Vaccinating Your Preteen: Addressing Common Concerns

As a parent, you may have questions about vaccines for your preteen. Below are frequently asked questions and answers you need from the American Academy of Pediatrics (AAP) to be confident about your decision to vaccinate.

HPV Vaccine Parent FAQs

Why is the HPV vaccine recommended at such a young age?

• The HPV vaccine is more effective if given sooner rather than later. This is partly because pre-teens produce more antibody after HPV vaccination than older teens do.  This is why younger adolescents need fewer HPV vaccine doses than older teens need to get the same protection.

• For teens who start the series before their 15th birthday, the HPV vaccine is now approved as a 2-dose series. The doses should be given 6 to 12 months apart.

• If the vaccine is started at age 15 or later, a 3-dose series of HPV vaccine is given (over a six-month period) for adequate protection.
  

Why does my son need HPV vaccine if it protects against cervical cancer?

• The most common cancer caused by HPV is cancer of the mouth and throat. This HPV cancer is more common in males than females.

• HPV vaccine can prevent other HPV-caused problems such as cancers of the penis and anus, and genital warts.

• HPV vaccine does prevent cervical pre-cancer and cancer in females. A preteen boy who receives HPV vaccine can protect his future spouse. When grown, a man who is infected and doesn't know it (there are usually no symptoms) can spread HPV to his partner.

If my child is not sexually active, why is the HPV vaccine needed?

• If we wait to vaccinate until someone is sexually active, the vaccine won't work as well.  Vaccines only work if given before someone is exposed to a virus. People may be infected with HPV without having sex outside marriage. They may be exposed to the virus during intimate touching or from intercourse during marriage. The HPV vaccine seems to last a lifetime—so it can never be too early to vaccinate, only too late. In short, the vaccine is recommended when it is most effective. Why wait?
  

Is HPV common enough to warrant vaccination of all young people?

• Studies show that 50-80% of people test positive for HPV within 2-3 years of the first time they engaged in sexual activity, making it important that preteens receive the full series before first sexual activity. The Centers for Disease Control and Prevention (CDC) reports that as many as 64% of teen or preteen girls may be infected with HPV, and 75% of new cases of HPV are found in persons age 15-24 years. Even if your child waits until he is married and or only has one partner in the future, your child could still be exposed to HPV by that partner.

Will receiving HPV vaccine give my child permission to engage in sexual activity?

• As pediatricians, we understand this concern—we want teens to be mature before sexual activity. Studies show that children who receive HPV vaccine do not have sex any earlier than those who only received other teen vaccines. This tells us that children do not see this vaccine as a license to have sex.

Don't condoms prevent the spread of HPV?

• Using condoms can prevent pregnancy and protect against several sexually transmitted infections. While condoms reduce the risk of HPV transmission, they do not eliminate the risk.  HPV can be spread by intimate skin-to-skin contact and oral sex, not just sexual intercourse. Condoms only cover a limited amount of skin and HPV can be spread even if a condom is used every t ime a person has sex. For the best protection against HPV, parents should have their children vaccinated.

FAQs About All Preteen Vaccines 

Do adolescent vaccines have serious side effects?

• Pain: Pediatricians do not like to cause discomfort to children of any age. Even though shots may hurt, getting a vaccine is not as bad as suffering from a serious disease such as meningitis or cancer. Talk with your pediatrician about ways to reduce pain during vaccination. Stroking the skin or applying pressure to the skin before the shot reduces the pain. In some offices, medication to numb the skin may be available.

• Fainting: Your pediatrician may ask your child to sit for 15 minutes after getting any shot in case your child faints (syncope). Staying seated for 15 minutes reduces the main risk from fainting -- getting hurt from falling.

• Vaccination at sick visits: Many families are busy, and it is hard to find time to visit the pediatrician's office to get a shot. It is smart to get any vaccines that are due when your child is in the pediatrician's office. This will reduce the chance that your child has to miss school, work, or other activities to receive vaccines.

• Safety: All vaccines routinely recommended for preteens have been licensed by the Food and Drug Administration and found to be safe. The safety of each vaccine continues to be checked after it is licensed. Your pediatrician can provide you with a Vaccine Information Statement that explains the mild side effects that can occur after receiving shots.
  

Why is more than one dose of vaccine needed?

• HPV vaccine: It is recommended that your child receives 2 doses of HPV vaccine between the ages of 9 and 12 for full and lasting protection. Both doses of the HPV vaccine are needed for the body to build up enough immunity to protect against infection. This is also true of many of the vaccines that babies get.

• Meningococcal vaccine: One dose of meningococcal vaccine protects a person, but immunity may decrease over time. A booster dose can "boost" immunity so that your child is still fully protected. Children should receive meningococcal vaccine as preteens to be fully protected for a few years and another dose at age 16 to boost immunity levels.

• Tdap: Recently, there have been several outbreaks of pertussis (whooping cough) throughout the United States. One study has shown that this is due, in part, to decreasing immunity. It is possible that booster doses of pertussis vaccine (in Tdap) will be recommended in the future. Studies are still underway to determine exactly when they will be needed.

What is the cost of these vaccines? I'm not sure if I can afford them or if my insurance will cover them.

• Pediatricians realize that healthcare can be costly for families. The Affordable Care Act (ACA) requires insurance companies to cover the cost of all recommended vaccines, which include those for teens and preteens. (If your insurance plan has been unchanged since March 23, 2010, it may not have to follow these new rules. If this is the case, your insurance plan may require you to pay part of the vaccination cost or meet your deductible before it will pay for vaccinations. Talk with your pediatrician about options for paying this.)

• The Vaccines for Children (VFC) Program vaccines at no cost to children.

• A child qualifies for VFC vaccine if she/he:

• Does not have health insurance,

• Has Medicaid insurance

• Has insurance that does not cover vaccines
  

• Is American Indian or Alaskan Native
  

• Most pediatricians provide VFC vaccines. Speak with your child's pediatrician to learn more about the VFC program. If your pediatrician is not a VFC provider, your child should be able to receive vaccines at your local health department. To contact your VFC coordinator click here .

Additional Information from HealthyChildren.org:

• Immunizations for Teenagers and Young Adults

• AAP Schedule of Well-Child Care Visits  

• Recommended Immunization Schedules