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It’s Time to Take the HPV Vaccine Seriously

February 23, 2016 by Kelley Leave a Comment

it's time to take the hp vaccine seriouslySince it became available in 2006, the vaccine against the Human Papilloma Virus (HPV) has had few passionate advocates outside medical circles, and no wonder: The vaccine was, after all, new, and therefore didn’t have an overwhelming volume of efficacy data behind it. Moreover, with so many parents still reluctant to immunize their children against diseases like measles, it would stand to reason that a good number might be skeptical of a vaccine that’s meant to protect 11 and 12-year-olds—some pre-pubescent, most sexually inactive— against an STD. “I realize it’s probably more about my squeamishness with the thought of (my daughter) becoming sexually active than the vaccination itself,” one mother told a reporter in a 2011 npr.org investigation. “It’s not the science. I think it’s my own issues around her developing sexually.”

And yet, some facts: Studies done before widespread HPV vaccination show that by the time they’re 15, nearly 10 percent of American girls are infected with HPV. By age 17, that has doubled to nearly 20 percent. And while not everyone who contracts HPV becomes very sick from it, 11,000 women in the U.S. do get HPV-related cervical cancer each year, and a growing number of men are developing head and throat cancers related to the virus. Anyone who has followed the heartbreaking story of country star Joey Feek, who’s battling end-stage cervical cancer, knows how devastating HPV-related cancer can be.

But for those who remain skeptical, some recent data shows that the HPV vaccine is not only safe, but working—and extremely well. Between 2011 and 2014, an array of large, controlled studies showed no association between the vaccine and serious side effects or adverse health problems. And just this week, data from a large, CDC-led study revealed that HPV infection rates among girls 14 to 19 years of age were 63% lower from 2009 to 2012 than before the vaccine was introduced in 2006; for women in their 20s, rates have dropped by a third.

So, even though none of us like to think about our kids becoming sexually active, much less contracting a terrible cancer, it’s time all of us with pre-teens start talking to pediatricians about the HPV vaccine. All boys and girls should get it, starting with a first dose at 11 or 12 years old, when they also get a meningitis shot and a Tdap booster. (They should get a second shot one month later, and then a third one after 6 months). Older teens who missed getting the vaccine earlier should try to get their shots by age 21 (men) and age 26 (women). According to the most recent U.S. statistics, four out of ten teen girls and six out of ten adolescent boys have not started the HPV vaccine series, and are vulnerable to cancers caused by HPV infections.

Think of it as not just an investment in the health of your own kids, but their future loved ones, too.

For more information, check out this HPV vaccine information page at the website for the Centers for Disease Control.

Photo credit: photo credit: HPV vaccine via Photo Pin, cc

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Pediatricians’ Wish List

September 23, 2014 by Kelley Leave a Comment

photo credit: byLorena.com via photopin cc

photo credit: byLorena.com via photopin cc

This is the first in a “Wish List” series in which I ask experts in different kid-related fields—medicine, education, etc.—what they really want parents to know and do better. I’d love to hear suggestions for our next Wish List expert…Kindergarten teacher? Day care worker? Dentist? Environmentalist? The possibilities are endless. Please make a suggestion here.

THE PEDIATRICIANS

Julie Kardos, M.D. and Naline Lai, M.D. are pediatricians in a busy clinic affiliated with the Children’s Hospital of Philadelphia. As fall and winter approach, and their offices fill up with sick and sniffling tykes, they share their top five wishes for patients and their families.

THEIR WISH LIST

1. Vaccinate fully, and on time. As more and more parents opt out of vaccinating or delay immunization appointments in certain pockets of the country, diseases like measles and whooping cough are cropping up again. Do your part for your kid and community by scheduling immunizations, including the flu shot or mist, on schedule. See and print out a complete schedule here.

2. Enforce bedtimes—for little kids and big kids. Too-little sleep leads to depressed kids, hyper kids, and weepy and emotional kids—regardless of their age and stage. Keep tabs and limits on media and even homework, and monitor bedtime, to make sure children get the daily sleep they need: 16-18 hours for babies, 11-12 hours for preschoolers, 10 hours for school-age children, and 9-10 hours for teens. For sleep guidelines and tips from the CDC, see here.

3. Trust yourself. Teachers, day care workers, and even doctors are all capable of “over-calling” or “under-calling” conditions in kids. You know your child best: If you think he is sick, push your physicians for answers; if she seems fine even though someone—the school, a grandparent—insists something is “wrong,” listen to your gut.

4. Teach your children to seek you for comfort. It’s tempting to shove an iPad or a lollipop in front of children when they are scared or uncomfortable, at a doctor’s office or elsewhere. Distraction when necessary—like pulling out a splinter—is okay, but after the deed is done, shower your child with the kisses, hugs, and words that only human interaction can provide.

5. Be careful about sending mixed messages. If you want your child to eat better, make sure you’re eating well. Same goes for exercise, fighting fair, hand washing, and any number of things. Kids notice more than you think; make sure you are role modeling the behavior you want to see in them.

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Surprising Cause of Skipped Vaccines

August 21, 2014 by Kelley Leave a Comment

You’ve probably read that certain vaccine-preventable diseases like measles and whooping cough are making a comeback. (The first four months of 2014 saw more measles cases than in any year since 1996.) Breakouts tend to be focused in communities where there are large pockets of parents who choose against immunizing or delay it, out of religious or personal beliefs (like that shots trigger autism, despite rigorous research showing otherwise). This “opt out” trend has gotten a lot of press lately, but there’s another, less newsworthy reason why many parents aren’t getting their kids vaccinated on time: They just haven’t gotten around to it.

Last year, a study sponsored by the Centers for Disease Control (CDC) revealed that 49% of some 300,000 toddlers in managed care programs were late on certain immunizations by their second birthday. But only about 1 in 8 of those kids were undervaccinated due to “parent choice.” Most were likely behind due to logistical issues, such as missed well visits and sickness at the time of a scheduled appointment, said researchers in a Reuters report on the study. HHK advisory board member Julie Kardos, M.D., who runs a pediatric clinic outside of Philadelphia, has seen this phenomenon—and its possible repercussions—up close. One of her patients was a four-year-old boy who was behind on his vaccines, and was hospitalized for pneumonia. Before measles was identified as the cause, he exposed an entire E.R. to the illness, which is one of the most contagious diseases there is. (As Dr. Kardos and Naline Lai, M.D. write in their Two Peds in a Pod blog,  nine out of 10 unvaccinated people get sick from exposure to measles, and are contagious before symptoms begin.)

Photo by: Dawn Huczek

Photo by: Dawn Huczek

What scares me is that this type of scenario seems pretty plausible. There are an incredible number of vaccines to keep track of now—the CDC now recommends immunizations against 16 preventable diseases, and a child could realistically have had 24 vaccines administered by age 2. Plus, many days, our family’s collective schedule seems like a deck of cards, and one false move—misplaced car keys, say—can cause everything else to topple. I can see how many parents could believe fully in the importance of vaccines, but feel they can put them off—and off, and off some more—until work slows down or Billy gets over his cold (and do toddlers ever really get over their colds before another one starts?). Even more convincing are the moms and dads who, due to multiple jobs or a lack of easy transportation, feel like they literally can’t get their child to the doctor’s office, despite their best intentions.

The thing is, every single person in the community is responsible for keeping vaccine-preventable diseases at bay. When even just around 10% of kids miss a vaccine against certain illnesses, so-called “herd immunity” against that bug is compromised, and something as minor as one undervaccinated child’s exposure to an infected person in an airplane, mall or doctor’s office can cause an illness to seep into a community. (I wrote more extensively on this topic in a Parents magazine article a couple years ago.) And these vaccine-preventable illnesses are no joke: Measles, for instance, can not only cause pneumonia, but encephalitis, which can lead to permanent brain damage. Keeping on track with vaccines is key, and especially when your child is young, says Dr. Kardos. For toddlers and preschoolers, shots are numerous and frequent not because doctor’s want to torture them (or us), but because their growing immune systems are more vulnerable to illness.

Dr. Kardos suggests printing out the CDC immunization schedule (filter by your child’s age and your favorite format—even tri-fold!— here) and keeping it on your ‘fridge or bulletin board or in your wallet. There are also some new apps for your phone that can help you keep track. (I like Vaccines on the Go, an app put by the Vaccine Education Center at Children’s Hospital of Philadelphia). In most cases, doctors will remind you what vaccines your child needs once you show up to a well visit, but knowing the schedule in advance can help remind you just how important those regular visits are. It can also prompt you to pack a favorite book, lovey, or my personal savior, lollipop, in your diaper or tote bag when you know it’s going to be a “special” day at the doc’s office. Vaccines can be a pain—literally and otherwise—but few things you can do for your kid and community are more important.

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