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:

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

■ Both are very safe.

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

■ Both are given as shots and require three doses.

And what are the differences? According to the CDC:

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

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

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

■ 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."

soundoff (736 Responses)
  1. michelle

    Shame on Perry – this is a parents choice – not the governments – plain and simple – Merk Pharmaceutical must be contributing nicely for his potential re-election – AMERICA beware – he has no business making rules like this for our 12 year old girls – shame shame shame on him for his gross overstepping his role and governments – this is simply not acceptable.

    September 14, 2011 at 8:01 pm | Report abuse |
  2. RC

    Michele Bachmann has terrified the country but for a good cause ... her own. Seriously, people should run for cover and board up their homes because Perry is trying to do nasty things to little grils. Michele Bachmann is a goddess for enlightening the world the evils that modern medican offers. Even though she is a chronic liar and only knows a shred of the truth, I believe she is the Republican carrier of information and knowledge and we should all be so thanks for for the alarmist views to protect and save out families from the evils of Perry and the big black man in the White House. God bless you Michele Bachmann. Bring your Bibles and pray for the salvation of the world ... the sky is falling and Michele Bachmann is destine to be the leader of the New Order of white people with gay husbands.

    September 14, 2011 at 8:09 pm | Report abuse |
  3. RC

    See ya next Tuesday Michele Bachmann.

    September 14, 2011 at 8:10 pm | Report abuse |
    • ardis

      I think there should be some kind of limit on these debates. But, she is funny.

      September 15, 2011 at 3:42 am | Report abuse |
  4. 21k

    you really only need to know one thing about the hpv debate last nite. all the participants were dewshebags who have no business thinking they are qualified to be president.

    September 14, 2011 at 8:17 pm | Report abuse |
  5. mary

    I heard that there is more than one type of HPV and this shot only protects against one.. Leaving a girl feeling she is safe when she is not..
    Also the shot burns as it goes in.. And many girls say the pain is bad.
    I don't know about mental retardation, but I do know that the drug companies always things in terms of numbers. If this protects 100 girls and one dies or suffers it is considered a worth while risk.. So I don't trust the drug companies..
    Any child should not be forced to take s drug based on the fact they might have s..x and it might be with some one who is infected..A shot being mandatory for this , steps way over the line..

    September 14, 2011 at 8:18 pm | Report abuse |
    • mary

      Typo.. always THINK in terms of numbers.

      September 14, 2011 at 8:19 pm | Report abuse |
    • Josh

      Hey Mary, CANCER. So the shot burns, that's unfortunate. So whats the shot doing? Oh that's right greatly reducing CANCER. 1 in 3 adults have HPV and most don't even know it. I assure you Mary, if 1 in 100 children would die from this shot the FDA wouldn't clear it for sale. I swear, people are scares ignorant rabbits in this country...

      September 14, 2011 at 8:58 pm | Report abuse |
    • michael456

      people always think and never research. The hpv vaccine protects against 2 types of hpv [1] the types that cause most cases of genital warts and cervical cancer. And no this vaccine won't give girls false hope and think they are always protected when there doctor explains that it only protects against 2 types plus they will be given the vaccine information statement explaining that says that as well. And this idea that drug companies make all this money from making vaccine is really getting old. There used to be 32 vaccine makers now there is 8, there is no money in this market. Its only 130 dollars per dose of hpv vaccine [2] but yet it cost vaccine makers millions of dollars plus years of work / clinical trails and FDA regulation. So if doctors, researchers and vaccine makers really wanted to make money they are in the wrong industry. They are just trying to help prevent disease that are now preventable and saves millions of lives.

      [1] http://www.cdc.gov/vaccines/vpd-vac/hpv/vac-faqs.htm
      [2] http://www.cdc.gov/vaccines/programs/vfc/cdc-vac-price-list.htm

      September 14, 2011 at 9:05 pm | Report abuse |
    • CJA

      Are you kidding "one in a hundred". You must of made that number up. Even one in a million is wrong. Your entire argument ails when yu use made-up facts that are so obviously wrong

      September 14, 2011 at 9:33 pm | Report abuse |
    • Kalie

      I also heard that once you have warts or abnormal cervical cells the "treatments" which include laser and freezing are painful... I will take a bit of pain on my arm than the pain in my cervix. I had the shot and it hurt, yes, but the tetanus shot is 100x worse than the Gardasil one. The Gardasil vaccine also protects against 4 strains of HPV not 1 (2 for warts, 2 which may cause cervical cancer). Did taking the vaccine make me feel more safe? Not at all but I do know that when I get married (and at that point protection does take a sideline since you trust your spouse, and at some point one may also want to have kids) if my spouse does stray for whatever reason I have a better shot at NOT having any of these 4 strains.

      September 14, 2011 at 10:35 pm | Report abuse |
    • ardis

      Fantasy, just pick a number out of the blue and hopes it sticks! This vaccine might protect against many genital warts that show up in a PAP sample. The youngest girl I knew with genital warts was six years old. No...I didn't get that information from a stranger in an audience. The perpetrator hired a good defense lawyer and he was found not guilty. The little girl could provide few details. Also, keep in mind this was long before DNA. If we had that resource, he would have been found guilty without a doubt.

      September 15, 2011 at 3:50 am | Report abuse |
  6. I call BS!

    That 8) should be and 8.

    September 14, 2011 at 8:24 pm | Report abuse |
  7. Steve

    The articel states most Medical Journals retracted studies done about vaccine safety, I beleive all did. Furthermore, getting an acrticle retracted is a very serious, uncommon event. Medical Journals do not publish factual info, meerly studies or papers performed by researchers. Not everyhting publish is actaull true or valid. That is why getting something retracted is such a rare occurance. But this created such a pandemic response by the uneducated (Yes, those who calim to have researched using the internet are still undecuated on the matter) they retracted the story. It created a bigger health risk from those who don't vaccinate than any vaccine has ever caused. Go research that, how many young children have died from measles/mumps in the last twn years versus those who have acutally been killed by a vaccine? Anyone?

    September 14, 2011 at 8:27 pm | Report abuse |
  8. 911insidejobber

    Once your little girl takes the vaccine, her immune system will be supercharged from the Squalene. She will be more likely to get immune over reactive diseases like Psoriasis and Asthma.

    September 14, 2011 at 8:34 pm | Report abuse |
    • Edwin

      This is nonsense, though I will retract my statement if you provide actual evidence to support your nonsense-sounding claim.

      September 14, 2011 at 9:09 pm | Report abuse |
    • JB

      list your sources! random internet hogwash is worthless give us hard proof of your accusations!
      And I would take Asthma or a skin rash over having cancer again any day.

      September 14, 2011 at 9:17 pm | Report abuse |
    • CJA

      What a bunch of bunk. You talk as if the immune system where one thing and not selective. Did you here this on some talk radio show?

      September 14, 2011 at 9:36 pm | Report abuse |
    • popejon

      9/11, Ignoring your made up statement, your name discredits anything you could possibly say....

      September 14, 2011 at 10:26 pm | Report abuse |
  9. GB

    Wait a minute !!!!
    How come that only the females are required to be immunized ? "Only one of the vaccines (Gardasil) protects against HPV types 6 and 11 – the types that cause most genital warts in females and males." Isn't this mandate discriminating ?
    Only the females are being required to have the vaccine when the vaccice Gardasil is also effective on males ?
    I think that instead of making a big deal about the vaccine we should concentrate on making it mandatory for both males and females. After all, it takes two to tango, right ? Why does it always fall on the females the responsibility for prevention of pregnancy, prevention of STD, raising children on a one parent (the mother) household and the males all that they do is shake off their pants and walk away ?
    If anything should be in question here is not the vaccine itself but why is it not being administered to both males and females when there is one vaccine that works for males as well.

    September 14, 2011 at 8:35 pm | Report abuse |
    • Peter James

      Men can not get cervical cancer...

      September 14, 2011 at 9:10 pm | Report abuse |
    • Edwin

      Warts do not kill. Men lack a cervix, so they cannot get cervical cancer even if they catch the disease.

      September 14, 2011 at 9:10 pm | Report abuse |
    • Mrs. Botwin

      The reason only females are required to get this vaccine, take birth control, and are damned if you do, damned if you don't between abortion and single parenting, is quite simply because of the Michelle Bachmanns and Sarah Palins in the world. They are perfectly happy keeping women lower tier. They are the women that make the rest of us look bad.

      September 14, 2011 at 9:17 pm | Report abuse |
    • JB

      peter and edwin...they can still spread the virus though so it would be a good idea to make males get it as well.

      September 14, 2011 at 9:19 pm | Report abuse |
    • TxResident

      At the time that Perry issued his executive order Gardasil was only FDA approved for females. It has since been approved for males and females. It's wise for the females to be proactive on this issue as there aren't any HPV tests for men...so even if a man has comprehensive STD testing done, he is not going to be able to confirm if he is or is not HPV free. Better safe than sorry, even if it does feel like there is a discriminatory approach to this issue. And for all the parents out there who aren't discussing this issue with there children...most health insurances will only cover these shots if the patient is under about 23, and the shots run about $200 each without insurance. To Mary...If you can't decide if these shots are a good idea for your children, please talk to an oncologist, or better yet, visit a cancer ward before putting them off because they sting a bit. There are over 100 strains of HPV, but the 2 addressed by the shots are responsible for about 70% of the cervical cancer cases. Having watched my wonderful sister-in-law die from this disease, please don't make an uninformed decision. Try http://www.CDC.Gov for more info.

      September 14, 2011 at 9:24 pm | Report abuse |
    • TxResident

      Peter and Edwin, men can develop anal and throat cancer from these HPV viruses. And there aren't any tests for them to determine if they've been exposed. So again, from a better safe than sorry point of view, it's a good idea for the sons to have the shots also. And besides, what self respecting man would want to live with knowing he may have been the source of the virus that killed or injured the woman he loved?

      September 14, 2011 at 9:33 pm | Report abuse |
    • howard feinski

      Since when do the young males "shake off their pants" anymore before they walk away?

      September 15, 2011 at 11:57 am | Report abuse |
  10. Jeff

    It's all BS. The Robert Beck Protocol will CURE HPV and a crap load of other blood born viruses...INCLUDING HIV/AIDS. That's right, I said it. Colloidal silver/Ozonated water along with acute bloodstream electrification will do the trick.

    September 14, 2011 at 8:49 pm | Report abuse |
    • Capt Nemo

      Please stop regurgitating nonsense. All colloidal silver does in most cases is turn the skin blue.

      Please don't add more pseudo-science to the discussion. If sliver and blood electrification were useful, they'd be all over the place because a) research would show it and b) it's so cheap.

      September 15, 2011 at 1:36 pm | Report abuse |
  11. Kenzie

    I have felt no need to get most vaccination. Except HPV. Yeah, it should be up to the person to decide if they want it or not, but to me there are really no cons, and many pros to this one.

    September 14, 2011 at 8:53 pm | Report abuse |
  12. timberowl

    We don't hesitate to pump our newborns full of innoculations, but when it comes to something effective against an STD and just as safe as a flu shot, we freak out about it. Get your kids vaccinated, and quit squabbling about morals. I bet if they came out with an HIV vaccine the same people would want to hold a debate about it.

    September 14, 2011 at 8:56 pm | Report abuse |
  13. Sal

    If a woman can choose abortion. She should be able to choose if she wants a drug like this in her body. No law should tell a woman what to do with her body. If we can't have a law to put men in jail for adultery then who needs to be forcing anything like this on people. I say let women decided. Not ever woman sleeps around which is what this is saying. I am so I want to decide to the drug company and to men and any other woman who wants to force stuff on me. What next forced abortions.

    September 14, 2011 at 9:05 pm | Report abuse |
    • CJA

      She can opt out of vaccinations but then no one wants her in their public school. Yes opt out but then please stay home. What's the quote? "My freedom to swing my arm ends when it hits your nose." Public health is like that.

      September 14, 2011 at 9:42 pm | Report abuse |
    • popejon

      Try reading the article before commenting on it. Parents can and always have been able to opt out....

      September 14, 2011 at 10:14 pm | Report abuse |
    • ardis

      CJA how foolish!

      September 15, 2011 at 3:55 am | Report abuse |
  14. Edwin

    The problem with vaccines is simple math. Or rather, the fact that a lot of Americans can't do simple math.

    Even though the government tries to downplay it, vaccines CAN AND DO cause serious problems in some people. Autism? I find it very reasonable to believe that vaccines could cause or contribute to it.

    But what the anti-vaccine people won't tell you is that the disease are BAD. Even mild chicken pox can kill, or at least blind and destroy lung tissue. HPV causes cervical cancer, which is either nasty and painful or deadly, depending on when it is detected and how good your insurance is. And the odds of getting sick and suffering a serious reaction from the disease are VASTLY higher than the odds of getting a bad reaction to a vaccine, except for people with certain specific conditions.

    So... get a vaccine and take a risk of it causing a bad condition, or don't get a vaccine and take a greater risk of a bad condition. The math seems clear to me, but as I said, a lot of Americans can't do simple math.

    September 14, 2011 at 9:16 pm | Report abuse |
  15. Andrea M

    I've had the Guardasil shots and they definitely hurt, but that's it. I didn't feel the need to run out and suddenly screw every guy in sight. I just said "ow" and went on with my daily life. I don't see any reason against giving young kids the shot since it's a huge case of "better safe than sorry."

    September 14, 2011 at 9:18 pm | Report abuse |
    • ardis

      Injections sting when they are refrigerated. If the person slowed down the plunger, it would be much better.

      September 15, 2011 at 3:58 am | Report abuse |
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