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. news watcher

    My daughter had one Gardasil injection a couple of years ago and immediately began to develop chronic pain in her joints and limbs. She still suffers from it, takes several meds just to cope and has some really really bad days, even with the meds. Definitely do not take this vaccine or ignore the injury it has caused.

    September 14, 2011 at 10:44 pm | Report abuse |
    • Really???

      Lyme disease or other joint problems are likely the problem, get a better doctor. Pre- existing conditions are not caused by vaccinations. It is likely she already had a problem because those are not side effects. I have Lyme in my joints & tissues & have none in my blood. Get her to a board certified infectious disease specialist first, & then an orthopedist if it is not Lyme.

      September 15, 2011 at 2:06 am | Report abuse |
    • ardis

      Well bone pain is common in many chemotherapy treatments as well, but I wouldn't wish that on anyone. Many of us who have bone pain, take vitamin D which helps.

      September 15, 2011 at 3:39 am | Report abuse |
  2. Chris Canto

    This article says she said this vaccine makes children sick, this is untrue. what she said was that this vaccination can make your child mentally retarded. she reached this conclusion based entirely on anecdotal evidence relayed to her by an uneducated, but impassioned mother. No fact checking was done. No science backs this claim.


    September 14, 2011 at 10:50 pm | Report abuse |
    • Chris

      You do realize that most people who don't get their kids vaccinated are wealthy, educated people with college degrees right? No, of course you didn't.

      September 14, 2011 at 11:02 pm | Report abuse |
    • popejon

      Yes Chris, but Chris Canto is correct. Most people who don't vaccinate their kids that are wealthy and educated obviously dont do any science based fact checking or educate themselves on this very serious subject. Otherwise they would vaccinate their kids....

      September 14, 2011 at 11:24 pm | Report abuse |
    • Chris

      Oh really popejon, I have read hundreds of scientific articles that show the LACK of safety and effectiveness of vaccines. It is you and people who sheepishly follow the CDC who are misinformed. You ever hear of ghost writers? Conflict of interest? The people who don't vaccinate are the educated ones, they look up the facts instead of letting people who make money from vaccines say they are good for your children. Why did the Association of American Physicians and Surgeons all voted "YES" on stopping the mandate on childhood vaccinations...are they uneducated? I know of a nurse who doesn't vaccinate her kids, and has many nurse friends who don't, because "they know what is in vaccines and what they are capable of"...are nurses uneducated? Oh, and since I figure you would ask for proof, Jane Orient MD, AAPS executive director was quoted as saying "Our children face the possibility of death or serious long-term adverse effects from mandated vaccines that aren’t necessary or that have limited benefits." Nov 2, 2000.

      September 14, 2011 at 11:36 pm | Report abuse |
    • popejon

      Oh really Chris? My dad was a doctor, my stepmother and two of my aunts were nurses. they would all 100% disagree with your dangerous opinion and would say all your nurse friends are foolish. Have you ever met someone with polio or are you to young? If you haven't, go find someone and ask how much fun their life is. Then get back to me on how bad vaccinations are....

      September 14, 2011 at 11:51 pm | Report abuse |
  3. JW

    Do they put mercury in these vaccines as a stabilizer as well? Can you buy ones without the mercury?

    September 14, 2011 at 10:51 pm | Report abuse |
    • popejon

      Mercury has been taken out of all vaccines several years ago.

      September 14, 2011 at 10:55 pm | Report abuse |
    • Keithb

      The whole mecury (thimerosal)-autism link has been totally debunked.

      September 14, 2011 at 11:13 pm | Report abuse |
    • Chris

      Popejon, seriously, you need to read. Mercury is still in the flu shot, and just like trans fat being labeled as "0g of Trans Fat" as long as it is under 0.5g per serving, so too is mercury in vaccines. Silly silly man.

      And KeithB, who debunked it? The CDC, vaccine manufacturers? Because I can show you independent scientists that strongly believe a link. Ask the thousands of parents who have to care for their injured kids for the rest of their lives that it is debunked. If you believe goons like Paul Offit that it is coincidence you are an idiot.

      September 15, 2011 at 12:02 am | Report abuse |
    • Warren

      May I try to add some sanity to what has become a very emotional debate in some quarters? There is a HUGE difference between this immunization and all the others that are mandated for school chlidren: All the others address communicable diseases that represent public health risks. The HPV is aimed at preventing an infection that the girl MIGHT acquire some years later. As such, I tend to be against mandating it.

      As the father of three daughters, (all of whom are were well beyond the age where this vaccine would have been administered at the time it first became available), I WOULD have had them immunized, had that been an option. But that would have been my choice as a parent.

      September 15, 2011 at 12:18 am | Report abuse |
    • josey

      They avoid using mercury in vaccines as much as they can now. Even at its maximum before they were changed vaccinese had less mercury than your tuna sandwich. Even if the false studies that linked vaccines to harmful side effects were true the chances of having the side effect are still less than the odds of death from not having the vaccines.

      September 15, 2011 at 12:30 am | Report abuse |
    • tommy d

      Okay Chris, show me a study—one—that shows a causative link between vaccinations and autism. I can point you to DECADES of research that has never been able to link the two. Either believe the scientific method or go live in a cave and do some voodoo. All we have is hypothesis, test, evaluate....

      September 15, 2011 at 12:38 am | Report abuse |
  4. Will

    I think what it comes down to for parents is they view it as a bruise to their egos. They don't like being told what to do, even if it is in the best interest of the health of their child. I mean let's be real, hypothetically, if a vaccine was developed tomorrow that proved to stop all women from having a child born with down syndrome as long as they were inoculated prior to getting pregnant, I am sure a large portion would object to it despite its benefit. If you can prevent your daughter from dying from cervical cancer why in God's name wouldn't you? Ego, pure and simple. Further evidence of the lack of intellect and failure to do your own research, instead you do what the right/left wing nuts tell you to do.

    September 14, 2011 at 11:13 pm | Report abuse |
    • mike

      The Amish do not vaccinate for anything and have an almost non existant rate of many diseases, including autisim.

      Tha fact is, some vaccines have potential side effects that are more dangerous than the diseases they prevent. Those side effects are rare, yes, but why take any chance of dying when the disease itself gives you very small and mhamrless conditions.

      Why in God's name would you want to put those chemicals in your body to rpevent something like chicken pox? Oh Lord, I need it to rpevent the ithc8ing, please.

      As a world, our immune systems have declined dramatically because of our reliance on shots and penicillin/amoxicillin.

      Saying parents wont get the shot for their kids due to bruised egos is assininie. how about it's a knock on parental rights.
      Yep, I want my daughter to die necause I have a big ego. Moron. By the way, she got the shot.

      Do my own research? You mena the research conducted by the left wing doctors or right wing doctors?

      September 15, 2011 at 12:04 am | Report abuse |
    • Bob

      I don't think that cervical cancer is a harmless condition.

      September 15, 2011 at 12:26 am | Report abuse |
    • tommy d

      mike, chicken pox may be no big deal, but you'll be singing a different tune when you're 65 and have shingles. oh, and he amish don't have high rates of certain diseases maybe because they don't associate with the general public so much. duh

      September 15, 2011 at 12:42 am | Report abuse |
    • ardis

      Tommy D, I was going to bring up the same subject of Shingles. Owww, I can still remember that episode I had. They don't go away very quickly either. Now, there is a vaccine which cost me $200 but that did not deter me. Sure wish we had that available a few years ago. I know many people who have had shingles recently. Polio is a very good reminder to many of us. So glad we don't have to deal with that anymore. Why would any parent want a young girl to go through any kind of cancer?

      September 15, 2011 at 3:08 am | Report abuse |
    • momtoboys

      Mike, the Amish actually suffer from outbreaks of measles periodically that are often deadly when it happens. It is one of the reasons that they segregate from the general community, though certainly not the only one. And as far as chicken pox goes, I actually do know someone whose 5 year old grandson died from it a few years ago and my ex-husband treated many teenagers in the hospital who had not contracted it as children, but did as teenagers. The reason they were in the hospital was because they had to be intubated when their throats closed up due to the swelling from the chicken pox virus. While for most people, it causes a mild illness, it has much more severe consequences for teens and adults who contract it, pregnant women, babies who do not have immunity yet, and of course as others have mentioned, shingles in the elderly. It also means weeks of school missed for children who have it and weeks of work missed when a parent has to stay home with them. You really do need to educate yourself on the economic and health impact of vaccinations vs. disease.

      September 15, 2011 at 10:17 am | Report abuse |
  5. john kesrouan

    #6. The media was all for mandatory Gardasil injections before being now against it. I call it the Gore Syndrome. Just
    like the Second Gulf War. They were all for it before being against it.

    September 14, 2011 at 11:40 pm | Report abuse |
    • RobfromMo

      Actually it's the health insurance mandate syndrome. Republicans were for it until Obama Proposed it.

      September 15, 2011 at 12:09 am | Report abuse |
  6. mike

    Shame on you CNN for not denying the link between vaccination and autism. it has been scientifically proven that there is NO connection by studies again and again. You should not report both sides of the issue as if they were equally true. One is WRONG.

    September 14, 2011 at 11:47 pm | Report abuse |
  7. Really???

    After watching a friend die of uterine cancer & knowing that 50% of my age group has been infected with this virus. Yeah all my daughters are getting vaccinated. Just stop this political BS & wake up. That McCarthy twit touted that bogus autism study, & we now have new epidemics that kill infants. Are you going to pass up a chance to prevent your child from having a cancer that can take away their chance to be mothers or kill them? Fools if you don't vaccinate.

    September 14, 2011 at 11:52 pm | Report abuse |
  8. never again RN

    The side effects can be dangerous! My girl got a bad case of gastritis that a year after shots 1&2 are still not gone even after medication routines. Needless to say, shot 3 never was given and pediatrician agrees! This robbed a healthy girl of a stomach that tolerated everything, but now is on pins and needles as to what will upset it next! Parents, read and be informed! RN

    September 14, 2011 at 11:52 pm | Report abuse |
    • RobfromMo

      It is very unlikely that the gastritis was in any way caused by the vaccine. When thousands of immunizations are given, someone will get sick soon after just by chance alone. I got gastritis the day after I watched Bill O'Reilly.

      September 15, 2011 at 12:07 am | Report abuse |
    • Matt

      Can you explain how a vaccine against HPV causes an infection (gastritis) that is caused by a completely different virus?

      Correlation does not necessarily imply causation. That said, the CDC website doesn't list gastritis as a possible candidate for side-effects, because their is simply no logical reason why a few antigens from HPV would lead to a stomach infection.

      September 15, 2011 at 12:13 am | Report abuse |
    • mike

      its sad that you think this way, but Matt is right. Its funny how so many will listen to you saying my daughter got sick. You have no evidence or an advanced scientific degree, but a lot of people will take your word over a doctors...Its sad that my generation of scientists might be this countries last hope of logic sanity.

      September 15, 2011 at 12:43 am | Report abuse |
    • Really???

      Your kid caught a bug coincidentally, maybe your kitchen sanitation was to blame.

      September 15, 2011 at 12:45 am | Report abuse |
  9. Chris

    Oh popejon...polio? You do realize that in 1977, Dr. Jonas Salk, who developed the first polio vaccine, testified along with other scientists that mass inoculation against polio was the cause of most polio cases through the USA since 1961. And the source is Science, April 4, 1977, “Abstracts". Ask any person who got polio or has a limp from polio and ask them if the leg that is limp or paralyzed was the site of the shot. You really don't want to go down this road.

    September 14, 2011 at 11:58 pm | Report abuse |
    • mike

      So if vaccines are so terrible then describe how another virus, smallpox, was eradicated from the human population? Oh and you can only use scientific journals. Careful I work for a research lab and have access to almost any journal I want, so I can tell if your BSing our not...

      September 15, 2011 at 12:54 am | Report abuse |
    • Really???

      Idiot, that was because there were 2 types of polio vaccines being administered; the LIVE vaccine & the KILLED vaccine. As a knowledgeable parent I was smart enough to demand they use the killed one FIRST to give the child some immunity before exposure to the live virus. Now ALL children receive the killed one first, & it has eliminated polio transmission from the vaccine. They used the live one more in the beginning because it was oral & could be administered by people untrained in the use of hypodermic needles. In the beginning adults & children ALL needed to be vaccinated quickly in a mass effort to stem the tide of deaths & disabilities that happened in waves leaving behind human devastation.

      September 15, 2011 at 1:04 am | Report abuse |
    • Jessica

      @ Chris:

      Anti-vaccine crazies love to pull out Salk's testimony for their own ends. To someone uneducated about Polio this seems like a slam dunk talking point. Too bad you have no idea what you are talking about.

      Dr. Salk DID testify that polio cases in the US were caused by a vaccine. He was right – they were caused by the attenuated-live virus vaccine developed by Dr. Albert Sabin. Salk was not against polio vaccination in general, he was against Sabin's live virus vaccine which replaced his own killed virus polio vaccine - Salk wanted the US to return to using a killed virus vaccine.

      Years later, the US did return to the killed virus vaccine for the very reason suggested in that hearing - new polio cases were being caused by the live virus vaccine and the US switched back to the killed virus version which didn't cause polio (a small number of polio cases were linked to Salk's vaccine, all were linked to one particular manufacturer's errors in production). The number of polio cases caused by both vaccines was MUCH less than the numbers seen during the polio seasons of the early 1950s.

      September 15, 2011 at 7:56 am | Report abuse |
  10. jonathen

    This may be a good idea except it has been common practice for the US to taint their so called "vaccines" with other chemicals in order to manipulate and do other things

    September 14, 2011 at 11:59 pm | Report abuse |
  11. RobfromMo

    Only an idiot would oppose a safe vaccine that significantly reduces the risk of cancer. I guess that explains Bachmann's opposition.

    September 15, 2011 at 12:03 am | Report abuse |
    • ardis

      I truly think people tell her things just to make look like a goof. She later told media that she was told this story by a woman in the audience who she never met before and didn't know her name. Mrs Bachmann then used this unqualified statement against a candidate vying for the same position a few minutes later. She belongs to the Flat Earth Society. Talk about Gullible!

      September 15, 2011 at 3:21 am | Report abuse |
  12. Christie

    Wow, does Merck own CNN? What an advertisement!

    September 15, 2011 at 12:13 am | Report abuse |
  13. MP2

    I hope this can help to rid us of HPV like the Polio of yore.

    September 15, 2011 at 12:14 am | Report abuse |
  14. tony
    -there's your debunking you twit

    September 15, 2011 at 12:15 am | Report abuse |
  15. Greg

    People signing up for the military know they are going to be shot at. During the second conflict with Iraq, Bush Jr. was pressured by the public to get the troops body armor. $2.5 billion was spent on over 44,000 bullet resistant vests which the troops were forced to wear. 80% of the Marines shot in the upper chest in Iraq had died because it turned out those vests were defective. The reason why they were defective was they were not tested first. Testing could take years and the public wanted those troops to have body armor because they think all body armor is the same. The body armor police wear will not work on the battlefield.

    I believe Bush Jr. and Perry made calls to try and save lives with the information they had at the time. That's leadership. It costs $350 to $500 to immunize somebody and over $13,000 to treat them if the cancer is caught early enough. About 10,000 women get cervical cancer in the U.S. each year and about 4,000 U.S. women die from it each year. Texas is also a boarder state and the cancer is mainly found in third world countries such as where those illegal aliens come from. Meanwhile Obama keeps trying to pass the buck and when there is success he tries to claim the credit and when there is failure he would rather blame others than himself. Reagan faced a Democratic congress and Clinton faced a Republican Congress. Obama had a fillibuster Democratic congress for two years and still failed including passing major legislation behind closed doors and wasn't even read till it became law. Obama has shown no signs of being a leader and being president is a leadership position.

    September 15, 2011 at 12:18 am | Report abuse |
    • ardis

      This started out as a debate issue and/or governmental mandates. You just want to bash Obama. Bill Clinton had a very rough start in his first term of office and he didn't have two wars to deal with. These are rather unique times right now. Not making excuses, but it is difficult to compare these years with the past. I personally think he has been too accommodating. We need decisive leadership, but I sure don't see much of that in those debates.

      September 15, 2011 at 3:27 am | Report abuse |
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