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. jstFACTS

    The fact is this is a vaccine for HPV nothing else (NOT CANCER) the fact that there is a tie between HPV and cervical cancer does not make it a Cancer vaccine. it is still possible to get cervical cancer after getting this vaccine. So all advertisments for this as a cancer vaccine are false. As for mandating this vaccine I am aginst this. HPV is not like polio or measles or smallpox. It will not cut down an entire school in weeks. Mandating this would only be for reasons of greed by politicions and drug manufactures.

    September 15, 2011 at 10:50 am | Report abuse |
  2. Dana

    My daughter's health completely deteriorated after receiving gardasil over 4 years ago. After having all other vaccines and not having a problem, and thinking she would be protected, she received the vaccine. I would not have believed it if I hadn't seen the devatating effects first hand. Make no mistake – gardasil is flat out poison for some girls. This vaccine has caused more devastating side effects than all the other 80 some vaccines combined. An absolute nightmare.

    September 15, 2011 at 10:52 am | Report abuse |
    • Capt Nemo

      What have you done to ensure that this was a bad outcome? Have you pursued this not only for your daughter but also to (hopefully) provide data that will prevent other such outcomes? Did you report the possible adverse outcome? Did you get your daughter checked out by the FDA-provided system to review such cases? By specialists? Have you moved heaven and earth to uncover what happened? Or did you just complain to your local medical doctor and then start telling the world your half-baked story?

      Do what it takes to find out what happened, don't assume it was the vaccine. If you have done no follow-up, your kid may be suffering from an unrelated and treatable condition...

      September 15, 2011 at 2:27 pm | Report abuse |
  3. True Scientist

    It is the other way around: *not* receiving the vaccine causes seizures. I personally know someone who got seizures mere hours after not receiving the vaccine. The link is obvious.

    Oh, and smoking is good for your health. My uncle smokes a pack a day and is nearly 100.

    September 15, 2011 at 10:53 am | Report abuse |
    • Emma

      haha, great analogy!

      September 15, 2011 at 11:14 am | Report abuse |
    • Meestor Yay

      Hahaha, I got a full night's sleep by not eating sushi. You could go on forever with that...

      September 15, 2011 at 12:05 pm | Report abuse |
    • Lara

      Hey, I didn't get the vaccine, and I didn't get cervical cancer. Obviously the vaccine *CAUSES* cervical cancer!

      September 15, 2011 at 12:23 pm | Report abuse |
  4. Buffy147

    There are a couple of issues here, one mandating vaccines, which should be a parents choice – as well as only requiring the vaccine for girls and not boys. The age of this requirement is quite shocking.

    September 15, 2011 at 11:00 am | Report abuse |
    • Captain Nemo

      The age is not shocking, it is scientifically chosen TO PROVIDE VACCINE BEFORE THE CHILD IS EXPOSED TO HPV.

      September 15, 2011 at 11:14 am | Report abuse |
    • footnotegirl

      How is the age shocking? Other vaccines are mandated for much, much younger ages.

      September 15, 2011 at 11:18 am | Report abuse |
    • charlie

      there is no vaccine for boys

      September 15, 2011 at 11:41 am | Report abuse |
    • Thomas

      If vaccinations were left up to parents to decide, we would still have epidemics of small pox, measles and polio. While most folks have common sense enough to do what is in their best interest, many have NO IDEA what "in their best interest" even means.

      September 15, 2011 at 11:42 am | Report abuse |
    • Lilmatley

      Last I checked Charlie boys don't have a cervix.

      September 15, 2011 at 12:00 pm | Report abuse |
    • WL

      I guess people are lucky to have you make that decision for them then, right Thomas? Please.

      The simple point is this, it makes sense for government to mandate vaccines for school age children when it is likely a serious disease can and will be spread by casual contact (such as in school buildings); this is not such a disease and vaccination is more of a medical decision which should be made by the pateient/parents in consulation with their physician. the government can, and should, recommend actions in such cases, but it has no business mandating them. One of the frustrating things in a democracy is that people have the right to disagree, and even behave stupidly, and the government has no right to intervene.

      September 15, 2011 at 12:01 pm | Report abuse |
    • saywhat56

      Boys do not have cervixes, and do NOT get cervical cancer. Other STD vaccines should be made available to boys.

      September 15, 2011 at 12:03 pm | Report abuse |
    • Jean

      um – I was not aware that boys were vulnerable to cervical cancer (what with them not having a cervix and all)...

      September 15, 2011 at 12:10 pm | Report abuse |
    • WL

      Boys don't have cervixes, but they do spread HPV. If the desire is to prevent the spread of HPV, vaccination of boys makes as much sense as that of girls (assuming the vaccines actually do prevent HPV infection in boys and prevent them from being "carriers".

      September 15, 2011 at 12:11 pm | Report abuse |
    • Sunflower

      No... boys don't have a cervix and don't get cervical cancer, but where do you thing the girls get HPV from? They are infected from their male partners, and visa versa..... If that's the case then boys should ALSO get the vaccine as they are carriers.... My husband was devastated when he realized he infected me after we were married. He had no idea that he was a carrier, and I went through hell. He's never forgiven himself. You want that for your sons????? shame on you.

      September 15, 2011 at 12:12 pm | Report abuse |
    • Lou9399

      How is the age even an issue? I was happy to have my child protected from CANCER way before it was even an issue! She had no idea what the shots were for...just another immunization as far as she knew. Plan on getting it for my son too when he is old enough...it is something i can do to protect them from CANCER for crying out loud!!!

      September 15, 2011 at 12:13 pm | Report abuse |
    • Lara

      There IS a vaccine for boys, because they can still get the warts, and they can transmit them to the girls.

      September 15, 2011 at 12:30 pm | Report abuse |
    • Thomas

      WL...I didn't make any decision for anyone. I don't know where you read that in my statement. I was just pointing out the very same stupidity that you cited in your counter-point. However, if people are in favor of their kids getting cervical cancer rather than a vaccination, more power to them.

      September 15, 2011 at 12:37 pm | Report abuse |
    • WL

      My apologies Thomas, I misread your post. And people are not always that stupid, I recall lining up to get the Salk (and later the Sabine) polio vaccines while they were still experimental. No requirement to get it, but most people wanted the protection and were willing to take a minor chance to get it (every neighborhood had someone with polio related problems in it, so the polio risk was readily apparent). I think with vaccines of this sort the scientists and medical profession need to do a better job in convincing people that the benefits far outweigh the risks rather than try to mandate vaccination; most people will listen when they're talked to rather than at.

      September 15, 2011 at 1:14 pm | Report abuse |
  5. Nate Dogg

    http://slog.thestranger.com/slog/archives/2011/09/14/religious-conservatives-hate-the-hpv-vaccine-because-they-want-women-to-die

    September 15, 2011 at 11:00 am | Report abuse |
    • dbrown

      You are beyond stupid. Get neutered before your genes infect the population please.

      September 15, 2011 at 12:07 pm | Report abuse |
    • HaleyWojcik

      Someones mom didn't hold them enough as a baby...

      September 16, 2011 at 2:30 pm | Report abuse |
  6. Captain Nemo

    >But they do NOT make a woman immune to cervical cancer.

    NOTHING WILL. If we do not act, there are significant and dire consequences.

    Big Pharma is not a charity (and is not always morally clean), but that doesn't obviate the need to do what we can to manage PREVENTABLE diseases.

    Unless, of course, you enjoy cancer or other preventable diseases in which case, go for it!

    September 15, 2011 at 11:11 am | Report abuse |
    • Captain Nemo

      for the irony impaired, that was an ironic joke. Just in case somebody thinks I'm serious...

      September 15, 2011 at 11:17 am | Report abuse |
  7. luvci

    Vaccines should be mandatory when the prevented disease poses a social risk, mainly for contagious diseases; however, a vaccine that would reduce a child's likelihood of getting sick himself or herself, while not putting others at risk, should be the parents' choice. That said, I am planning to vaccinate my daughters!

    September 15, 2011 at 11:19 am | Report abuse |
    • Kevin

      People are always complaining about medical costs going up so much, yet don't realize that preventative care is much cheaper than having to deal with things like cancer down the road. As for the moral objections, well...Texas hasn't really done well with that whole abstinence preventing pregnancy thing, we're talking about social health not religious objections. If they have that much of a problem about it, then opt out, but stop screwing with the rest of society.

      September 15, 2011 at 11:56 am | Report abuse |
    • Sunflower

      Good for you!!!! YOu're saving your daughters from a lot of pain, heartache and misery in the future.... And maybe even saving their lives..... Wish it had been available when I was a kid......

      September 15, 2011 at 12:09 pm | Report abuse |
    • Lara

      There *is* a chance of putting others at risk. If you vaccinate your child, you're not only protecting her, you're protecting her future partners, and any of their future partners. So it *is* a public health issue.

      September 15, 2011 at 12:31 pm | Report abuse |
  8. howard feinski

    Would you want the gov't mandating that you eat broccoli? It prevents cancer too.

    September 15, 2011 at 11:23 am | Report abuse |
    • Guinn

      Yeah... that's a great idea. I'm not all for government getting involved in our lives, except when the involvement deals with people too dumb for their own good.

      People should eat healthier and excerciese, and if a laundry list of facts that state how healthy eating can keep them from having miserable lives (illness, cancer, obesity, heart disease, etc.) and the majority of people STILL don't respond to it, then someone needs to step in. These people cost the rest of us money. It's the same with smokers. If you end up on Medicare/Medicaid and you're still a smoker, then yeah, SOMEONE needs to step in and either eliminate the smoking, or the Medicare for that person.

      September 15, 2011 at 11:40 am | Report abuse |
  9. Sunflower

    I wish this vaccine had been available and in widespread use when I was a child..... It would have saved me a lot of heartache, pain, and invasive surgeries. Thank God I was lucky enough to survive. But many aren't. If I had a daughter, I'd be the first one in line for this miracle drug. I wish they also gave it to boys.... My husband was devastated when he realized he infected me when we were married. He's never forgiven himself.

    September 15, 2011 at 11:32 am | Report abuse |
    • MNCounselor

      Gardasil can be used for boys and is now recommended for them as well as girls. It just isn't stated in this article because it was tested and approved for girls first and wasn't ok'd for boys when Gov. Perry tried this mandate.

      September 15, 2011 at 10:50 pm | Report abuse |
  10. Carla

    I opted to have my daughter take the series of shots. I spoke to her doctor, did my own research, and decided to do it . She did with zero side effects. That said, I do believe that this should be a decision made by parents only. No government mandate.

    September 15, 2011 at 11:34 am | Report abuse |
    • GOP Logic

      great, and now she won't get HPV at least from the most common types responsible for 70% of HPV cases.

      September 15, 2011 at 12:48 pm | Report abuse |
  11. Are You Kidding?

    I believe in this case it really should be left in the hands of the parents. If it were a timely fashion then by all means push for it, but its only for girls, there are no garentees and it should be a personal choice

    September 15, 2011 at 11:39 am | Report abuse |
  12. deelogeelo

    I read an article at blacklistednews that claimed Dr. Diane Harper, lead researcher during the creation of both Gardasil and Cervarix, found that Gardasil would do very little to fight cervical cancer, but the CDC ignored her recommendations. Coming from Merck, the proud makers of Vioxx, it just sounds fishy. How is it that when side effects occur after clinical testing, there is never proof of causality, but when there are positive results, it is without doubt because of the vaccine? Where is the undisputable proof of causality that the vaccine does anything at all?

    September 15, 2011 at 11:47 am | Report abuse |
  13. Mark

    At last count, over 100 children have died from Gardasil. This is a completely uneccesary and hurtful vaccine.

    September 15, 2011 at 11:51 am | Report abuse |
    • Bob Brown

      Please tell us who did the counting and what their qualifications were.

      September 15, 2011 at 12:16 pm | Report abuse |
    • Sunflower

      Did Bachman provide you with this statistic?

      September 15, 2011 at 12:18 pm | Report abuse |
    • Lara

      I'll add my voice. Says who?

      September 15, 2011 at 12:32 pm | Report abuse |
    • Facts and Data

      http://vaers.hhs.gov/data/index

      September 15, 2011 at 12:48 pm | Report abuse |
    • GOP Logic

      his extreme right wing anti vaccination web site told him so.

      September 15, 2011 at 12:49 pm | Report abuse |
    • AJ42

      Children die from vaccines all the time. My sister died of whooping cough at 4mos after getting the pertussis vaccine. The lastest data that I could find was 2007 but over 4,000 women died of cervical cancer that year. 125 people die each year from food allergies, we should stop requiring that parents give their children food...

      September 15, 2011 at 1:02 pm | Report abuse |
  14. Bobby

    Parents who opt out and have their kids catch HPV later should be charged with child abuse. If it then directly spreads to other people, make it assault with a deadly weapon. Stupidity and ignorance aren't excuses.

    September 15, 2011 at 11:53 am | Report abuse |
    • John

      Considering it's a very new vaccination with no long term study results, parents who force their children to receive this vaccination without getting educated and weighing out pros and cons from various studies should be convicted of child abuse.

      September 15, 2011 at 12:04 pm | Report abuse |
  15. Peter

    Perry for President – 100%. He wanted to act on something that has solid scientific basis and he acted. Politics aside. This guys is the kind of worker tha USA needs
    Also REM that his order had provision for parents to object!

    September 15, 2011 at 11:54 am | Report abuse |
    • texan

      Perry is charismatic. He works for big corporations and big money. He would be a lousy president. He said Merk only gave him $5000, they gave him over 20,000. He said he raises 30mil and says he can't be bought for 5000.. yeah.. his price is a little higher.. but while he slashed funding for firefighters during our worst drought while raising taxes funding firefighters- he is out of the state campaigning. The taxes he raised he left in the general fund- instead of putting it where it belonged. He also signed legislation that has led to thousands of teachers being fired or their contracts not renewed, our schools with no text books, and a financial mess. I could go on.. but you prob won't listen anyway...

      September 15, 2011 at 12:35 pm | Report abuse |
    • GOP Logic

      far right texas governor with little intelligence running for president?

      i saw this movie already, the ending sucks.

      September 15, 2011 at 12:50 pm | Report abuse |
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