HPV Vaccine: Mandatory?
 

Ok.... so I just heard on CNN or CNBC that starting in 2008, Texas has made it mandatory for girls entering 6th grade to get the HPV vaccine.

I don't know much about this, except that it is supposed to prevent HPV and cervical cancer. One of my sisters that works in a pharmacy said that this vaccine isn't good because it's actually injecting HPV into your body (like the flu vaccine) and if you don't have the virus in your body, then you'll most likely get HPV anyways... or something like that.

Does anyoen know more about this?

The vaccine is called Gardasil. I actually asked the nurse at my GYN's office in Nov/Dec about it (when I went it for my Depo shot). She said that my GYN was actually recommending for her patients to get the shot.

www.gardasil.com has more information.

Here's what I don't get, Merck is saying that girls/women from 9-26 should get the shot, what about women older than that? What about women who are older than 26 but not sexually active (ie. haven't been in years or still virgins)? Shouldn't they get the vaccine as well?


I'm not to sure I would want my 9 year old getting a vaccine for HPV. Yes, if when she gets older she comes to me and say's "I'm having sex". Hell, she be taken to the GYN and put on BCP's and given the vaccine. But I'm not sure I would want my 9 year old having the shot and thinking "hey it's okay when I get older to have sex". Because no matter what parents say, teenagers are going to experiment. We can just guide them to make the right decisions (I'm not a parent but a teacher, which means I basically act like a parent).

I imagine that it's like any other vaccination where you are given a weakened or inactive organisms. The chance of getting an infection from the vaccine is rare just as though you were being given an MMR or tetanus vaccination which most of us received when we were infants.

I don't necessarily agree with it being required- I think it should be a parental choice. Particularly since it's not a disease like TB, measles, etc.

I don't remember the particular explanation, but it is not like a flu shot. You can't get HPV from the shot- something about it not having the viral DNA.

I had my first dose of Gardasil a couple weeks ago- it's a series of 3 shots, each 2 months apart. It was just approved by my insurance company for 26 year olds on January 1st, so I'll be able to get all three doses in by the time I turn 27. It doesn't make a lot of sense to me why it's limited like that. I had absolutely no side effects from it, aside from the injection site being slightly sore if I touched or bumped it.

HPV is scary, particularly for women who don't get to the gyno on a regular basis. There are no symptoms (well, aside from the strains that cause genital warts) and its not really detected until there's been a change in your cells that is seen on the pap and follow up testing. HPV itself isn't necessarily a huge deal, but that it can lead to much bigger issues (i.e. cervical cancer) its not something to mess around with.

Gardasil has not been extensively tested in women over 26 which is why it's not FDA approved for women older than that. The Gardasil fact sheet says that research is still being conducted on the effectiveness of the vaccine on women 27+.

If it's proven safe over time, I think Gardasil should be required just like any other vaccine. If we can essentially eradicate cervical cancer with this vaccine, then I see it as a matter of national -- not sexual -- health.

I would absolutely get my daughter to get the vaccine as soon as she was old enough. For me, it's not a matter of my daughter thinking it's okay to have sex. If, God forbid, my daughter were a victim of sexual assault or molestation she would at least be protected from HPV. Besides, I got hepatitis vaccinations when I was in middle school (some strains are sexually transmitted) and I never got the idea that it was okay to have sex or anything like that. It was just another routine vaccine for me.

I probably wouldn't even get into the shot's purpose with my daughter. It's not like my mom or dad ever sat down with me and explained how TB or polio was contracted. I just knew I had to get a bunch of shots.

It just bugs me that as a 27 year old I can't get the shot.

Rephrase, I can but I'll have to probably pay a butt load out of pocket because my insurance company won't cover it. I'm sorry the risk for cervical cancer or genital warts doesn't just suddenly disappear the moment you turn 27 years old. I find it asine that 27+ women cannot get the shot with their insurance covering it.

I wonder how it works if there is a history of cancer in the family. Cancer is cancer.

Maybe I should contact Merck and volunteer to be part of their 'research' on 27+ women. :D

I'm wondering why people have issues with their daughters getting this vaccine when many 12 or 13 year olds are getting Hep B shots.

Yeah, I got the prescription too, but I'm not getting it unless I get a favorable second opinion.

I've heard that Merck is really pushing states to require it--because if there's ever a recall or problems with it, the fact that it would be governmentally mandated would relieve Merck of any liability. Cervical cancer isn't a major health issue here as it is in developing nations--where it's the cancer with the highest mortality rate. Also, the cervical cancer rate has been declining so much. So, I don't understand why this is such a major deal with states.

On the Gardasil fact sheet my doctor gave me, they said that there would be more research done on women over 27 and men.

I have mixed feelings.

One the one hand, because we as individuals typically don't pay full cost for our health care (in some cases because we're in an employment pool for insurance, in others because we're government employees for whom health care is paid like the military, or in others because we get public assistance because we're poor), it seems a little bit like the agents of the state can/should require that we take actions that will limit our health risks and health cost down the road.

On the other hand, requiring this vaccination of sixth or seventh graders to enroll in public schools, which is what I think the Texas governor just did, seems like gross interference in private individuals' lives.

In the other cases that I can think of, required vaccinations are for diseases that are transmitted through casual contact. (As far as I know, hepatitis vaccines are recommended but not required, right?) It's hard for me to see the compelling reason for the state to require this vaccine for school. For enrollment in insurance coverage, sure. As a condition of receiving public health services, sure. But to attend middle school, I don't think so.

ETA: my guess is that in women over 27, the assumption is partially that you're fairly likely to have already been exposed to the virus. Isn't the stat something like one in four college aged people?

I googled HPV rates and found this: "According to a 1997 American Journal of Medicine article, nearly three in four Americans between the ages of 15 and 49 have been infected with genital HPV at some point in their life."

Because you can get Hep B other ways besides sexual contact. I teach in a jail 2 nights a week and had to have the Hep B series--all the corrections teachers were required to--because the incidence of Hep B is so high in the prison population and we could acquire it from, say, blood. Hopefully not from spit, since somone always seems to be hacking and sneezing in my face over there.:(

Here is a news release I received from the NVIC which outline concerns over this new vaccine by a vaccine safety group. I've bolded a few of the more interesting passages.

Vaccine Safety Group Finds Serious Reactions, High Costs

VIENNA, Va., Feb. 1 /PRNewswire-USNewswire/ -- The National Vaccine
Information Center (NVIC), the nation's leading vaccine safety and informed
consent advocacy organization, is urging state legislatures to investigate
the safety and cost of mandating Merck's HPV vaccine (GARDASIL) for all
pre- adolescent girls before introducing legislation amending state vaccine
laws.

In an analysis of reports made to the federal Vaccine Adverse Event
Reporting System (VAERS) since the CDC's July 2006 universal use
recommendation for all young girls, NVIC found reports of loss of
consciousness, seizures, joint pain and Guillain-Barre Syndrome. In a
separate evaluation of costs for young girls being vaccinated in private
pediatrician offices, NVIC discovered that parents living in the
Washington, D.C. area will be paying between $500 and $900 to have their
daughters receive three doses of GARDASIL.

"GARDASIL safety appears to have been studied in fewer than 2,000 girls aged 9 to 15 years pre-licensure clinical trials and it is unclear how long they were followed up. VAERS is now receiving reports of loss of consciousness, seizures, arthritis and other neurological problems in young girls who have received the shot," said NVIC President Barbara Loe Fisher.

"At the same time, parents who take their daughters to private
pediatricians are going to be shocked to find that they will be paying two
to three times the widely publicized $360 cost for the three-dose series.
The cost is going to break the pocketbooks of parents and break the banks
of both insurance companies and taxpayers, when the reality is that almost
all cases of HPV- associated cervical cancer can be prevented with annual
pap screening of girls who are sexually active."

Between July 2006 and January 2007, there have been 82 reports of
adverse events filed with VAERS following receipt of GARDASIL by girls and
boys ranging in age from 11 to 27 years. Reaction reports have come from 21 states, including Virginia and the District of Columbia. All but three of
the reports were for adverse events which occurred within one week of
vaccination and more than 60 percent occurred within 24 hours of
vaccination.

"The most frequent serious health events after GARDASIL shots are
neurological symptoms," said NVIC Health Policy Analyst Vicky Debold, RN,
Ph.D. "These young girls are experiencing severe headaches, dizziness,
temporary loss of vision, slurred speech, fainting, involuntary contraction
of limbs (seizures), muscle weakness, tingling and numbness in the hands
and feet and joint pain. Some of the girls have lost consciousness during
what appears to be seizures." Debold added "The manufacturer product insert should include mention of syncopal episodes, seizures and Guillain-Barre Syndrome so doctors and parents are aware these vaccine adverse responses have been associated with the vaccine."

VAERS reports also indicate the doctors are administering GARDASIL to
girls and women at the same with Tdap, DT, meningococcal (Menactra),
hepatitis A, and other vaccines, even though the Merck product insert
states that, with the exception of hepatitis B vaccine, "Co-administration
of GARDASIL with other vaccines has not been studied." There is no publicly
available information about how many of the 9 to 15 year old girls in
Merck's pre- licensure clinical trials received GARDASIL simultaneously
with hepatitis B vaccine.

Although approximately half of all families in the U.S. select a
pediatrician in private practice to provide their children routine care,
including vaccinations, children can receive government subsidized reduced
cost or free vaccinations in public health clinics through the Vaccines for
Children program if they cannot afford to pay for vaccinations administered
by private pediatricians. NVIC's survey of four private pediatric practices
in the Virginia suburbs of Washington, D.C. found that parents could be
charged anywhere from $525 to $930 for three GARDASIL shots depending upon whether the child was a first-time or current patient. Costs for the
vaccine plus an administration fee ranged from $140 to $275 per shot with
an additional office visit charge that fluctuated between $35 and $185
depending upon whether a nurse or doctor saw the child.

HPV is the most common sexually transmitted infection in the U.S. and
most persons naturally clear the infection from the body without symptoms.
However, many years of chronic HPV infection is associated with a higher
risk of pre- cancerous changes in the cervix that can lead to cancer unless
diagnosed and treated promptly. High risk factors for chronic HPV infection
include smoking, long-term use of oral contraceptives and co-infection with
HIV, herpes and chlamydia. There has been a more than 70 percent drop in
cervical cancer deaths in American women since the 1950's due to routine
pap smears and nearly all cervical cancers can be prevented with regular
pap smear screening and treatment.

In its product manufacturer insert, Merck states that "Vaccination does
not substitute for routine cervical cancer screening. Women who receive
GARDASIL should continue to undergo cervical cancer screening per standard of care." Merck also states that "The duration of immunity following a complete schedule of immunization with GARDASIL has not been established."


For more information about HPV infection and GARDASIL safety, including
NVIC's five-page report on GARDASIL adverse event reports to VAERS as well
as a direct link to VAERS reports, go to NVIC's website at
http://www.nvic.org.

Absolutely, I think all girls should be getting this vaccine. We have a vaccine that can actually help prevent a type of cancer, and people are all jumpy because they think it's going to give their daughters a free pass to go out and have sex. Promiscuity has very little to do with vaccinations, IMHO, and a whole lot to do with poor instillation of morals. If you raise your kids right, a vaccine isn't going to change that.

What hasn't really been discussed, and should be, is that little boys should be getting the vaccine as well. Women are at a much greater risk of developing squamous cell carcinoma related to the HPV virus, but the men are the ones spreading it to those women. Vaccinate boys and you have a shot at stopping the spread.

Women who want to get the shot who are unfortunately over the age of 26, its going to cost us almost 400 dollars and not counting the doctors visits. Totally bites!

It sucks that I'm being, basically, discriminated against (although I'm sure someone will argue the point with me) because I'm 27 and I want the shot to protect myself, and my insurance won't cover it. Bites just a bit!

Not to split hairs, but parents could resent the government telling them to have their sixth grade girls get this shot for reasons other than the idea that the shot will encourage sexual activity.

Personally, I've yet to see anyone actually make the claim that the vaccine will encourage sexual activity, but I see a lot of people assuming that people will oppose it for that reason.

Have I just missed the news stories?

NVIC is the oldest and largest parent-led organization advocating reform of mass vaccination programs.

Notice that it's 'parent-led', not physician- or scientist-led. These are the same people who passionately believe that autism is caused by vaccinations. I'd suggest checking with the CDC and the FDA before believing anything that comes from a crackpot fringe group. I consulted a PharmD and an OB/GYN about this and was soundly chastised for even suggesting that the NVIC was a reliable source of scientific information.

This comment was actually made by another poster in this thread.

Untrue.