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. Mr Ed

    the vaccine may be good or bad.....that is just a perceptive opinion of the rationalizer....fact is I rather have the option than to be negated of such option by the perception of others.

    September 15, 2011 at 12:36 am | Report abuse |
  2. Barry


    If you mean the USA that has a wider spread between wealthy and poor than Egypt ,yes I want to bring it down.
    If you mean the USA where 1 in 6 live in relative poverty, yes I want to bring it down
    If your mean the USA where more people died last year from lack of access to medical care than in the twin towers, yes I want to bring it down.
    If you mean the USA that spent more on unjustified war than on educating our children, yes I want to bring it down.
    If your mean the USA that is more worried about tax cuts than putting people back to work, yes I want to bring it down
    If you mean the USA that exports jobs to countries without any protections for workers, evironments our our own citizens as consumers, yes I want to bring it down.

    This country is still the last best hope on earth, but that does not mean we do not need to work on improving it or fixing our errors. Conservatism leads to a lack of progress or growth, I wish to go forward.

    September 15, 2011 at 12:38 am | Report abuse |
  3. josey

    People don't understand what a side effect is. Say my dog barks and following which I ring a bell. My dog barks again and I ring a bell. This does not mean the dog barking caused me to ring the bell or that the next time the dog barks I'll ring the bell. Just because you get a shot and you get sick does not mean the shot caused you to get sick. Autism rates are higher only because we changed the definition of what autism is.

    September 15, 2011 at 12:38 am | Report abuse |
    • jimmyd787

      agreed.they act like autism is more common than asthma. uh, no. it's not.

      September 15, 2011 at 12:44 am | Report abuse |
    • pastafarian

      the studies linking vaccinations to autism were retracted because the data was falsified. It was a big load of bulls.hit, but ignorance reigns supreme once again in the uneducated GOP masses.

      September 15, 2011 at 1:11 am | Report abuse |
    • moral hazard

      Is that why the Mercury binding agent was removed, bc there was no hazzard...nice, keep spinning the truth and someday it will b u.

      September 15, 2011 at 1:35 am | Report abuse |
    • GH

      They took the thimerisol (ethly mercury not to be confused with methly mercury) out of the vaccines because of people like "Moral Hazard" believing that is was harmful. Before you post non-sequitur logic look up the real facts from a scientific point of view.

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

      This is Bull-spit, look at this more logically. There has historically always been a balance of power and a struggle between individual liberties and security. This kind of logic not only oversteps those bounds, but jumps it in the General Lee. The two things are completely unrelated, most vaccines are given to prevent diseases that could be contracted AT SCHOOL. If children are doing the deed at school, there is a larger issue here. I am not a member of the Tea Party, but am a firm believer in the fact that these mandates are not the responsibility of the state governments. I beg someone to try the arguement that it is the governments responsibility to protect its' citizens. Yes, but there are limits to even this, does the government also have the right to say children cannot play sports for injury rates are higher for athletes? No, this would seem ridiculous.

      September 15, 2011 at 2:23 am | Report abuse |
  4. Jaded

    I'm a Texan who hates Perry but I did get my daughters vaccinated after talking to my DOCTOR about it. Bad enough for Perry to be climbing in my uterus but downright creepy for him to be invading my daughters' cervises too. Is that the plural of cervix? 😮

    September 15, 2011 at 12:46 am | Report abuse |
    • pastafarian

      I thought you wrote crevices at first. lol.

      September 15, 2011 at 1:11 am | Report abuse |
    • natalie

      what? that doesn't evenmake sense. You don't think he should care about your daughter's health, but you did it anyway? good lord.

      September 15, 2011 at 2:09 am | Report abuse |
    • sshscaptain

      You completely miss this good sir's point, individual liberty versus governmental mandate. Just because I choose to take a shower everyday, doesn't mean the government has the right to force me to do so. People go back and read the actual political theory our government is based upon and you will see the error in turning to the government to fix every problem!

      September 15, 2011 at 2:27 am | Report abuse |
    • lamborghini-Dallas

      Why is DOCTOR in large caps? Is o'bozo your doctor and he could make it right?

      September 15, 2011 at 4:27 am | Report abuse |
  5. Big Silly

    According to miss Bachman the HPV vaccine is a cause of mental retardation, ergo miss Bachman was more than likely vaccinated with it.

    September 15, 2011 at 12:49 am | Report abuse |
    • natalie

      her son does have a mullet, so there is your proof....a mullet, in 2011.

      September 15, 2011 at 2:10 am | Report abuse |
    • ardis

      I watch her just to find out what crazy thing she is going to share with us. She makes the men look much smarter than they are.

      September 15, 2011 at 2:55 am | Report abuse |
  6. pastafarian

    People PLEASE! The study linking vaccines to autism was FRAUDULENT! Here is a link from a repsected site, with a video even a republican can understand. It's only 2 minutes long. Watch it NOW! For Fux Sake, use your brains!!!

    September 15, 2011 at 1:23 am | Report abuse |
  7. pastafarian

    THERE IS NO LINK BETWEEN AUTISM AND VACCINES!!! The study showing that link was COMPLETELY fraudulent. It's nearly impossible to repair public perception, but it's so simple to do a little research. Here's a link from a non-partisan medical education site with a 2 minute video explaining the fraudulent nature of the paper. Please educate yourselves before speaking!

    People PLEASE! The study linking vaccines to autism was FRAUDULENT! Here is a link from a repsected site, with a video even a republican can understand. It's only 2 minutes long. Watch it NOW! For Fux Sake, use your brains!!!

    September 15, 2011 at 1:32 am | Report abuse |
  8. Kris

    Most other diseases for which immunizations are required for school are transmitted through casual contact. The schools have an interest in reducing the incidence of disease to lessen the time lost to sick days. Therefore, to require vaccination for school attendance is reasonable. HPV is not transmitted casually. The schools have no interest in preventing this disease. This is an issue that should be decided by the parents after discussing it with their doctor. The state may have an interest in reducing cervical cancer but this should be accomplished through education not coercion.

    September 15, 2011 at 1:56 am | Report abuse |
    • Really???

      Kids get caught scr3wing around at school all the time. Stairwells, locker rooms, auditoriums, ect. They were doing it back when I was in school, but now they are doing it as young as elementary school. Our public school is so bad the doctors recommend the HPV vaccine at age 9! We had a girl graduate at 17 with 3 children. The oldest was in kindergarten. These girls need HPV to be mandated because they are blanking like bunnies! As single mothers, who will raise their children if they die? Will you?

      September 15, 2011 at 2:21 am | Report abuse |
  9. BlackYowe

    First of all the vaccine does not protect a women from all of the strains and only a small number of people exposed to the virus actually get cancer . I do not trust the corporations who are pushing this. My neighbors daughter almost died after getting a horrible reaction to the meningitis vaccine they are pushing for teens. Giving this vaccine to your child is also saying I don't trust you so I am going to have you vaccinated and you have to live with the consequences good or bad because I don't trust you.

    September 15, 2011 at 2:16 am | Report abuse |
    • ardis

      Parents are still able to opt out. I have three grand-daughters and am very glad their mothers signed the girls up. You take a vaccine before the event, not when they are on their own.

      September 15, 2011 at 2:59 am | Report abuse |
    • Conerly

      When someone you love dies of cervical cancer then you may change your opinion. And it does protect against the strains that cause the disease. The other strains are not relevant. My grandmother died of cervical cancer. It was a fast horrible death.

      September 15, 2011 at 2:59 am | Report abuse |
  10. ApprxAm

    Don't care about the debate as much as the government forcing children to support BigPharma yet again.

    September 15, 2011 at 2:59 am | Report abuse |


    September 15, 2011 at 2:59 am | Report abuse |
  12. Lynn

    A lot of what is being written about the HPV vaccine issues misses some very important points and incorrectly focuses on whether you should or shouldn't get the shot.

    #1: No one knows or can decide what the best healthcare for themselves or their family members is except themselves.

    #2: It is a dangerous path to go down for government to start mandating drug injections, when all the potential effects are never known when a drug is new. It violates basic human rights for people to control what to do with their and their children's bodies and what substances to inject. We are not the property of the state. We are free individuals.

    #3: The FDA has repeatedly approved drugs as safe and effective, only for those drugs to be taken off the market years later because the "safe" drugs in fact caused too much disability and death. When the FDA says a drug is safe and effective, they are asking you to trust them and gamble with your health and life. You are free to decide not to trust the FDA and not gamble. They have far from a perfect track record.

    #4: Remember, prescription drugs like vaccines are made by drug companies to make a profit, so they have a huge financial incentive to promote positive things about those drugs and ignore the negative.

    #5: We are free people with the freedom to question claims about the HPV vaccine and make our own decisions on whether to take it. Again, we are not property of the state, and the state has no right to dictate our choices on health care.

    #6: I have studied alternative medicine the past few years. Did you know it's a scientific fact that women who get more of certain nutrients (folic acid, lycopene) mostly avoid cervical cancer? Why didn't the vaccine company tell you about that method of prevention? Why isn't the CDC and the FDA educating women on that safe effective preventive measure which has absolutely no safety questions and is not costly like a vaccine? Apparently our CDC and FDA are too bought out and corrupted by the drug companies!

    I question why we have the CDC and FDA in their current forms because they are not making safe and scientifically proven methods of disease prevention, such as diet and nutrients, their number one priority. So they are really not acting in the public's best interests. The CDC covers up the existence and severity of diseases such as long term borrelia infection (lyme disease) also.

    No, I don't like Mrs. Bachmann's speech errors.
    No, I don't like Mrs. Bachmann saying the government should control what women can and can't do with their bodies (i.e. abortion). It seems to contradict everything else she says about getting the government out of people's lives. There are other ways to encourage fewer abortions than the big brother government way.

    But I applaud Mrs. Bachmann for speaking out on the outrageous violation of our individual freedom by a state by trying to force for-profit prescription drug injections into children. That is repulsive and inexcusable. This HPV vaccine issue wasn't and isn't about health care – it's about the violation of our individual right to freedom of choice on our health care decisions.

    Don't underestimate Mrs. Bachman's ability to win. Her defense of individual freedom and smaller and less wasteful government will win her many votes, maybe even mine if there isn't a better choice. Her opponents don't seem to have a good track record on that. Rick Perry fell apart on that the other night.

    September 15, 2011 at 3:28 am | Report abuse |
    • Slash

      People too stupid to do their part to protect themselves and others from easily-preventable diseases should have the decisions made for them.

      Your right to be stupid does not trump public safety.

      Oh yeah, and your distrust of vaccination is hilariously ignorant. Stop trying to pretend that you have the faintest clue of what you're talking about and trying cracking open a book that wasn't written by science-class failures for a change. The scary FDA and vaccine manufacturers have saved countless lives, and making profit doing so is not a crime. Provide evidence that there's something wrong going on or shut your trap.

      September 15, 2011 at 3:43 am | Report abuse |
    • ardis

      Simple solution for you..opt out. You didn't need to waste all those words.

      September 15, 2011 at 4:29 am | Report abuse |
  13. Slash

    The fact that perhaps the ONE good thing Perry did is treated like a bad thing is hilarious. Well, no, it's not, but it would be if the retraction of this requirement didn't lead to numerous easily-preventable deaths.

    The Republican Party is anti-science. Period. They cling to ancient beliefs and long-debunked modern myths. Vaccinations have saved hundreds of millions of people if not BILLIONS - smallpox ALONE killed more than 300 million people in the 20th century alone but will never kill one more person thanks to mandatory vaccinations across the world. Parents who refuse to vaccinate their children are abusing their children and do not deserve to raise any. Politicians who refuse to support vaccinations (and worse, spread lies about them) are abusing their nation (as well as their species as a whole) and do not deserve to govern any.

    September 15, 2011 at 3:40 am | Report abuse |
  14. duh

    the claim that autism is caused by vaccinations is so ridiculously ignorant. i don't know where these hpv rumors are coming from but as far as vaccinations that you get when you're a todler, of course the first symptoms of autism can manifest at the same time as children are vaccinated. you get your shots when you're about 2 years old and you can't see the first signs of autism until 2 years old because autism is a social disease and you can't tell if a child has it until they start to.. well, socialize. wake up people. statistics can be made to say just about anything. if you don't learn how to read them correctly and your child suffers by contracting something horrible like the mumps, then shame on you.

    September 15, 2011 at 3:42 am | Report abuse |
  15. jhnz

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    September 15, 2011 at 4:23 am | Report abuse |
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