As we sat around picnic tables waiting for the girls’ volleyball team to come for lunch after their tournament game that Saturday morning, the mothers talked about the bad influences their daughters faced in today’s culture. One mother commented in a blasé tone of voice that she had spent the afternoon before taking her 15 year old daughter to the doctor for the first of her HPV shots. None of the other mothers seemed to find that action extraordinary and the conversation continued to flow on, with the mothers’ complaints about the time it takes today to be a good mother.
Indeed, few people question the advisability of girls getting the HPV (genital human papillomavirus) vaccine. We are told that genital HPV is a common virus that is passed on through genital contact, most often during sex, and that most sexually active people will get HPV at some time in their lives, though most will never even know it. Further, the virus, according to conventional wisdom, is most common in people in their late teens and early 20s.
We know that there are about 40 types of HPV that can infect the genital areas of men and women with most of the types causing no symptoms and going away on their own. But, some types of HPV can cause cervical cancer in women. Every year, about 12,000 women are diagnosed with cervical cancer and almost 4,000 women die annually from this disease in the U.S. Some HPV viruses can also cause genital warts that while not life-threatening, can cause emotional stress and their treatment can be very uncomfortable. About 1% of sexually active adults in the U.S. (or 1 million people) have visible genital warts at any point in time.
The vaccine, Gardasil®, is given in three shots over six-months. The vaccine is routinely recommended for 11 and 12 year old girls. It is also recommended for girls and women age 13 through 26 who have not yet been vaccinated or completed the vaccine series. Gardasil is often recommended for girls as young as nine-years-of-age. Never mind that the vaccine is only effective for about five years and never mind that there is limited data on the drug’s effect on pre-teen and girls in the early teenage years; it is marketed as “widely tested” and with promises that the vaccine will last “a long time.” The promoters recommend the vaccine be given “before a girl becomes sexually active” because that is when it is most “safe and effective.” Some school districts are even engaging in mass immunization programs and many parents are viewing the HPV shot as just another of the childhood immunizations necessary to protect their kids from contagious diseases.
It is time for a reality check.
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While Gardasil was tested on a population of about 1200 girls ages nine to 15, the clinical trials included only 100 nine-year-olds and they were followed for only 18 months –– hardly long enough to declare definitively that the drug is safe for young children. Further, the clinical trials included only participants who were screened for any pre-existing medical conditions; all the girls in the clinical trials were healthy. The trials did not evaluate the drug’s impact on those with undiagnosed medical conditions or the long-term consequences of the immunizations.
The unavoidable fact is that the long-term effects of the drug on girls are unknown and the drug’s manufacturer, Merck, admits that the possibility for negative neurological responses, negative impact on the immune system or other damage in a girl’s future from using the drug has not been studied. In fact, after the long list of relatively minor side effects (pain, swelling, nausea, dizziness, etc.) the official brochure for the drug states that the list is not a complete list of possible side effects.
To date, in only two years of use, there have been nearly 10,000 reports of side effects from Gardasil. Obviously, most side effects are not serious, but some are quite serious (paralysis and seizures) and some are life-threatening enough to require hospitalization. While there is no proof that Gardasil is responsible for the side effects, that is enough to warn many parents away from a drug that protects only those who are sexually active and protects only against two of the HPV viruses that can lead to cervical cancer.
Abstinence and fidelity, of course, are the best protection against sexually transmitted diseases. In addition, a regular Pap smear remains the most effective measure for most women in predicting and preventing cervical cancer –– especially since the average age of a cervical cancer patient is 47 years old.
This summer (July 2, 2008), U.S. News and World Report recounted the story of 13-year-old Jenny Tetlock, a California teenager who began experiencing muscle degeneration about a month after being vaccinated against the HPV virus. After about 15 months of deterioration, she is now nearly completely paralyzed. This earlier this fall, The Flint Journal of Flint, Michigan reported that after only one dose of the HPV vaccine, TaQuaria Williams, a 17-year-old, began experiencing a rash and swelling in her limbs. She now is required to take 6-7 pills a day for what has been diagnosed as a “connective tissue disorder” that is a form of lupus.
In addition, 21 deaths have occurred to girls who have just had the HPV vaccinations. Those deaths are considerably more serious than the warning that the shot might cause soreness in the recipient’s arm or that some girls might faint after the shot so it is recommended that they remain in the doctor’s office for 15 minutes after the vaccination.
Few mothers, armed with the facts, would take the risk that her daughter might be one of the girls who has a severe, even fatal, reaction to the HPV vaccine. That volleyball mother who complained about the time involved in taking her daughter for the HPV shots, would be better advised spending that time explaining the benefits and modeling the ideal –– psychological and emotional well-being as well as good health outcomes –– of abstinence before marriage and fidelity afterwards.