Should My Young Daughter Get the HPV Vaccination?
As the parent of a teenage or preteen girl, you may well be aware of the controversy surrounding the relatively recent release of the vaccine Gardasil. Gardasil helps to protect girls against the strains of an STD known as the human papillomavirus (HPV), which causes 70% of cervical cancer and 90% of genital warts. The CDC reports that over 80% of women will contract HPV by the age of 50. Therefore, it has recommended vaccination with Gardasil for all girls aged 11 or 12; Gardasil is also recommended as a catch-up vaccination for all girls between ages 13 and 26. Furthermore, many states are considering making Gardasil vaccination for girls mandatory for school attendance. Find out what you need to know about Gardasil in order to make the decision about whether to have your daughter vaccinated.
Since the 1980s, sexually transmitted diseases (STDs) have become an increasingly publicized health concern in America. With the advent of HIV and AIDS, sex has become a very risky business. STDs can cause many health problems -- anything from itchiness, to genital warts, to cervical cancer, to death. In spite of the skyrocketing rates of STD infections, many people are still having premarital sex -- and the majority of these people are teenagers. Adolescents are at greater risk of contracting STDs than adults, for a variety of reasons. Thankfully, science is continually making advances on this front: new methods of STD prevention, detection, and treatment are constantly being developed. One relatively new development in STD prevention is Gardasil.In 2006 the FDA approved the release of Gardasil to the public. In tests, nearly 100% of participants vaccinated with Gardasil remained free of the types of HPV covered by the vaccine. This is an astounding statistic, and you may well be asking yourself, "Why then has there been so much debate about Gardasil?"
In part, the answer is simply that with every new vaccine, both old and new concerns are unearthed. When the polio vaccine became available in the 1950s, many parents worried that the vaccine would infect their children with the disease, instead of preventing it. This is because many vaccines, including the oral polio vaccine used at that time (OPV), contain live specimens of the virus they are intended to prevent. The risk of actually developing a disease from its live vaccine is relatively small, but it's still a risk.
When Gardasil emerged in the public market, this old fear was dredged up. However, Gardasil does not contain live HPV. In fact, it doesn't even contain inactivated (dead) HPV, so the risk of contracting the disease from the vaccine is 0%. Of course, Gardasil, like every vaccine, can produce negative side effects. The FDA reports that the most common side effect of the vaccination is soreness at the injection site. Some cases of fever, dizziness, nausea, and diarrhea have also been reported. You can judge for yourself whether the medical risks of Gardasil outweigh its benefits. But the CDC, which tests all vaccines and weighs the costs and benefits of each, has given Gardasil a hearty nod of approval.
Another concern that some have expressed about Gardasil is that it will lull young women into a false sense of security. Medicine has come a long way towards reducing the death toll of cervical cancer. Gardasil is another step in this same happy direction. However, Gardasil does not prevent 100% of all cases of cervical cancer, since cervical cancer is not always caused by the strains of HPV prevented by the vaccine. It is therefore vital that young women who have received the vaccine continue to see their gynecologist for PAP screenings, so that cervical cancer will be detected in its early stages. When the disease is detected early, the five-year survival rate for cervical cancer is now 90% in America (CDC). No one should consider herself safe from cervical cancer because she has received the Gardasil vaccination. However, as long as you make it clear to your daughter that she must continue to be concerned about developing cervical cancer -- and therefore must continue to see her gynecologist regularly -- Gardasil is one way to reduce her risk by 70%.
The final and perhaps most vocalized concern about Gardasil is that it will lead more young people to have sex too early. This is the same concern that has continually been voiced about making condoms and other prophylactics available to young people. The fear is that protecting a teenage girl against the most dangerous strains of HPV via Gardasil will make her more likely to have sex outside of marriage or before she is mature enough, because she won't have to fear the possible consequences. To help you decide whether this argument should carry any weight in your decision-making, consider these points:
- Will the danger of contracting HPV prevent my daughter from having sex? The National Center for Health Statistics reports that in 2002, 46% of never-married women between the ages of 15 and 19 had had sex. At that time, Gardasil was not available, and therefore all of those women were at risk for contracting HPV. So for 46% of teenage women, fear of HPV and other STDs was not enough of a deterrent to prevent them from having premarital sex. Still, it is possible that even more teenage girls would have had sex if Gardasil had been available and they didn't need to fear infection.
- If your daughter does decide not to have premarital sex, could she still be at risk for contracting HPV and, in turn, cervical cancer? The possibility exists that she might be forced to have sexual contact against her will. The CDC reports that one out of every six adult women has been a victim of rape. If your daughter is raped or otherwise sexually assaulted, she could contract cervical-cancer-causing HPV from her attacker.
- A woman can also contract HPV from her husband, because there is currently no HPV test to determine whether a man is infected. Most infected men don't even show symptoms of HPV, though they can still pass on the infection. To date the FDA has not licensed the administration of Gardasil to women over the age of 26, since it has not been sufficiently tested beyond that age range. Although some physicians will administer the vaccine to older women if asked, once your daughter is older than 26, it will be harder for her to get vaccinated.
For more information on HPV and the Gardasil vaccine, see the CDC's publications.
