HPV Vaccine – Do We Need It?

061120_vaccine_vmed_12pwidecThe New York Times published an article in which some health experts questioned whether we should inoculate otherwise healthy young girls with the HPV vaccine, given that it carries some risk and cervical cancer can be prevented with proper screening.

“There are not a huge number of side effects here, that’s fairly certain,” said the editorial writer, Dr. Charlotte Haug, an infectious disease expert from Norway, about the vaccine. “But you are giving this to perfectly healthy young girls, so even a rare thing may be too much of a risk.

“I wouldn’t accept much risk of side effects at all in an 11-year-old girl, because if she gets screened when she’s older, she’ll never get cervical cancer,” Dr. Haug said in an interview. “You don’t have to die from cervical cancer if you have access to health care.”

Okay, her argument makes sense. But can any of us truly count on always having access to health care?  Let’s say some wealthy parents decline the vaccine.  These parents assume their children will always have access to health care that includes an annual exam and screening for cervical cancer.  Is that a safe assumption? I don’t think so.

These critics of the vaccine also seem to overlook the fact that the vaccine protects against some strains of HPV that cause genital warts. That alone seems a worthwhile reason to get the vaccine.

Any of the parents whose children have suffered side effects after the vaccine may well be asking whether it was necessary or even helpful given that their children could have been protected from cervical cancer in other ways.

Years ago I read a story about national research looking for a vaccine for chlamydia. Chlamydia, in addition to being a common sexually transmitted infection, is also the world’s leading cause of preventable blindness. If you have access to health care, you don’t have to go blind from chlamydia. People without access can and do go blind from it. For those who do have health care, if there was a vaccine for chlamydia, wouldn’t you get it just to avoid ever having chlamydia?

Maybe the information we should take from the NYT and the experts cited there is that the vaccine has been directed to the wrong audience. Merck has invested a lot of money into its “one less” commercials encouraging women to avoid becoming a woman with cervical cancer. Perhaps this money would have been better spent in handing out free vaccines to those members of our society who have the least access to health care.

Merck has in fact made some efforts to do just that; however, I do wonder how these uninsured patients will ever access the private doctor’s offices where the free vaccine is administered:

Merck has also initiated a new patient assistance program for vaccines. Through this new program, currently available in private physicians’ offices and private clinics, Merck is making available, free of charge, GARDASIL and other Merck vaccines indicated for use in individuals aged 19 and older who are uninsured and who are unable to afford vaccines.

I would think this program would be more effective if they gave away the vaccine at places like Rite-Aid, where the pharmacist can give them and you wouldn’t have to have a doctor visit. But their efforts nonetheless are noteworthy.

I don’t purport to know what is best for 11-year-old girls around our country; but I do think we have been bombarded with information about the vaccine and now have a bit more information to counterbalance Merck’s advertising. Ultimately there are numerous risks to be weighed.

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50 thoughts on “HPV Vaccine – Do We Need It?

  1. I think part of the reason they have a doctor, rather than a pharmacist, administer this vaccine is that there have been occurrences of girls passing out and fainting after receiving it.

    I totally want to prevent genital warts and other nasty HPV’s for my daughter. I’ve thought of having her get it soon. But I’ve also recently read a study saying that reports of negative reactions to this vaccine are mounting. I don’t like that.

    • I think it’s one of those things that should be the girl’s decision, when they’re old enough to make it. The type of hpv and genital warts that it protects against are the sexually transmitted ones which can be prevented by practicing safe sex. I think as long as a teen girl is taught that any sex she practices should be safe than she can wait until she knows exactly what this vaccines positive and negative affects are. There are over 40 types of hpv and the vaccine protects against 4. It’s still such a controversial vaccine.

      • Genital warts that aren’t covered by a condom can infect you. And that’s icky.
        But I agree about not wanting to take something so experimental at this stage.

        • Hahah I’d just be like, “Daughter, if a man’s penis is covered in warts, it’s better to just not have sex with him. There are other non warty fish in the sea.” My mom had us wait and now I’m glad she did (I’m 19) I am happy that I could decide what was best for me. Since me and my fiance are committed to each other and I get regular ob/gyn care it’s not necessary for me to get it. If I didn’t receive care and engaged in casual sex I would definitely be open to it.

        • Men can be carriers of HPV and never know. And there’s no way to test men for it.

          Also, you can have it for years without ever getting a wart.

          So, just because you don’t see warts on a man’s penis doesn’t mean he can’t give it to you.

          Also, condoms are fairly ineffective at preventing it (over 60% of women have been exposed to HPV; it’s very common unfortunately). HPV can easily be contracted from areas not covered by a condom. And, like I said, there’s often no way to tell if someone has it visually (for women or men) and men can’t be tested for it.

        • It can still be contracted if you get the vaccine, but the vaccine protects against 70% of cervical cancer types diagnosed every year and 90% of genital warts. It just seems worth it to me. I mean, even if I always practice safe sex, what if I get raped?

          You can’t always be so sure.

    • Medicine has come a long way since drugs like Thalidomide were distributed. I’m sure making that comment you know the exact history of how the vaccine was developed? I don’t mean to sound snarky, I just find that most people don’t have a clue about the vaccine, from the structure, chemical components and their effects, etc. (This is coming from someone studing a medicinal subject at university).

      • I waited until the report on the vaccine came out before I made a definite decision. It came out and I decided no. It doesn’t personally make sense for me to get it, I’d rather not just put random things into my body for the sake of doing so. I also don’t get flu vaccinations unnecessarily even when they’re offered to me for free through school and work. You don’t need to know the exact history of how a vaccine was developed to know the side effects versus the purpose of the vaccine. They want to make this vaccination mandatory for young girls to get in order to attend public school and I think that’s wrong. Younger girls have had seizures after receiving it and they don’t yet know the true long term side effects. They have no idea whether or not this drug could possibly cause long term effects in the drug-takers children (like with DES) or 50 years down the road. No thank you.

  2. I was right at the cut off age to receive it – had I been 2 months older I wouldn’t have got it. But I have had 2 of the 3 vaccines now needed to complete the course – really glad I accepted to do it. I got it at my university (I am 19 now) – on the first day they were issuing the vaccine, hundreds of girls turned up from the university.

    Anyway, I didn’t feel the injection at all – totally painless going in and out, both times. If anyone were to faint from it, it would be from fear of needles, or working yourself up over nothing (I honestly panicked for about a week before hand, completely over nothing however). One of my friends felt faint after having it, but admitted it was because she was afraid of needles, rather than the injection itself being sore. Side effects I had were just slightly painful stiffness for about 2 days – like working out hard at the gym, and feeling the muscle stiffness after.

      • It may be due to the age of the cohort that’s getting the vaccine. Most girls of the eligible age have not received vaccinations for anything since they were small children.

        Who more apt to get hysterical and make themselves feel goofy than a bunch of teenage girls?

        Even at 28, and having had many many injections of different nasty things and lots of “home surgery”, I had about 15ccs of lidocaine injected in my toe yesterday and started to feel a little loopy. I promise you it wasn’t the drug itself doing it, it was seeing that volume of fluid being injected in a place that didn’t look like it had room for it. Yuck.

    • I’m kind of jealous that it didn’t hurt you–i have no fear of needles whatsoever, was not worked up or anything, but that first shot hurt like a mofo. AND i had a bruise the size of my fist for about two weeks. I can easily see how that could be even more severe in someone smaller/younger than I was.

      • I just got the first shot last week and it didn’t really hurt when I got it, but my arm is still incredibly soar. It made my best friend’s arm go numb, but really we figured it’s worth it.

      • You must not have had a tetanus shot in a while. I’ve had to get a booster every year effectively forever due to my work and recreation interests. Feels like getting socked in the arm by a prize fighter.

        Don’t even get me started on Depo shots… ouch.

      • Can’t be any worse than the BCG. Shots don’t usually bother me but that thing was painful and it tends to leave a mark. I only have a small one but I know people with pretty deep indentations up to an inch wide on their upper arms from that shot. Also it means I need to get a chest x-ray if I need a TB test because it makes the skin test come back positive.

  3. I’m not anti-vaccine but there is no way in hell I’d be getting this one if I were in the age bracket or getting it for a daughter if I had one. It’s unnecessary and there are so many cases of girls dying or becoming sick just after getting the vaccine. Sure that could be coincidence but I’ve looked at the evidence and I’m firmly in the against camp on this issue.

  4. I have mixed feelings about this vaccine. I have HPV; I was diagnosed while I was 6 months pregnant. I felt totally betrayed because I have only had birth control sex with 1 person, and 1 person only. Everyone else used a condom (even now at 33 years old!!). Before I had “birth control” sex with him, I made him get an AIDS test, which he passed. I have NEVER had genital warts, but I did have pre-cancerous cells on my cervix. I had laser surgery when I was 26 to remove the top layer of my cervix– it grows back. It also removes all the bad cells.

    Anywhooo, I am cancer free now and have been for a long time. My doctor told me that 85% of the US population has HPV, most will never know. I am lucky that I have excellent doctors and excellent insurance. I don’t know if I will make my daughter get the shot. It is a hard call.

  5. I’m not saying that I don’t think this is a good idea–I know people who’ve contracted HPV from a supposedly “clean” partner, and avoiding that would be a great leap forward for medicine.

    But at the same time, contracting HPV can also be avoiding by entering into only purely monogamous sexual relationships. I don’t have to worry about HPV because my husband and I were both virgins when we first had sex.

    So I guess I’m a fence-sitter.

    • That really is great for you, and I hope you and your husband are happy :l-), but the vast majority of people have had sex with more than one person, or their partner has. Even if both were safe, and had only ONE other partner, they could still have it.

  6. I got the shot, my sister didn’t. I don’t have hpv and she has the type that can cause cancer. It’s not a hard choice for me to make for any future children I may have.

  7. situation in Spain: the goverment is administrating it through the free social security to girls from 11 to 13

    the idea of administrating it to girls (and not women) is that the vaccine is only effective if you still dont have the virus, and as the virus is transmited sexually, it is assumed the 11-13 year old girls are virgins so they do not have it

    I had to pay 450€ to have the vaccine, but even if I always have safe sex and so on, I think it is totally worth it, life is priceless.

    The goal of the vaccine is to prevent, so yearly check ups are extremely useful, but if they detect that you have it, there it is, you can’t get rid of it.

  8. I am confused by the quote in the article that regular checkups can prevent cervical cancer. How can a checkup prevent cancer? It could prevent it from spreading, and potentially killing you, but how could it stop you from actually getting cancer in the first place?
    It is generally recommended that women get a full physical once a year. So does that mean, in theory, a woman could have cervical cancer for a while year and not know it? How fast does cervical cancer spread?
    As several posters have attested, someone can get HPV no matter how careful they are. It is a risk for anyone who is sexual active, and I have trouble seeing why people would choose not to prevent a risk when given the option.
    In terms of potential side effects in the future, that is something we deal with on a daily basis without questioning. What are the future side effects of aspartame? What about new forms of cleaners? New food preservatives? Fertilizers? There has been far less research done into the potential effects of general everyday chemicals than into ones used for medical purposes. Whether you like it or not, you are being exposed to chemicals without knowing their future effect on your body.
    If we are going to take these risks anyways, then why not take the risk that will prevent yourself from getting an incurable disease?

    • Someone can correct me if I’m wrong, but I believe regular pap smears and checks can detect cervical abnormalities, which if left untreated, can LEAD to cancer. So, they can detect abnormal cells, etc, that if treated/removed can prevent cancer from developing.

    • “If we are going to take these risks anyways, then why not take the risk that will prevent yourself from getting an incurable disease”

      That makes no sense. If I’m taking the risk of crossing the street and driving a car then I may as well take the risk of sky diving and stock car racing? It’s all about minimizing risks. We’re all going to be exposed to stuff like exhaust fumes, cleaners in public places, other situation we generally have very little control over. That makes it all the more important to control the stuff we can but not eating frankenfoods and artificial sweeteners and using safe cleaners in our homes.

      Also, I’m pretty unlikely to just drop dead after eating a new preservative or using a new cleaner but girls have dropped dead shortly after getting the vaccine. You have to look at the pros and cons of this and other vaccines. For example, I don’t get the flu shot. I have a slightly higher chance of getting sick because I don’t get it but on the other hand my grandfather wound up paralyzed in hospital as a direct result of getting the flu shot. I’d rather take the risk of sneezing for a few days than the risk of being in hospital for a week unable to move.

      • And what of the risk you pose to others (such as the elderly) if you pass the flu onto them? I have a friend with diabetes, and one night her mother randomly showed up in my house with a whole bristol board presentation on how I could pose a risk to my friend if I did not get the flu shot (A bit odd, I know, but her mother works for the City’s disease control unit).
        I might be more valuable to suggest that if you are more likely to be hit by a car when crossing the street, then to immediatly die from taking this vaccine. Yes, weigh your risks. People can drop dead from taking any new medication. But would you suggest that people not take them because of these potential risks? This vaccine has been released because the scientists who created view the benefits as greater than the risks. If it was really such a danger, it wouldn’t be avaiable.
        It seems to me there are many other reasons to not give a child this vaccine. But the minimal risks are not one of them.

        • This vaccine was created by a company who knew they could charge a lot of money for it. Drug companies aren’t exactly altruistic.

        • I’m sure you’re trying to make some sort of point here but I’m not seeing it. FDA approval does not mean that something is safe. It just means that that chemical has a strong lobby behind it. Look at aspartame. It’s FDA approved despite all the evidence against it because the company producing it stood to make a lot of money off of it. Look at stevia. It’s not FDA approved as food (that’s why it’s marketed as a supplement rather than a sweetener) because it’s a herb and nobody is going to make millions from it therefore there’s no point in paying the lobbyists.

          Merck stands to make a whole bundle of cash from the vaccine. That means they’re willing to spend a bit of cash greasing the wheels to get approval.

          It’s nice to think that these bodies are in place to protect us but it doesn’t work like that in the real world. It’s always better to do your own research and figure out if something really is safe and if it really is worth the potential risks.

        • I have done my research, which is why I find these fears of death upon vaccination unfounded.
          Less than 0.00005 of Gardisil inoculations have led to death, (of which not one of those has been directly proven to be caused by the vaccine itself), which is a very similar rate to the booster shot most children are given before they reach school age.
          Imagine if parents were hesitant to give their child their booster shots because of unproven potential future side effects? Smallpox and polio would still be claiming lives in North America. More than 273,000 people die from cervical cancer each year.
          I can’t understand why someone wouldn’t want to be protected from such a thing, and from spread it to others.

  9. Here is another kettle of fish…
    The US mandates that any woman under 26 must get the HPV shot in order to immigrate to America. It has joined the list of standard vaccines. I’m also part of an immigration forum and we discussed this issue. A few woman wanted to “get around” having the vaccine before coming to the US.

    • Thoughts? If you want to get around it, you don’t get in. Vaccination is good for the individual and for society. It’s the price of immigration; if you don’t want your sticks, you don’t get in.

  10. I got this vaccine a couple years ago, as did several of my friends. None of us had negative side effects. I would definately recommend it.

  11. I got this is 2007 along with all the year 10,11 and 12′s at my school. This is in Australia, everyone gets them free if you are under 19. We were the first lot to get it so the year 12′s went in, we peeked in (we were in grade 11) and there was about 50 of them in there, most were crying, several a lot.. people had fainted, and it was just general hysteria :P Then about 120 of us joined them, totally PANICKING! And it was SO painful, omg. I felt sick and dizzy and my arm went cold because I couldn’t move it (or was too scared to). The 2nd time I didn’t feel sick but it hurt more, then the 3rd was fine. So yeah I would recommend it, you get over it, the worst that happened from all 400-ish of us was fainting, girls going home sick.. Most people are fine, reactions are rare (serious ones).. same as any vaccine..

  12. I didn’t read all the posts, so I don’t know if anyone mentioned this yet. But a bigger issue about the vaccine is group immunity. The more people inoculated against the disease, the less people the disease can infect and, consequently, the rarer the disease becomes. It’s how we stomped out things like smallpox and polio. The more people we protect from this disease the fewer people will get the disease. In time, perhaps these strains of HPV will die out.

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