The five things you need to know about the HPV debate
Gardasil is one of the FDA-approved vaccines to protect against the types of HPV that cause most cervical cancers.
September 14th, 2011
02:18 PM ET

The five things you need to know about the HPV debate

The U.S. Centers for Disease Control and Prevention has suggested that parents have their middle-school-aged daughters vaccinated against a sexually transmitted disease closely linked to cervical cancer.

The human papillomavirus is the most common STD, according to the Centers for Disease Control and Prevention, and the second leading cause of female cancer mortality worldwide, according to the World Health Organization. There are currently two FDA-approved vaccines - Gardasil and Cervarix - to protect against the types of HPV that cause most cervical cancers.  While each vaccine uses different substances to rev up the immune system, both are given as shots and must be received in three doses over a six-month period, according to the manufacturers.

That's nothing new.

1. So, why is there such a debate swirling around the issue? Well, politics.

You've probably seen headlines about the HPV vaccine for years now, so what's new? A bigger spotlight, essentially, and the vaccine has come up amid jockeying for the GOP presidential nomination.

The debate over the use of the HPV vaccine - and specifically how it is given and who can mandate it - became a hot topic after some tense exchanges during Monday’s CNN/Tea Party GOP debate.

GOP presidential contender Rep. Michele Bachmann challenged one of her rivals for the Republican nomination, Texas Gov. Rick Perry, on his 2007 executive order that would have required Texas schoolgirls to receive vaccinations against HPV. Bachmann suggested the governor acted for political reasons, noting that the maker of Gardasil - the only Food and Drug Administration-approved HPV vaccine at the time – contributed to his campaigns, and that his former chief of staff lobbies for the company. She also said the drugmaker, Merck & Co., stood to make millions of dollars because of the order.

Truth Squad: Was Bachmann's claim about Perry's mandate for political reasons true?

Bachmann’s challenge came as candidates discussed the pros and cons of executive orders, and when and how the president should use one.

Perry said during the debate that if he could do it over again, he wouldn’t use an executive order, but would work with the legislature.

2. OK, wait. What actually happened in Texas?

Since 2006, 19 state legislatures have attempted to pass legislation that would mandate HPV shots for school, after the CDC recommended that parents be advised that the shot was a good idea and a way of preventing cervical cancer.

Perry took that one step further. In February 2007, he signed an executive order directing the state Health and Human Services commissioner to mandate HPV vaccinations for all girls before admission to the sixth grade. Perry at the time released a statement saying that the vaccine "provides us with an incredible opportunity to effectively target and prevent cervical cancer.”

Texas' rules were to take effect in September 2008. However, the Texas Legislature passed a bill overturning Perry's order in April 2007. Perry declined to veto the bill, which went into effect in May 2007, killing his order.

3. Politics aside, what are the health concerns?

We've been vaccinating kids - by mandate - for school for years.  And for all of those vaccines, parents have the ability to opt out. Again, that's nothing new.

But public perception is changing.

The debate over vaccinations picked up steam after concerns and arguments over whether childhood vaccinations were linked to autism or other diseases became another hot topic. Some were quick to warn of harmful side effects. And then, some medical journals retracted studies linking the two.

Many advocates against vaccinations still said that not enough was known and stood by the idea that there was a connection.

During Monday’s debate, much of the brouhaha over the HPV vaccine centered more on how Perry approached the issue than the vaccine itself. After the debate, Bachmann did touch on whether the vaccine was safe: She said parents told her that the vaccine had made their children sick.

But when it comes to the HPV vaccine, the CDC breaks it down pretty easy: It is safe and can go a long way in preventing a deadly cancer. The CDC says studies of the vaccine "showed no serious side effects," but "common, mild side effects included pain where the shot was given, fever, headache, and nausea." The CDC has said that if you get sick after the shot, it's a coincidence, not cause and effect, CNN's Senior Medical Correspondent Elizabeth Cohen reports.

Then there's the issue about the age of vaccination.

Middle school children are the targets of the vaccine, and there are some concerns about whether they should be vaccinated at an age when many may not be sexually active. And in some conservative areas, there is concern that the vaccine might encourage children to have sex at an earlier age.

4. So what do the vaccines do?

The FDA has licensed two HPV vaccines recommended by the CDC: Cervarix and Gardasil.

So what are the similarities? According to the CDC:

â–  Both vaccines are very effective against HPV types 16 and 18, which cause most cervical cancers. So both vaccines prevent cervical cancer in women.

â–  Both are very safe.

â–  Both are made with very small parts of the human papillomavirus (HPV) that cannot cause infection

â–  Both are given as shots and require three doses.

And what are the differences? According to the CDC:

â–  Only one of the vaccines (Gardasil) protects against HPV types 6 and 11 - the types that cause most genital warts in females and males.

â–  Only Gardasil has been tested and licensed for use in males.

â–  Only Gardasil has been tested and shown to protect against cancers of the vulva, vagina and anus.

â–  The vaccines have different adjuvants, substances that are added to increase the body's immune response.

(You can read more about HPV and the vaccines from the CDC here.)

5. Where do things currently stand across the country with regard to the vaccine?

Of the 19 states that tried to pass legislation mandating vaccination for children to attend school, only two passed the legislation. (You can see a full list of the attempted bills in each state here.)

Only Virginia and Washington, D.C., have passed measures to require the mandate. In Virginia, the legislature tried to reverse the mandate. The state's House passed the reversal, but the bill was killed in a Senate committee, so the mandate still stands.

Even there, where this is a mandate, it appears that more families are choosing to opt out of the program than to take part in it.

"Just 17.3 percent of eligible girls had received the first of three vaccinations, as envisioned by the law, at the start of this school year," according to Rosalind S. Helderman, writing for The Washington Post in February. "Only 23 percent of this year's eligible sixth-graders in the District have received the vaccine."

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Filed under: Health • Politics
soundoff (736 Responses)
  1. mranthrope

    I have a neice who lives in a town of about 2500. SHe developed severe myelitis shortly after getting the hpv vaccination. Two other girls in this small town had similar events. These were not minor side effects, none of them have returned to prevaccination levels of activity. I believe Jenny McCarthy and her autism claims are ridiculous "I have a child with autism so I'm an expert" i have 2 sons who have broken their arms so I'm an orthopedist. The testing oh Gardisil(sp?) were kind of hasty, so I believe that vaccination for hpv should be the choice of the patient and the parent/guardian

    September 18, 2011 at 8:57 pm | Report abuse |
  2. jen

    My 15 yr old daughter has major reactions to ALL immunizations, if I were to allow her to get the Gardasil Vaccine, I believe it could be life threatening. This is still a new vaccine and the side effects can be severe. The government can not and should not make this a standard for all teen girls.

    September 18, 2011 at 9:24 pm | Report abuse |
  3. Vaccine Choise

    The whole point is that it should be our CHOICE whether we get vaccinated! And yes, vaccine injuries are real! Too many people go with the herd mentality and "government know best". Do you really think the governement has our best interests in mind? They care more about who's funding their campaign. Wake up!

    September 19, 2011 at 1:28 pm | Report abuse |
    • Abbs

      3 years ago I found out I had abnormal cells "down there" and immediately had them removed by my lady doctor. They weren't cancerous, but had the potential to become cancer.... She administered the Gardasil vaccination to me. Every 6 months for the last 3 years I have been back for pap's to make sure these bad cells haven't returned. Because I had the Guardasil injection, my lady doctor said that once my body fought off the HPV infection, I would be protected from getting the same type again.. Since I am married, my husband may also have this disease. Since I am vaccinated, his immune system has an excellent chance of fighting off the virus as well. 3 years later, and all of my tests have come back clear, I STRONGLY believe this Guardasil vaccination to be one of the best vaccinations availiable for the general public to prevent a tragedy. Around my office, 5 women have had abnormal paps in the past due to hpv, 3 have had cervical cancer, and 1 woman just found out last week she has it also. I can think of an additional 10+ women that I know who have had abnormal paps, which is ALWAYS an indication of HPV according to my dr.

      I don't think a lot of people realize just HOW MANY PEOPLE THAT THEY KNOW have this disease. It's so much more widespread that I had ever imagined, before I learned about it. Truly, I had no idea. I've heard that condoms cannot stop the spread of HPV. HPV can pop up at any time after exposure. It is also linked to cancers of the neck, mouth and throat.

      My question: If given the opportunity to get a shot that could help prevent you from getting certian types of cancer, why the heck wouldn't you take it!!! It's not chicken pox we're talking about here....an aquaintance of mine spent quite a bit of time doing chemo to treat her cervical cancer. She had beautiful long dark glossy hair, and eventually it all fell out. Guardasil is NOT linked to autism, or brain damage, or any other major side effects.

      I was most concerned when I heard about how HPV is linked to oral, neck, and throat cancers also. With such a high percentage of the population affected, it seems almost epidemic-like.

      October 4, 2011 at 3:30 pm | Report abuse |
  4. erik

    hpv causes cervical cancer, this is not a theory but a fact, please explain to me why we would not want to protect our female population when this is known. As a 24 year old male in medical school I can tell you that all of my female colleges, medical professionals have been vaccinated, it is a no brainer for anyone in the field. And believing that vaccinations will lead to higher rates of promiscuity is outrageous. If in the next ten years a vaccine is developed for HIV I wonder if these same people will rally against it.

    September 20, 2011 at 2:11 am | Report abuse |
    • Maggie

      Erik, as a med student, I would also think you look into so many things new to medical science, especially this HPV. I was actually hoping to read something here I didn't know.
      If an HIV vaccine was created, would I hop on the bandwagon? No. Not if it was created the way this has.
      There are a large amount of HPV strands. This shot covers very few.
      Statistically speaking, (This is not me spewing numbers, this is statistics, and you can't really argue math)
      If you contract HPV, your body will more than likely fix this problem on it's own.
      This vaccine is not like a vaccine for communicative diseases. HPV has not shut cities down and put them under quarantine. You can't cough on someone and give them HPV. This is not like meningitis, that can kill someone in a very short period of time.
      When they have reformulated gardasil to be more reliable, work on many more strains, and have a lower rate of harm, I will reconsider it for my kids. Unless they reach the age of consent and decide to do it.
      I highly suggest you look into how this testing phase went. It's pretty low-rate when it comes down to it and they still don't even know how affective it is.
      Again, you can say the same about many other vaccines. and again, this is not a vaccine for an illness that causes death when someone coughs on you.
      If CNN would allow for me to write an article, I would. And you would all question the legitimacy of this "wonder" vaccine.
      Oh lord, it prevents CANCER! No people, it doesn't. It prevent 3 strains of hpv that has a low statistical rate of turning into cancer.
      I will say, they're damned if they do and damned if they don't put this vaccine out there.
      If they don't, they're accused of not caring. If they do, they're both Gods and evil people trying to turn a profit.
      I also don't think it'll make women more promiscuous. that's also a ridiculous claim.
      Please, I ask for you to simply do the statistical research. A bit of patience, google skills and about 3 hours is all it takes.
      Read several article on what they claim the statistics to be. If it's a praising article, many of the "facts" are wrong.
      They're not looking at all the facts when doing their mathmatical homework.
      http://www.guttmacher.org/pubs/tgr/06/3/gr060304.html
      Just a place to start your 3 hour tour shedding the shadows of HPV and what they don't say in articles.

      September 20, 2011 at 1:01 pm | Report abuse |
    • Mike

      4,021 women in the United States died from cervical cancer in 2007 http://www.cdc.gov/cancer/cervical/statistics/
      158,599 people die a year from lung cancer http://www.cdc.gov/cancer/cervical/statistics/
      Sounds like a lot of tax payer money spent on cervical cancer, compared to the amount of people sick from it. All types of cancer are bad and it is a terrible situation for people and their loved ones to go through. The pharmaceutical companies are lobbying our politicians, so they can get filthy rich on our tax payer money. This is a problem

      October 3, 2011 at 8:31 am | Report abuse |
  5. Joan

    It seems as if Merck's biggest hurdle is being able to censor whatever bad news comes out as a result of this 'life saving' vaccine.....

    Gardasil Researcher Speaks Out

    http://www.cbsnews.com/stories/2009/08/19/cbsnews_investigates/main5253431.shtml?tag=cbsnewsLeadStoriesAreaMain;cbsnewsLeadStoriesPrimary

    September 26, 2011 at 11:06 am | Report abuse |
  6. caitlin

    HPV. let me tell you about HPV. I had my first irregular pap come back 7 years ago when I was 23 years old. I went in shortly after that for a cervical biopsy, owch, not comfortable. Followed by days of spotting and being miserable. Biopsy confirmed I had the HPV virus, showing moderate dysplasia...... and I was shocked. Mainly because this was before Guardasil and all the publicity this virus has received lately. I had never even heard of HPV before! I was soon booked for a LEEP procedure (where a thin wire loop receives electrcal current and cuts out the infected tissue)(and by the way, having anasthetic injected into your cervix does NOT feel pleasant at all)...... this cylce repeated itself and I had another LEEP procedure done about 2 years later. It took me almost 3 years to beat the virus.... I had a hard time dating guys for a while, it was really embarassing talking about my condition.... what people need to know about getting vaccinated is that parents should discuss the vaccination option with their child. kids are smart. guide them, tell them the facts, let them decide... they dont have to do it right away. but this is an easily preventable disease now.... HPV can be spread through skin-to skin contact... condoms can only help, but not fully prevent its transmission. PLUS, and MOST IMPORTANTLY, I was lucky that I had good medical insurance when I went through this ordeal, BUT A LOT OF GIRLS DONT NOW AND WONT IN THE FUTURE. They may not be getting annual PAPs, they may not know they have the infection until its in a more advanced state.... I really REALLY wish I had the option to get vaccinated when I was younger.

    October 4, 2011 at 4:34 am | Report abuse |
  7. genital warts

    Hello my friend! I wish to say that this post is awesome, nice written and come with approximately all significant infos. I'd like to peer extra posts like this .

    March 31, 2012 at 3:00 am | Report abuse |
  8. Godofredo

    The three doses of the vaccine against the HPV cost $ 300 ( three hundred dollarrs). USA have 2 death by cervical carcinoma (CC) by 100000 women. Have to vaccinate10000 women to prevent the death of 2 women by CC, have to spend 30 millons of dollars; each death:prevented shall cost $ 15 millons (fifteen millons of dollars). if the vaccine is 100 % efficacy. It is absurdity. I send you the link to prove
    Sincerely yours
    Dr. Godofredo Arauzo
    http://appliedresearch.cancer.gov/icsn/cervical/mortality.htm

    May 6, 2014 at 6:52 pm | Report abuse |
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