state and federal government about funding and a philosophical change about how healthcare might be delivered through public facilities (schools).”

According to Santoro, “HPV is essentially ubiquitous. It is everywhere… Given how common the virus is and how readily it spreads, the likelihood of seropositivity at some point for a sexually active teen is nearly 100 percent.”

Some HPV infections cause warts, but not all infections are detectable. Someone could contract the virus — and transmit it — and not even know.

Both parties are then at greater risk of developing certain types of cancers.

If you think your teen is safe because they aren’t sexually active, think again.

Santoro says that although many parents and educators believe teens shouldn’t be sexually active, “[Teens] are not listening to us, and 75 percent of them have sex before they turn 20.”

Immunization is protection, and it has other benefits as well.

Santoro says vaccinating against HPV has also resulted in reduced rates of cervical, anal, and oral cancers.

“The possibility of eliminating cervical cancer in the not-too-distant future is an astounding medical achievement,” she said. “The drop in oral and anal cancer is a bonus that has led scientists to understand that HPV is likely playing an even larger-than-expected role in causing these types of cancers.”

Dr. Cynthia Leifer, associate professor in the department of microbiology and immunology at Cornell University, says that “no matter what parents do, and regardless of whether a teen or young adult engages in risky behavior, every child has an 80 percent chance of getting HPV in their lifetime. Since HPV can cause cancer, eliminating HPV infection with the vaccine prevents cancer and saves lives.”

Leifer shares a few more key points:

  • Boys can pass the virus to girls, so vaccination for all teens is important.
  • Parents should start talking to their children about the vaccine by age 10 or 11. Around age 10, children begin hearing about sex and sexuality in school, and should be aware a vaccine exists to protect them when they’re older.
  • Boys and girls around age 11 or 12 should receive their first dose of the HPV vaccine. Only one booster is needed, six months after the initial vaccine.
  • If you wait to vaccinate until age 13 or 14, teens will require two boosters for full protection.
  • Parents should explain that HPV is transmitted during sexual contact, so it’s a good idea to abstain from sex, including oral sex, and to use a latex condom if they do engage in sexual activity.

HPV is preventable and eradicable.

Protecting people from this widespread disease and its resulting cancers means educating them early on and immunizing them in their teen years.

Experts say the United States can model Australia’s success by destigmatizing the vaccines, funding them, and making them mandatory for all children alongside other life-saving vaccines.

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