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Should you vaccinate your teen daughter for HPV/cervical cancer with Gardasil?
Results so far:
| No | 43% | 270 votes | Total: 630 votes | |
| Yes | 57% | 360 votes |
No
by Alicia M Prater PhD
Created on: December 23, 2008 Last Updated: December 24, 2008
In general, vaccinations maintain public health by keeping disease at bay. There a number of childhood vaccines that, barring pediatric immunity disorders, have only rare and mild side effects with great benefit to the general well-being of the population.
Gardasil, Merck's cervical cancer vaccine is being marketed as a personal health issue, which it isn't. Vaccines are a public health issue, something that benefits the populace as opposed to individuals, who have to deal with side effects and adverse events, even if rare. Another issue with the assumption that Gardasil is a traditional vaccine is that it does not prevent an infection, it prevents the development of a secondary, or associated, disorder.
Some strains of human papilloma virus (HPV) have been associated with the development of cervical cancer after persistent infection and re-infection. According to Brazilian studies among promiscuous women, persistent infection only occurs in approximately 5% of women, and exposure does not usually occur until a woman's 20s. Meanwhile, according to the American Cancer Society, the average age of women with cervical cancer is the mid-40s, with most being over the age of 65.
In addition, cancer development occurs in a two-hit model. There must be two alterations in the genetic makeup of the human cells, either genetic or environmental, to result in cancer. The virus offers one possible environmental explanation to work in concert with genetic predisposition to the disease. The only women who would truly benefit from the vaccine are those who have a genetic predisposition to cervical cancer.
However, the human body usually clears HPV without incidence and, based on the FDA information for the drug, Gardasil does not prevent HPV infection, only the development of cervical cancer in women followed for 2 years after vaccination. Also, the vaccine is only likely good for 4-5 years (long-term testing is still needed), leaving a woman unprotected after the age of 26, the cutoff for vaccination and before most cancerous changes occur.
There have also been serious side effects reported in association with Gardasil vaccinations: Thousands of cases of seizures and paralysis and at least 8 cases of death in girls under the age of 20 in the United States and UK. There have been no long-term tests on the effect of vaccination of reproductive health and function.
Until more research has been done on the effects and a test developed to determine the girls most at risk for developing cervical cancer, not another child should be given this vaccine. It was rushed to market with no actual benefit demonstrated, only hypothesized and extrapolated information regarding potential reductions in incidence.
When deciding to vaccinate, parents need to know that 1) Gardasil does NOT vaccinate against HPV, it is approved for the prevention of some strains of HPV-associated cervical cancer (and possibly genital warts) and 2) no long-term testing has been done to show that it is truly effective for preventing cervical cancer as adults. The FDA has all of the clinical study and approval information available online.
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Yes
by Lynn Jacobs
Created on: November 08, 2007
Approximately 3,670 women in the U.S. will die from cervical cancer by the end of this year, according to the American Cancer Society. PubMed, a service of the National Library of Medicine and the National Institutes of Health, reports that the second most common cancer in women across the globe is cervical cancer, which is caused by human papillomavirus (HPV) infection. According to the Centers for Disease Control and Prevention (CDC), there are more than 100 different types of viruses under the umbrella of HPV, all of them without a cure, and about one-third of those types cause cervical cancer.
These startling statistics should prompt us to proactive measures to not simply seek early detection of cervical cancer but to prevent it whenever possible. Regular Pap tests can detect abnormalities in the cervix before cancer develops and can detect most cervical cancers at an early stage, but the CDC admits that regular Pap tests and follow-up cannot prevent or detect all types of cervical cancer.
The U.S. Food and Drug Administration (FDA) recommends the vaccine Gardasil for not only the prevention of cervical center but also for abnormal and precancerous cervical lesions, abnormal and precancerous vaginal and vulvar lesions and genital warts. "The vaccine is effective against HPV types 16 and 18 which cause approximately 70% of cervical cancers, and against HPV types 6 and 11 which cause approximately 90% of genital warts," according to the FDA. Despite the effectiveness of Gardasil for these HPV types, it does not protect against certain other types of HPV which can cause cancer, and no vaccines are 100% effective. Therefore, the FDA recommends regular Pap tests in addition to Gardasil.
Some opponents to the vaccine are aghast at the FDA's approval of administering it to girls as young as nine years of age. This does not appear to be an admission by the FDA that the average nine-year old girl in the United States is engaged in sexual activity, but the FDA seems to be stating simply that the vaccine is safe enough to be given to girls at that young age and why not protect them as soon as possible.
The best prevention, of course, would be abstinence from all sexual activity, and some opponents to Gardasil have suggested that this is the primary issue at hand-the proper teaching of abstinence, or, rather, the lack thereof. While I agree with the fact that abstinence is the best preventative medicine, it is unrealistic to assume or even hope that all of our daughters will listen to us when we tell them that sex before marriage is not only against our moral standards but it can have serious health ramifications. We must also consider that a woman may marry a man who had contracted an HPV infection from a prior relationship, but he remained unaware because many of the symptoms of HPV lie dormant for years or never appear at all. He then would unwittingly pass it along to his new bride.
The unfortunate prevalence of rape should also be taken into account, especially when we are constantly reminded by the media of the high number of young girls who are victims of sexual crimes. 1 in 4 girls will be sexually assaulted by the time she reaches the age of 18, according to a 1990 survey.(1) In 2005, the Justice Department estimated that 1 in 6 victims of sexual assault was under the age of 12(2).
My 15-year old daughter has been brought up in a Christian home, and she has very high moral standards. In spite of this, however, she has received the Gardasil vaccine in addition to annual Pap tests because I want to be sure she is protected should she ever become a victim of rape by someone infected with HPV or should she give in to temptation in the heat of a moment with a boy who has HPV. I would hate to put my daughter's life in jeopardy because of a poor choice that she had made or because she was involved in a crime beyond her control.
Prevention is always better than a cure . . . especially if there is no cure.
Sources:
(1) Finkelhor, David, et al. "Sexual Abuse in a National Survey of Adult Men and Women: Prevalence, Characteristics, and Risk Factors," 1990.
(2) Rape, Abuse and Incest National Network, 2005 statistics.
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