Too much information? Birds, bees and HPV

Alexander has had frank discussions with his own daughters, ages 14 and 17, about the consequences of HPV.

“You can get three doses of the vaccine,” he tells them. Or, he says, they might eventually have to deal with a colposcopy — close examination of abnormal cells in the cervix that can be caused by HPV and that often require a biopsy. He also explains various treatments for cervical cancer.

“It’s your body,” he tells his daughters. “The decision is yours.”   Alexander and others concede, however, that deciding how much to tell preteens is trickier, even for parents who feel like they have good communication with their children.

Karen Hales, mother of an 11-year-old girl in Slidell, La., is one of those.

“She’s a pretty aware child and asks a lot of questions,” Hales says of discussions she and her daughter, now a seventh-grader, have had about sex. “It’s never been that sit-down talk that you dread. It’s kind of been natural.”

Even so, while she plans to have her daughter vaccinated for HPV in January when the shots will be available at their clinic, she’s still wondering how to broach the subject. Most likely, she says, she’ll handle the part about cancer prevention. “And our pediatrician will manage the rest with me in room,” she says.

Doctors say parents often think their daughters don’t need the vaccine because they’re not sexually active. While he wholeheartedly encourages abstinence, Alexander reminds parents that the vaccine is a preventive measure that should be given early — so even if teens aren’t sexually active now, the inoculations guard against future problems.

Biggest vaccine since measles
“It’s a little bit like putting money in the college fund. You don’t put money in the bank when they’re already in college,” says Alexander, who also believes the HPV series of shots is “the most important vaccine to come along since the measles vaccine, in terms of the misery it will prevent.”

Susan Rosenthal, a pediatric psychologist at the University of Texas Medical Branch at Galveston, says several surveys have found that parents’ most frequent concerns are with the seriousness of the illness and whether the vaccine works. “They’re much less concerned how the infection is transmitted,” she says.

But, Rosenthal believes, parents should still explain how genital HPV is contracted. To that end, she favors the so-called “apprenticeship model,” encouraging parents to let teens make increasingly independent decisions about their health as they get older.

“You meet the kid where they are in terms of what information they’re ready for,” Rosenthal says. Deciding whether to fully explain the HPV vaccine to an 11- or 12-year-old girl, for instance, may depend on whether she is menstruating or showing other signs of puberty.

Rosenthal says a parent might begin by saying, “This is a vaccine for a disease that you can get in your vagina or your cervix. If you get it, it can cause warts and sometimes it can cause cancer.”

“If they ask, 'How does it get to your vagina?’ then you explain that,” Rosenthal adds. “It’s a great time to talk about sexuality — to demystify the pap smear and talk about reproductive health.”

Back in Indiana, Amanda Zaborowski is getting set for the second of three shots this fall and has been telling her friends about HPV and the vaccine.

“Most of them have never heard of it,” she says.

She and her mom hope parents and teachers will help them learn more.

“If you inform them,” her mom says, “they understand the consequences.”

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