Health & Fitness

HPV vaccine: mandatory or not?; chronic sinusitis

Q: My daughter’s school advocates her getting an HPV vaccine. She is only 12 and infection with HPV isn’t really an issue for her, is it? -- Miriam P., Portland, Oregon

A: Your daughter is just the right age (11 to 12) to be vaccinated against several deadly cancers and genital warts. So, be a high-information parent: Understand that the HPV (human papilloma virus) vaccine is most effective for preteens, boys included, because their bodies produce a stronger immune response to the deactivated HPV strains in the vaccine. That maximizes protection against the virus and the cancers it can cause. Also, the vaccine has been studied extensively. It’s been shown to have no serious side effects, and the benefits outpace the risks by at least 40,000 to 1!

But unfortunately those stats haven’t helped many parents truly understand how important this is. A new survey of 1,501 parents of 11- to 17-year-old kids found that only 21 percent of them thought laws requiring HPV vaccination for school attendance “are a good idea”; 54 percent disagreed. But if there were a provision to opt out of the vaccination, the numbers flip-flop; 54 percent of parents said OK while only 21 percent disagreed. Clearly many parents would choose to opt out.

We want to help you understand that the vaccine is a life-long gift of protection. There are three approved vaccines: They all help prevent infection by HPV-16 and HPV-18, which cause about 70 percent of cervical cancers and pre-cancers, as well as many cancers of the anus, penis, vulva, vagina and throat. One also helps prevent infection with HPV-6 and HPV-11, which cause most genital warts. Another protects against nine strains of HPV and about 90 percent of cervical cancers, as well as vaginal, vulvar, anal, penile and throat cancers.

If you had cervical cancer and you knew your parents could have vaccinated you against it when you were 12, but they just didn’t; how would you feel about that?

Q: I have chronic sinus pain and a stuffy nose. It’s not a cold. It’s not allergies. What could be going on? -- George F., Williamsport, Pennsylvania

A: We know chronic sinus problems can be debilitating and frustrating. For an official diagnosis of chronic rhinosinusitis (that’s a more precise term for sinusitis, since it usually involves the sinuses and the nasal passages), the condition has to persist for 12 or more weeks and have symptoms such as nasal or post-nasal discolored discharge; difficulty breathing through your nose; pain, tenderness and swelling around the eyes, cheeks, nose or forehead; and a reduced sense of smell.

Over 30 million Americans have been diagnosed with chronic sinusitis, and they’re often not treated effectively. Research published in the Journal of the American Academy of Otolaryngology -- Head and Neck Surgery found that in Canada only about 20 percent of patients were given intranasal corticosteroids, the recommended treatment. In the U.S., the understanding that antibiotics are not the go-to solution is recent; about 20 percent of all antibiotics prescribed to adults are for sinusitis!

Turns out inflammation, not infection, is the main cause of your woes. But your doctor should also check for nasal polyps and ask if you have asthma, cystic fibrosis or other medical conditions that may influence your rhinosinusitis and treatment. Also, discuss environmental factors that could be triggering your symptoms. Air pollution, allergies, chemicals in your work environment can cause an inflammatory response. In your area of Pennsylvania, there’s extensive “fracking” going on, and a new study by the Johns Hopkins Bloomberg School of Public Health found that 24 percent of folks who have the greatest exposure to active, fracked natural gas wells had chronic rhinosinusitis (plus migraine headaches and severe fatigue). If you do identify environmental triggers, talk to your doctor about how to reduce your exposure. And use nasal saline irrigation, intranasal corticosteroids or both to manage your symptoms effectively.

Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at youdocsdaily(at sign)sharecare.com.

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