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. bhj

    I wonder how long it was going to be before we were all mandated to have solar panels,, manufactured by solyndra, installed in our homes? Again, another example of why lobbyists should be outlawed. Why aren't people enraged by the government and big corp. padding their pockets and haphazardly spending our hard earned dime? They are not concerned about our health, is about GREED...I am not ignorant and feel fully capable of making decisions in the best interest of myself and my mandates, please!

    September 15, 2011 at 2:14 pm | Report abuse |
  2. ReallY!!?

    If DC can mandate it r they in the tank for Merck too?

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

      This is on a state level (texas, to be specific), Perry accepted thousands of dollars from Merck to campaign for govenor...Once elected, he attempted to mandate gardisil to rising 6th grade females...he claimed the other night, Merck has donated $5000 to his white house campaign, but did not mention how much $ Merck had previously donated to him. Win-win...Perry, accepts major $ from a drug corp to hopefully get elected to the White House, gardisil is mandated...Merck profits even more...corruption is what it is...

      September 15, 2011 at 2:24 pm | Report abuse |
    • bhj

      And last time I checked, DC is not in the tank for anyone, that would be me and you, the taxpayer!!!! We are in the tank for $528 million on that bad decision!

      September 15, 2011 at 2:26 pm | Report abuse |
  3. nce

    Way to go Mitt Romney. Harvard guy all the way, makes the right calculated anticipated decision ahead of time. The strategic way.

    September 15, 2011 at 2:25 pm | Report abuse |
  4. Concerned Mom

    I have a 12 year old daughter that has not been vaccinated as of yet because after speaking with both her pediatritian (who as 2 daughters) and my Gyno (who has daughters) I was told by them directly, when asked what they would do given they both have daughters between the ages of 10-15.They both told me told me in their opinion there is not enough long term data in for them to feel comfortable vaccinating their own children with it. They both opeted NOT to have their children vaccinated.

    Still not sure...

    September 15, 2011 at 2:37 pm | Report abuse |
    • Kate

      Don't wait too long for your daughters sake. I contracted HPV when I was 17 and now at the age of 22 I have high grade cervical dysplasia. I only wish my gyno had told me about the vaccine before it was too late for me. And although I already have type 16 I have opted to have the guardasil vaccine to prevent the other HPV's from causing me more problems.

      September 15, 2011 at 3:01 pm | Report abuse |
    • Todd in DC

      For a man, HPV is an annoyance. For a woman, the consequences can be devastating. How can a vaccine be worse than HPV in a woman? Note that it is VERY difficult to eradicate the virus in a woman.

      September 15, 2011 at 3:27 pm | Report abuse |
    • 8_THE_S

      So ignorance breeding more ignorance... way to go Mom...

      September 15, 2011 at 4:48 pm | Report abuse |
    • Lisa

      Todd, where are you getting your information? HPV is like the common cold, in most cases it clears up on its own without any treatment or long-term effects whatsoever.

      And Kate, did you know that getting the HPV vaccine when you already have HPV actually increases your chances of developing cancer by about 40%?

      September 16, 2011 at 10:42 am | Report abuse |
  5. nce

    There are answers in numbers – gold in numbers. Pile the budgets on my desk and let me wallow. He makes decisions based on researching data more deeply than anyone I know....that's Romney for you.

    September 15, 2011 at 2:37 pm | Report abuse |
  6. Capt Nemo

    The underlying (and unspoken) issue with HPV vaccines is that, however tangentially, the discussion touches on s e xuality, specifically, the s e xuality of young girls.

    Just like the fringe extreme right can't talk about s e xuality but will harp all day about abortion, we can't have a discussion of preventing an STD because (gasp!) we might have to address teens and s e x in an open and detailed manner. Oh My! It isn't like they AREN'T having s e x, just look at the rates of teen pregnancy and's just that many parents can't talk about s e x or are to "embarrassed" to do so or are afraid of "embarrasing" their kids. Would you rather your kids are embarrased or pregnant (or dead?)

    The population sub-section that's so vociferously against HPV vaccines (using the mandate as a smokescreen in many cases) are also dead set on "abstinence only" s e x education, despite overwhelming evidence that such alleged "education" (really just promoting ignorance) doesn't work and in fact leads to:

    lowered age on onset of s e xual activity
    higher rates of teen pregnancy
    more s e xual partners
    higher rates of STD (all types)
    higher HS drop out rates (especially for the teen moms)

    The joke where I come from among the kids is that if you "want to get some", sign the abstinence pledge. Stats show that 75% of kids who signed the pledge were s e xually active within months...

    Face the issue of your children's burgeoning (and completely normal) s e xuality, and deal with all aspects of it, including prevention of pregnancy and STDs. Otherwise, you and your kids will deal with the harsh and permanent consequences of ignorance.

    September 15, 2011 at 2:50 pm | Report abuse |
    • nwatcher

      It sounds like you know nothing about abstinence education. You have abstinence as a lifestyle choice confused with ignorance. Kids still get the "plumbing" facts in health and science class. What they don't get is a complete education on all the emotional and physical long term (terminal) complications of sx activity outside a lifelong committed relationship because they are told – take precautions and everything will be ok. Yup, the kid who can't remember to take his football cleats to practice will be "prepared" at all times to protect your daughters. Did I mention Ignorance is the problem?

      September 15, 2011 at 4:47 pm | Report abuse |
    • Capt Nemo

      To nwatcher: I DO know about abstinence s e x education, and it is a massive failure. What makes kids wait and make better decisions (fewer partners, safe behaviors, etc) is having the full picture and that includes detailed explanations of the consequences of s e xual behavior. Just telling them not to fails miserably: when they get overwhelmed by desire they don't know how to make good decisions and the results are depressingly predictable.

      September 15, 2011 at 7:20 pm | Report abuse |
  7. eepah

    Was this article brought to you by Gardasil or what?!

    September 15, 2011 at 2:57 pm | Report abuse |
  8. Carlybee

    I dont know if it will let me post this link but a Merck scientist admitted some of their vaccines were contaminated. Take at your own risk and keep doing what the voices tell you.

    September 15, 2011 at 3:22 pm | Report abuse |
  9. Debbie in Florida

    I had my daughter vaccinated as soon as possible. I went through years of abnormal pap smears followed by two years of procedure after procedure for the pre-cancerous condition caused by HPV. This first came on the scene when shortly after I was first married. I spent two long years not knowing if it would turn into cancer or not. I doubt Bachmann has any idea what it's like to live with that in the back of your mind for that time frame. The constant stress and worry that you might not be there for your children was hard to bear – along with continuing to hold down a full time job to pay the mortgage.

    There's absolutely no way if there is any chance that if I can help my daughter possibly prevent the same frightening feelings that I would not do it.

    September 15, 2011 at 3:48 pm | Report abuse |
  10. toby

    What we have here is a the clash between good, sound science and human progress and religious fundamentalism; it is just that simple. Peace.

    September 15, 2011 at 4:09 pm | Report abuse |
    • nwatcher

      Nothing like a quick,demeaning oversimplification and generalization to make you think you got it right...did you notice the number of people who had questions or reservations that were not religiously motivated? If you think science has it right, make sure you have ALL the science not just the part you agree with. Otherwise you fit in the same category as those you bash. (and Peace be to you)

      September 15, 2011 at 4:55 pm | Report abuse |
  11. BuckeyeJim

    All attempts to prevent STDs are immoral as the goal is to remove one or more of the Lord God's sanctions against naughtiness.

    September 15, 2011 at 4:17 pm | Report abuse |
  12. melg

    Maybe I'm missing something, but how could they even think of requiring this for entrance to school? I agree that it may be a good idea to get the vaccine, but the whole point of requiring kids to get vaccinated is to protect against the spread of disease. As an STD, this particular disease isn't going to spread like wildfire through a school to unsuspecting kids. They have to do something (each other) in order to get it.

    September 15, 2011 at 4:36 pm | Report abuse |
    • MNCounselor

      So you think it won't spread like wildfire because you have to have s ex to get it? Are you kidding me, have you seriously never heard of STD outbreaks in schools, h ell there was even a lifetime movie based on it! LOL As much as adults don't like it (even though they most likely were doing it at their age too) TEENS are having s ex!!!! We need to educate them how to be responsible physically and mentally when doing so if that is what they choose, we don't have to support the choice but don't be blind to it. By far, more high school age kids are having s ex then aren't especially taking into account oral s ex, which is thought by many teens to not be considered "s ex". For far too many parents ignorance and blindness is apparently bliss, until it's your daughter who comes home pregnant or with an STD. Isn't it funny that the highest rate of teen pregnancy is in the bible belt and that in places (usually liberal states) where there is focus on education and prevention the numbers drop. I don't know when you people are ever going to understand that.

      September 15, 2011 at 7:05 pm | Report abuse |
  13. elso

    If we vaccinate all the boys, we get the same result, right?

    September 15, 2011 at 5:43 pm | Report abuse |
  14. moderatekansan

    based on what ive read from parents that dont want to protect their daughters from cancer, i bet if you studied everyone who got the vaccine compared to those that didnt, the average IQ scores would be much higher in those that were vaccinated.

    People pray each day for cures to cancer, we have a way to prevent cervical cancer, a leading cancer death of women worldwide...and some people dont want it. PROTECT YOUR CHILDREN FROM CANCER!

    September 15, 2011 at 6:19 pm | Report abuse |
    • Lisa

      Ugh, this is NOT A CANCER VACCINE!!! This is a vaccine against a virus that causes SOME cases of cervical cancer, but not all. You can still get cervical cancer no matter how many Gardasil shots you've had!

      September 16, 2011 at 10:45 am | Report abuse |
    • HaleyWojcik

      This is NOT a cancer vaccine. Also, cervical cancer is no longer in the top 10 of leading killers of women.

      September 16, 2011 at 2:18 pm | Report abuse |
  15. BigBill8517 a perfect world. Unfortunately our boys and girls are being exposed to pressures that were not there when I was growing up, when just increasing hormones were difficult in themselves to deal with and remain faithful to God.'re right....I've talked to my R.N. wife and this vaccine inoculates against more STDs that just cervical cancer. Boys would also benefit if given to a broad group.

    September 15, 2011 at 6:43 pm | Report abuse |
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