HPV Vaccine... Yes or No?

When I was at the doctor's office, I asked the girl's pediatrician if Emily will need to get any shots next year when she turns 12. She replied, "Yes, the HPV vaccine". She said that she highly recommends it to girls between the ages of 9-12. I asked her if this vaccine was mandatory and she said, " No, not for the schools... yet. But I highly recommend it."

So I went home to ponder if I should have my soon-to-be 12-year old daughter get this HPV vaccine. I wondered if any of my friends had their teenage daughters get this vaccine. I wonder...

No more wondering... I took a survey (email is a great information gatherer) and got lots of responses. Before I share my opinion, let me tell you a little bit about what HPV is and the HPV vaccine.

Human Papillomavirus (HPV) is the most common sexually transmitted disease (STD) in the States.

• There are more than 40 types of HPV; most are harmless; some are not.

• Most people with HPV do not develop symptoms or health problems from it. In 90% of the case, the body's immune system clears HPV naturally within two years. But, sometimes, HPV infections are not cleared and can cause:
- Genital warts
- Rarely, warts in the throat - a condition called recurrent respiratory papillomatosis or RRP
- Cervical cancer and other, less common but serious cancers including cancers of the vulva, vagina, penis, anus and oropharynx (back of throat including base of tongue and tonsils).

• Millions of men and women are infected with HPV.

• Many who are infected don't know it because they don't have any noticeable symptoms.

• Infections with some types of HPV can cause genital warts.

• Some types of HPV can be associated with cervical and anal cancer; these are the ones that don't cause warts so you are pretty much symptom-less.

• Often a person will be infected with more than one type of HPV.

• Currently, there is no cure for HPV.

How do you get HPV?

• It is spread by skin-to-skin contact (genital-genital, oral sex), usually during sex, even if condoms are used, and even if no genital warts are present.
• The virus lives in the skin of infected people in areas like the penis, scrotum and vagina. 
• Condoms do not offer much protection because the virus can often be in areas that the condom doesn't cover.

How do you prevent getting HPV?

• The sure way to protect yourself from HPV is to not have sex.

How do you know if you have HPV?

• Existence of genital warts
• An abnormal pap test result (sometimes)
• Positive result of HPV test (cervical swab)

They say HPV is so common and so easy to transmit, most sexually active people will have HPV infections at some point in their lives. One way of protecting yourself from having an HPV infection possibly turn into cervical cancer is to get the HPV vaccine (prior to exposure) and have regular Pap tests.

The HPV Vaccine (Gardasil vaccine):

• Approved by the FDA in 2006 for females ages 9-26.

• Protects against the strains of four of the most common HPVs that may cause precancerous changes in the cervix and some genital warts.

• Given in three doses: four weeks after the 1st dose; 12 weeks between doses 2 and 3; 24 weeks between doses 1 and 3

• Vaccine is only effective when it is given before they are exposed (usually ages 9-12).

• According to the Center for Disease Control (CDC), the vaccine is most effective at age 11 and 12, before they may have any type of sexual/skin to skin contact with a partner.

• Ages 11 and 12 were chosen due to many who develop an interest in the opposite sex at that age.

• Insurance will not cover anyone over the age of 26 (thus the maximum age of 26) because it is assumed that most people will have been exposed to the virus at that age if they are sexually active.

• If you desire to get the vaccine after age 26, the retail price is about $130 per dose ($390 for the full series).

• But once they are exposed to the HPV virus via contact, the vaccine can't protect them no matter what age they are at.

• The side-effects of this vaccine are no different than any other routine vaccines.

Some common concerns regarding this particular vaccine (other than the usual side effects of any vaccine) are:
• the feeling that if you give this vaccine to your child, it 'allows' them to be promiscuous;
• you, the parent, are indirectly saying it's 'okay' to have sex because you've given them the vaccine;
• you, the parent, may be implying that your child "may" have sex before marriage

The above concerns are all 'assumptions' and not fact. You don't know if that will happen to your child.

But the following will happen to your child if you don't give them the vaccine:
• As with any vaccine, it is protection against a disease that they may be exposed to. One that does not have a cure.
• If your child doesn't have sex until marriage, their future partner may not have waited and thus may have been exposed to the virus thus will be passing it to your child.
• Even if your child does not have "sex", HPV is contracted through skin-to-skin contact, not only through intercourse.
• When contracted, there is no cure.

Okay.. with all this info on the table, I received many responses regarding this vaccine. Out of the 14 parents who have teenage girls I contacted, only four allowed their daughters to get the vaccine.

The reasons for "No" were:
• Child not sexually active and trust that she won't be until marriage
• Vaccine too new and unknown long term effects
• Conservative vaccinating: fear of linkage to autism and other severe irreversible reactions/consequences

The reason for "Yes" was:
• Protection from a disease for my child

One mom said, "My personal view as a mom and a Christian is I can't predict what will happen to my kids or their future partner/spouse, so I rather have them be protected. I don't feel that the vaccine will cause them to be promiscuous, after all, they need to know that the vaccine will only cover 4 of the 40 HPV viruses, plus there are so many other STIs out there. Along the same line, hardly anyone objects their kids to get the routine Hepatitis B vaccine, which is transmitted by sex or sharing of needles. In my opinion, it is much easier to "catch" HPV then Hepatitis B."

One father said that he had his daughter get the vaccine at around 16 or 17 (right before she headed off to college), an age when she understood what the vaccine was for and it's effects and consequences. His reasoning was to protect her from her future partner/spouse in case she fell in love and wanted to get married at a young age.

Another mom said she knows of someone who was infected with HPV via rape and developed cervical cancer as a result. Involuntary exposure.

What about the BOYS?
The CDC just came out with the recommendation for boys to also receive the vaccine so insurance might pay for it in the future. This vaccine can protect them from genital warts.

All food for thought... so with all that in mind....

My opinion is (and note this is only MY opinion):
• I cannot 'assume' that my daughter will not have any type of sexual activity whether if it's intercourse or any skin-to-skin contact whatsoever before marriage.
• I cannot 'assume' that her future partner/spouse would not have any type of sexual activity whether it's intercourse or any skin-to-skin contact whatsoever before marriage.
• I agree with another mom, "if there's anything I can do to protect my daughter from harm, especially a terrible disease, I'd have her do it."
• My girls have had all the vaccines that is recommended for them at their current age and maybe even more since we have traveled abroad a few times too.
• I do not think age 12 is an appropriate age to get the vaccine. I personally feel they are still too young.
• But I do think that it is an important vaccine to receive at an age where they personally are aware of what they are receiving. I think before they go off to college, if they have not started dating, would be an appropriate time.
• Of course, I could let her decide if she wants the vaccine when she becomes an adult  (18 yrs old), but it's a three dose process. Can I trust that she'll be diligent enough to go to the doctor's three times within the assigned time periods to get it?
• For those of you who refrain from all vaccines in general, I understand and respect your hesitance.

My intent in writing about this topic was to not to tell you what to do but to help all of us be better informed of what our children are/will be exposed to. I want to thank all the parents that I contacted and responded to my survey and a huge thank you to my dear friend A. who is a nurse and was able to give me answers to all the medical questions I had in regards to the disease and vaccine.

So what do you all think? I know that many of you have daughters and this topic will come up. I'm curious to hear your thoughts.

ONGOING CONTEST... remember I will enter your name with each comment you post on anything I've written through February 9.  Random winner will receive a BIG prize! Note that I need to know who you are so if you comment using Anonymous please add your name or initials!