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A lot of adolescent girls are not getting a vaccine recommended by the federal government. It's been two years since the government recommended that 11 or 12-year-olds get a new vaccination. It protects against HPVs, human papillomaviruses. Some HPVs contracted through sexual contact can lead to cervical cancer. The vaccine needs to be given before girls are sexually active to be effective, but only one in five girls has gotten the three HPV shots. We asked NPR's Brenda Wilson to find out why.

BRENDA WILSON: American parents have been sold on early childhood vaccinations. Up to 90 percent of children get those shots before the age of two. But Dr. Neal Halsey, a pediatrician and professor at Johns Hopkins Bloomberg School of Public Health, says adolescent vaccines are not as popular.

NEAL HALSEY: For adolescents, or even the routine booster doses of tetanus and diphtheria toxide, we were in the 50 to 60 percent range.

WILSON: And the uptake of HPV vaccine, especially for the younger adolescent girls, is less than even those booster shots, an issue that Dr. Jessica Kahn confronted as a pediatrician, research scientist, and the mother of an 11-year-old girl.

JESSICA KAHN: When I brought her into her doctor's office, I said to the pediatrician, you know, she's 11, maybe we should wait until she's 12 to get this vaccine. And so I really understand the concerns of parents who think, you know, my child is not really at risk. And I thought she's 11, she's not really at risk. The vaccine is recommended for girls 11 to 12. And my pediatrician said absolutely not, she is getting the vaccine.

WILSON: Jessica Kahn found out that other health professionals shared her inclination. When she did a survey of 10,000 mothers who are also nurses, less than half were in favor of giving an 11-year-old the vaccine, while 90 percent said they would agree to it for 15 to 18-year-olds. Neal Halsey thinks parents will eventually accept the vaccine for younger adolescents, and says there are consequences for putting it off.

HALSEY: I do think there's a problem of waiting until you know your child is sexually active, or you think they are, because then it may be too late. It's almost universal, I mean, children are sexually active some times or frequently before the parents know they're sexually active. So, I wouldn't encourage parents to wait until they're suspicious that their child might be sexually active.

WILSON: The vaccine provides no protection once a girl is exposed to the strains that cause cervical cancer. But Jessica Kahn says middle to high-income parents, like the nurses she surveyed, tend to be suspicious of the vaccine's safety.

KAHN: There has been quite a bit of coverage in the media related to adverse events caused by HPV vaccines. And in my practice I've noticed that that's impacting parents' willingness to vaccinate their daughters.

WILSON: Since 2006 there have been 21 HPV vaccine-related deaths reported to the CDC out of 60 million doses of the vaccine that have been distributed. Investigators were able to gather evidence on 12 of those deaths and concluded they were not caused by the vaccine. Neal Halsey serves as a vaccine safety adviser to the CDC and the American Academy of Pediatrics.

HALSEY: To date, my knowledge of the investigations of those rare cases that have occurred have not led to any evidence to suggest that the vaccine was causally related to those.

WILSON: He says the rate of serious allergic reactions to the HPV vaccine appears to be about one in a million. Parents in Great Britain appear to be less concerned about the vaccine's safety than in the U.S. A survey shows that up to 70 percent of parents would agree to have their young adolescent daughters get the vaccine against cervical cancer. Part of the reason may be that it is provided free of charge through the country's National Health Service. In the U.S., cost is a major obstacle if the girl is not covered by insurance. Brenda Wilson, NPR News.

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