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. Jack

    This group only opens their mouths to exchange their feet!

    September 15, 2011 at 11:55 am | Report abuse |
  2. Clock_Strikes_Twelve

    I received the Gardasil vaccine in late 2008 and early 2009, and while I consider it to have the worst side effects of any vaccine I have ever been administered – fever, shaking and paleness for days after each shot, swelling at the injection site, the scabs wouldn't heal for months at a time, and now I have raised scars at each of the three injection sites – in the long run, it was worth all the misery. Female cancers run in my family, so if I have even the slimmest chance to prevent even one of them, I will do the smart thing and try to prevent it.

    I am aware that pharmaceutical companies are probably the leading cause of unhappiness in our country – you take one drug, it causes a side effect, so you need another drug, which causes depression, etc,etc. In the end, the drug companies make millions off of the average citizen who's just trying to solve a health problem.

    However, in this particular situation, I do not believe that is the case. Granted, the drug companies will make millions if every schoolgirl is vaccinated as Rick Perry's vision was, and yes, he would make quite a bit of money too. And while I disagree entirely with his politics and the manner in which he went about his mission, there is a higher purpose here.

    If every schoolchild – not just girls, but boys as well – is vaccinated, there is a possibility of eradicating HPV and thus the grand majority of cervical cancer caused by it in this country. It would be like the polio vaccine. Would it take years? Yes. Possibly two generations of children. Would it be worth it? I believe so.

    September 15, 2011 at 11:56 am | Report abuse |
  3. Jean

    I say that if parents choose to opt out, they should instead be required to pay into a fund that will later be used to offset any medical costs the government may incur...

    September 15, 2011 at 12:17 pm | Report abuse |
    • Hannah

      So I guess someone has to pay for their moral values now?

      September 15, 2011 at 12:53 pm | Report abuse |
    • AJ42

      If you opt out of a vaccine for "moral reasons" then you should be added to a registry of people who are ineligible to receive any screenings or treatment for that disease in the future without prepaying for the services 100%. If you honestly believe that your child will never contract HPV then signing the registry should be a non-issue and your morality will not cause my health insurance premiums to increase or my taxes to be raised or tax dollars to be diverted to health care instead of schools, roads, etc.

      September 15, 2011 at 1:15 pm | Report abuse |
    • Brian

      You guys who want to have a registry are clueless. Will we have a registry for people who eat way too much, smoke, ride motor cycles, play football etc etc? Sheesh. If people want to get this shot, they should, sounds like a pretty good idea. But government shouldn't be paying for your insurance anyway! And if your hard earned private insurance co. wants to mandate some shots, they can. And people who don't like it can leave, like they do when people demand and get free abortions.

      September 15, 2011 at 1:25 pm | Report abuse |
    • tcp

      You people are downright Orwellian!

      September 15, 2011 at 2:04 pm | Report abuse |
  4. MS Holbie

    I wonder if we need to consider the fact that if it is mandated by government it will be covered under insurance policies? http://www.ncsl.org/default.aspx?tabid=14381 Something to consider. . .

    September 15, 2011 at 12:21 pm | Report abuse |
    • Q in VA

      I think rather that if the state mandates the vaccine, the state's public health will pay for it. That was at least part of the consideration in Gov. Perry's original mandate. He was well aware of the proportion of his state's population that worked low-wage jobs and/or had no health insurance. Remember that a 3 shot course of treatment cost about $350.

      September 15, 2011 at 1:28 pm | Report abuse |
  5. kmcg

    First: Parents – just because you give your child a vaccine to stop cancer, does not mean that they will suddenly engage in s*x.

    Research shows that parents who talk to their children about s*x (not just "don't do it") have children who are more likely to abstain or use protection. So either use this as an opportunity to talk about the issue, or just say its for cancer.

    Second: Not only does having children vaccinated at 10-12 mean they are less likely to have come in contact with HPV, it is also during that time that this particular vaccine works best in the human body.

    Third: Even if your child does remain perfect and abstain until marriage, what about their partner? Can you guarantee that they will keep your child safe? Especially considering that HPV passes skin to skin, not through liquids. It's probably unlikely, but just like you pass plantar's warts, you could share HPV if two friends sat on each other's laps in bathing suits to take a picture by the pool.

    Protect your child from cancer!!

    September 15, 2011 at 12:30 pm | Report abuse |
    • AJ42

      Agreed. We still don't have conclusive evidence that the viruses that we call HPV cannot be spread from toilet seats or other objects and the only way to detect it is to have a pap test while the patient has an active outbreak.

      September 15, 2011 at 12:43 pm | Report abuse |
    • AL

      COULDN'T HAVE SAID IT BETTER MYSELFY!!!

      September 15, 2011 at 2:09 pm | Report abuse |
  6. kmcg

    First: Parents – just because you give your child a vaccine to stop cancer, does not mean that they will suddenly engage in baby-making activities.

    Research shows that parents who talk to their children about s*x (not just "don't do it") have children who are more likely to abstain or use protection. So either use this as an opportunity to talk about the issue, or just say its for cancer.

    Second: Not only does having children vaccinated at 10-12 mean they are less likely to have come in contact with HPV, it is also during that time that this particular vaccine works best in the human body.

    Third: Even if your child does remain perfect and abstain until marriage, what about their partner? Can you guarantee that they will keep your child safe? Especially considering that HPV passes skin to skin, not through liquids. It's probably unlikely, but just like you pass plantar's warts, you could share HPV if two friends sat on each other's laps in bathing suits to take a picture by the pool.

    Protect your child from cancer!!

    September 15, 2011 at 12:31 pm | Report abuse |
  7. Joyce

    I was wondering what the long term testing was. Are there any reports on long term affects of the drug?

    September 15, 2011 at 12:32 pm | Report abuse |
    • AJ42

      Vaccines tend to be rushed to market (unlike prescription drugs) because they are made to prevent a communicable disease rather than treat someone who is already infected. The polio vaccine was created in '53, 2 million children were vaccinated in '53 as a "test" and by '57 the incidence of polio had fallen 85% or more.

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

      I had it, I'm almost thirty now. I'm fine. My friends have all had it too! It just hurts a little when they inject it, I didn't even have any side effects.
      If they can come up with a vaccine for the boys next we can wipe this out completely!
      Like others have said, it's spread through contact with the skin and men are carriers (an alarmingly high number of men are carriers!) so even if your child does save herself for marriage (and she hopefully will) who is to say her husband isn't a carrier? I wasn't willing to gamble with my health and I'm not going to gamble with my future child's either. You don't have to tell them what it's for if you don't want to. Just tell them it's a shot that will help their body fight off diseases just like the other vaccinations they have to get for school 🙂

      September 15, 2011 at 12:48 pm | Report abuse |
  8. Mike280

    It will be interesting to see if in 6-10 years another story is run about rates of cervical cancer in girls who's parents opted out of the vaccine. I wonder if a girl will resent her parents for making a decision that cost her the ability to have children because of idiological reasons.

    September 15, 2011 at 12:45 pm | Report abuse |
    • Arienette

      Seriously. Speaking of tallies on children who have died because of failure to vaccinate, there is a running tab online of the children who died after their parents followed Jenny Macarthy's (spelling?) advice over their doctors...hmmm...listen to an ex-str1pp3r or my doctor...even after the research article was retracted from the medical journal after discovering the original study was all made up! I wish parents would put health first and religion and politics second when it comes to gambling with their childrens' lives

      September 15, 2011 at 1:22 pm | Report abuse |
    • Jules

      The saddest thing is that girls whose parents are balking at the HPV vaccine have probably also been convinced that they don't need an annual pap. If you get your pap, they will catch the virus and treat the problem BEFORE it becomes cancer. Years before you would notice anything wrong.

      We can prevent cancer here, people. What is the argument?

      September 15, 2011 at 1:38 pm | Report abuse |
  9. CJ

    After reading article after article I saw what parents were balking at. First the CDC fails to include the boys and girls that had problems since day one of the shot, but no connection was made to the vaccine until months later. So many girls and boys who got the shot, and had problems that esculated were excluded from the CDC reports. This is why parents are saying no to the vaccine. When you can see first hand that something is wrong, and the CDC is ignoring the problem, there is definately an error in how the CDC is handling the outcome of the vaccine. Unfortunately the ones suffering regardless if it is considered mild or as severe such as death which is accuring needs to be addressed. I suggest a full audit of everyone that has recieved the vaccine so far, and any medical evidence gathered to see if any paterns show up in the audit.

    For your information... Even some of the boys and girls that died did not get entered at the CDC for the vaccines side effect. Why? Because even though they recieved the shot and had side effects they did not die until a few months later after recieving the vaccine.

    This is why I am against this vaccine at least for now until they do a side effect audit that includes everyone that has recived the vaccine.

    September 15, 2011 at 1:07 pm | Report abuse |
  10. Lisa

    Take it from a 44 yr old woman who had a cervical cancer scare because her partner was unfaithful and infected her with HPV: GET YOUR DAUGHTER THE SHOTS!
    Cancer can kill her later, take the time and little discomfort to protect her for life.

    September 15, 2011 at 1:12 pm | Report abuse |
    • tcp

      You didn't have a cervical cancer scare. You had a HPV scare. And now you're trying to scare everyone else...

      September 15, 2011 at 2:15 pm | Report abuse |
  11. SouthernCelt

    Governments forcing things on people is exactly what our forefathers rebelled against. If this guy gets elected look out for another Revolution!

    September 15, 2011 at 1:12 pm | Report abuse |
    • GOP Logic

      No it was taxation without representation if i recall...

      September 15, 2011 at 1:17 pm | Report abuse |
  12. Julie

    I know someone who is an invalid now because she took the vaccination and got really sick. Why aren't they talking about that?

    September 15, 2011 at 1:28 pm | Report abuse |
    • Luther

      I know people who are dead now because of cervical cancer.

      September 15, 2011 at 1:43 pm | Report abuse |
    • Lou

      Julie,

      You say her illness was caused by the vaccination. What evidence of causality do you have. While her illness may have followed in time, her vaccination, that is not the same as demonstrating it was caused by the vaccination. If I get vaccinated against measles this week and die of a heart attack next week, you cannot conclude that measles vaccinations cause heart attacks. While the two events are correlated in time, correlation does not imply causality.

      By the way, I am sorry about your friend's illness.

      Lou

      September 15, 2011 at 1:47 pm | Report abuse |
    • roger

      Because correlation does not equal causation, and your anecdotal evidence is just that: anecdotal.

      September 15, 2011 at 1:57 pm | Report abuse |
  13. JimF

    Last I checked there were NO studies on long-term effects of the Gardasil, for the simple reason that it has not been around long enough.

    To do massive, semi-mandatory inoculations of all children for a disease most will not contract, using a single-source drug that lacks long-term testing strikes me as doing a health experiment on our children.

    September 15, 2011 at 1:30 pm | Report abuse |
    • tcp

      correct

      September 15, 2011 at 2:09 pm | Report abuse |
    • Capt Nemo

      Calm down: the HPV vaccines have been in use for years in multiple countries with many tens of million doses administered. If the HPV vaccines were causing an epidemic, we'd know by now...

      September 15, 2011 at 2:39 pm | Report abuse |
  14. vaboater

    So let me get this right... our economy is in th toilet, we have two wars going on, congress can't agree on anything, and we are going to elect leaders who have done nothing but talk about the HPV vaccine since the last debate. Wake up America.

    September 15, 2011 at 1:37 pm | Report abuse |
  15. tcp

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

    VERY misleading and a COMPLETELY inaccurate and unsubstantiated conclusion. The vaccines are VERY effective against the types that cause MOST cervical cancers. And yet the author unequivically states that "both vaccines prevent cervical cancer in women."

    September 15, 2011 at 2:07 pm | Report abuse |
    • MNCounselor

      What exactly is misleading about it? No where does it say it prevents ALL cervical cancer, it says exactly what it should, it prevents the cervical cancer that is caused by certain strains of HPV. Don't try to split hairs to make a point or make an argument when there isn't one.

      September 15, 2011 at 11:08 pm | Report abuse |
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