Teen HPV vaccine injects controversy
By age 50, 80 percent or more U.S. women have been infected with the genital human papillomavirus, according to the Centers for Disease Control and Prevention.
Although some infected women will develop genital warts, most will experience no symptoms and do not know they have been infected with HPV, which is transmitted through genital contact. Yet others infected with high-risk strains of HPV may ultimately develop cervical or other cancers, according to the CDC.
Drugmaker Merck began marketing the HPV vaccine Gardasil in 2006 with the claim that it can prevent up to 70 percent of cervical-cancer cases. Manufacturer GlaxoSmithKline also is developing Cervarix, which covers against a few more strains of the virus that causes cervical cancer than does Gardasil, but does not protect against genital warts.
Gardasil’s release was met with controversy because some lawmakers across the country immediately began pushing for mandatory vaccination of girls 11 and 12 years old.
In April, the New York State Catholic Conference’s public-policy committee agreed to take no position on the vaccine itself but opposed legislation to make it mandatory, said Jann Armantrout, the Diocese of Rochester’s life-issues coordinator.
“While everyone appreciates that anything we can do to prevent a cancer death is important, people are reluctant to say that their underage daughter should be vaccinated, particularly when this is a sexually transmitted disease,” she said.
In a January position paper on the HPV vaccine, the Catholic Medical Association said that it supports the use of the vaccine in general but does not support vaccine mandates.
“Prevention of HPV infection is distinct from, and should not be construed as encouraging, the behavior by which HPV is spread,” it said.
The HPV vaccine has both Catholic and local roots. Two decades of HPV research by University of Rochester virologists William Bonnez, Richard Reichman and Robert Rose included blood tests and sexual-history surveys from Catholic clergy and women religious, who were chosen because of their celibacy.
Local researchers continue to study HPV treatments and the vaccine’s long-term effectiveness. Dr. Cynthia Rand, associate professor of pediatrics at Golisano Children’s Hospital at Strong, also is studying parent and teen attitudes about the HPV vaccine.
As with all childhood vaccinations, parental consent is required to administer the HPV vaccine. Rand said she has had only a few HPV vaccine refusals in her own pediatric practice. One was from a parent who wanted to see 10-year safety data before making a decision on the vaccine (only about five years of safety data is available). In another instance, a parent felt the teen should make the decision about the vaccine, and the teen opted against receiving an additional shot, Rand said.
In a study Rand published earlier this year, she found few teens see their doctor enough to get the three rounds of HPV vaccine shots and other newly recommended adolescent vaccines, including a meningitis vaccine, a chicken pox booster shot, and a vaccine against tetanus, diphtheria and whooping cough.
“Anytime an adolescent comes in for a cold, a sore throat or a sprained ankle, we need to fit the vaccines in,” Rand said.
In February, Merck announced it would stop lobbying nationwide for vaccine mandates after it came under scrutiny for such lobbying. Still, legislators in at least 41 states and Washington, D.C., have introduced proposals to require, fund or educate the public about the HPV vaccine, according to the National Conference of State Legislatures.
New York state allocated $5 million in its 2007-08 budget to promote and expand access to the HPV vaccine, which costs about $360 for the three-round vaccination. Some legislators in New York also have proposed vaccine mandates for students in public and private schools. One proposal would allow for parents to opt out, while another would allow a religious exemption.
The unknown aspects, such as the vaccine’s long-term effects and effectiveness, are why the public-policy organization Concerned Women for America opposes vaccine mandates, said Anne Downey, the organization’s state director.
“Parents as a whole have the right to make decisions on whether to give the vaccine to their children,” said Downey, of Boston, Erie County.
Armantrout said one concern some parents have is that they fear the vaccine will give their children the message that promiscuity is permissible. On the other hand, some parents have chosen the vaccine because their daughters could be victims of a sexual assault, she said.
The Catholic Medical Association notes that the debate underscores the church’s fundamental message of abstinence outside of marriage and monogamy in marriage.
“Consistent messages about and support for this virtue will not only help to reduce disease, but will help individuals, couples, and marriages to flourish,” it said.