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. No

    If the drug has been tested on boys then the least they can do is require it for all children. Otherwise sounds like a pharmaceutical companies way to riches – The government should get out of people's personal lives and start providing accurate information for people to make their own informed decisions

    September 14, 2011 at 4:24 pm | Report abuse |
    • Bill

      The studies on males were done much later. Eventually, it will be recommended for all humans but since the data was so overwhelmingly positive in the studies on females the vaccine was recommended to them first.

      September 14, 2011 at 6:19 pm | Report abuse |
    • footnotegirl

      Yes, it should be required for everyone, BUT it's main reason for existence is to prevent cervical cancer... and men can't get cervical cancer what with not having a cervix.
      Government needs to be involved with regulating vaccines because of the way vaccines work. It's not enough to just be vaccinated yourself. 'Herd immunity' is also important.

      September 15, 2011 at 11:20 am | Report abuse |
  2. Kait

    Yeah, I really let some politician tell me what medical procedures to have done to my kids. Riiight. Pft, what a joke.

    September 14, 2011 at 4:24 pm | Report abuse |
    • Adam

      In fact, yes. For most of the past century. If you don't like it, too bad. People think everything is their right these days. Cripes.

      September 14, 2011 at 5:40 pm | Report abuse |
  3. Revolter

    Governor Perry did leave the choice to the parent. You need to educate yourself before you speak. There was an opt out by parents in the bill. You liberals will say anything to get Obummer elected again. Why I have no idea? Revolt conservatives and start speaking up! The liberals are going to bring the USA down!

    September 14, 2011 at 4:26 pm | Report abuse |
    • Informed

      it was an excutive order mandate....not a bill, can you cite your resources that says there was an opt out...I can't find any.

      September 14, 2011 at 4:35 pm | Report abuse |
    • Wendy

      There was an opt out, however, most parents do not know this unless asked. For instance, when you go to the pediatrician, you follow the CDC schedule of vaccines. Rarely does a parent ask about the vaccines, they just follow what the Dr. Tells them which is usually what the CDC tells them. I happen to be a parent that does ask questions and was overwhelmed to fine out how many doctors would not see my child unless I followed the schedule. Finally I found a doctor but needed to have an "exemption" form from the Board of Health which is ridiculous. The bigger issue in this case is how Perry went about this. He, himself, admitted if he could change the way he handled, he would so this really shouldn't be an arguement.

      September 14, 2011 at 4:42 pm | Report abuse |
    • Adam

      So Wendy, what were you thinking when you decided to opt out?

      September 14, 2011 at 6:18 pm | Report abuse |
    • Adam

      The reason the doctors wouldn't do it your way was because they thought you were a fool. And who are you to think you know better than they do? Were you an only child?

      September 14, 2011 at 6:18 pm | Report abuse |
    • sugartaste81

      Uh, it was Michele Bachmann (hardly a liberal) who accused Perry of making the vaccinations mandatory. Maybe you're the one who needs educating?

      September 14, 2011 at 6:47 pm | Report abuse |
    • Wendy

      @Adam – I was thinking, I should get informed about these drugs they want to put in my child before letting them do so. My issue was not vaccinating at all, I wanted to wait until my child was at least 2 when his T1 cells were developed and he would have a higher immune system to penetrate any bad reaction of these vaccines. Luckily, I found a doctor who had the same belief system. Who do I think I am? A PARENT, that's who. I do not jump off bridges because people tell me to. I respect the medical field but there is always room for error and I will always be 100% informed when it comes to the health and safety of my children. Just because I do not have an MD after my name, does not mean I am not educated in the medical field. The fools are the doctors who think they should follow everything they read in the Medical Books when most of the information is outdated and new cures and diseases are created regularly. I happen to be the youngest of four but I have no idea what that has to do with anything. As far as HPV is concerned, I have an issue giving my 12 year old daughter a vaccine to prevent an STD. For the record, I have HPV and it is not a death sentence. It also subsides on its own and is not detected on every PAP Smear. Men are a carrier of it as well but for some reason, they only want to give this vaccine to women? Get informed Adam, because it looks like the only fool here is you!

      September 15, 2011 at 9:57 am | Report abuse |
  4. GOP Logic

    OH HAI, does any one remember when that doctor in the UK cooked up the bogus link between vaccines and autism, was actually found out to be attempting to pattent his own autism-free vaccine that would have made him $100's of millions, and then he took bribes totalling $millions from lawyers sueing vaccine manufacturers to lie? yeah, i remember that too....

    OH YEAH, does anyone else remember that hundreds of (legitamate) studies have been done on this bogus vaccine/autism link since this fraud doctor fabricated this entire lie, and each study shows no link at all??? Yeah i remember that too....

    BTW, does anyone else remember reading that the doctor who made up this lie lost his Medical license years ago because of his fabricated studies and and fraud? and killed thousands of kids who died from preventable diseaases because they were unforunate enough to have easily mislead mothers? ...yeah i remember that too...

    OH, and do you remember when CNN posted some story implying that there is room for debate on the false vaccine/autism debate... and when the author was quickly required to publish a retraction???? yeah i remember that too....

    September 14, 2011 at 4:26 pm | Report abuse |
    • Yup

      The above comment sums it up pretty well. I'm not so sure about the ethics of mandating vaccines, but the science behind vaccines is pretty straightforward.

      September 14, 2011 at 7:17 pm | Report abuse |
  5. Darlene Buckingham

    PR damage control piece. Until we make decisions based on wisdom and knowledge we are going to harm ourselves and our children. PEace to ALL

    September 14, 2011 at 4:27 pm | Report abuse |
    • allanhowls

      I think you mean "science and fact."
      Bachmann is the wackjob liar who's trying to scare everyone. And now she's dipping her toes into the antivax camp, too!

      Why does Michelle Bachmann hate reality?!?

      September 14, 2011 at 4:29 pm | Report abuse |
  6. Leslie

    I find it troubling that Perry has such a close tie to the company (his chief of staff is a lobbyist for Merck?), which calls into question his motivation for mandating it. I also feel that parents should make the decision, not the state, especially considering that it is controversial for a number of reasons. It seems obvious to the pro-vaccine crowd that everyone should be vaccinated. After all who wouldn't want to prevent cancer? It seems equally obvious to the anti-vaccine crowd that one shouldn't inject a substance that may not be safe.

    It is equally troubling that all too often the "experts" are found to have a personal stake in the outcome of the discussion, hence making their opinions suspect. I have seen articles with "experts" touting the benefits of vaccines or other medicines, only to find out that the so-called "expert" has a financial stake in the sale of the product. I wish I could be confident that the reporters did their homework and reported on any conflicts of interest.

    September 14, 2011 at 4:28 pm | Report abuse |
  7. Informed

    Research it and make an informed decision....it is not a nobrainer as so many seem to believe. Read this article and see that the vaccine still leaves you vulnerable and possibly gives you a false sense of being protected. I choose not to give this to my daughter. I have read lots of research and believe this vaccine offers very little protection against her lifetime chances of getting cervical cancer and is not worth the risk.
    http://news.yahoo.com/hpv-vaccine-controversy-175600587.html

    http://abcnews.go.com/Health/CancerPreventionAndTreatment/gardasil-hpv-vaccine-faces-safety-questions/story?id=8356717&page=3

    September 14, 2011 at 4:28 pm | Report abuse |
    • Bill

      What is the risk that you're so worried about? (just curious)

      September 14, 2011 at 6:22 pm | Report abuse |
  8. fernace

    This is not a vaccine against polio, tuberculosis or measles! HPV is an STD, a s.e.x.ually transmitted disease, not socially transmitted, therefore it should not be mandated by government officials, whos motives are questionable at best! These vaccines prevent the spreading of genital warts, which, if left untreated can cause cervical cancer, so it's primary function is to guard against HPV, not prevent cancer! This is a hypocritical move by politicians who dismantle womens healthcare & then say they're so concerned about preventing womens health threats! Bogus, it's all about kick backs!!

    September 14, 2011 at 4:28 pm | Report abuse |
    • Mark

      you are NOT correct. HPV can cause cervical cancer without any sign of warts, or even after warts are 'cured'. The virus can remain active without visible warts, and certainly the cervix is not readily visible. This vaccine will prevent cancer. period. HPV is very easily caught, more easily than any other venereal disease, even with just 'casual' contact.

      This vaccine is a no brainer, but alas those with no brain dont want to protect their children.

      September 14, 2011 at 4:38 pm | Report abuse |
    • newton

      you can be deluded and believe your conspiracy theories that the Govt is out to get you, but dont victimize innocent children who trust us parents to make sound decisions for them. Sentencing children to suffering or death because you dont like Government is reckless.

      Every American has been following CDC, FDA etc recommendations for generations, and for that we dont have epidemics and our food is quite safe (we all know the occassional exception, but please, dont point out a couple of issues per year in an otherwise very responsible Government oversight.). We are far safer because of these Govt oversights, and our kids rely on us to be responsible. Guess what, the Govt is people. I trust people. We should all learn to trust people a little more and stop watching TV shows and movies about conspiracies a lot less.

      September 14, 2011 at 6:40 pm | Report abuse |
    • footnotegirl

      I fail to see how the means of communication of the disease makes a difference. It's a very, very common disease. It can have troublesome and even deadly results. We have a vaccine to prevent some strains of it. WHY IN THE WORLD would anyone choose not to vaccinate?

      September 15, 2011 at 11:27 am | Report abuse |
  9. fernace

    This is not a vaccine against polio, tuberculosis or measles! HPV is an STD, a s.e.x.ually transmitted disease, not socially transmitted, therefore it should not be mandated by government officials, whos motives are questionable at best! These vaccines prevent the spreading of ge.nit.al warts, which, if left untreated can cause cervical cancer, so it's primary function is to guard against HPV, not prevent cancer! This is a hypocritical move by politicians who dismantle womens health-care & then say they're so concerned about preventing womens health threats! Bogus, it's all about $$!!

    September 14, 2011 at 4:33 pm | Report abuse |
    • Johan S

      You can get it via accidental blood exposure and also via forceful intercuorse (r.ape). How are you going to guarantee against exposure by accident?

      September 14, 2011 at 4:38 pm | Report abuse |
  10. Chris

    As a card-carrying liberal, I dislike Michele Bachmann intensely. However, on this issue, she is absolutely right. It's ridiculous to mandate any vaccines. They are not properly tested, and the side effects harm children. The media gets this issue wrong over and over again.

    September 14, 2011 at 4:34 pm | Report abuse |
    • Johan S

      I suppose you rather have small pox and be stricken with polio?

      September 14, 2011 at 4:35 pm | Report abuse |
    • michelle

      Please cite your assertion that vaccines harm children.

      September 14, 2011 at 4:37 pm | Report abuse |
    • Andrew

      Vaccines have been thoroughly tested. There are virtually no side effects. The media actually feeds the doubt about vaccines.

      Please read Deadly Choices: How the Anti-Vaccine Movement Threatens Us All, by Paul Offitt.

      But then yourare an anti-vaccine propagandist aren't you?

      September 14, 2011 at 6:19 pm | Report abuse |
    • newton

      if it were voluntary would you elect to vaccinate your daughter? Or do you allow your paranoia to make your daughter a victim of your irresponsibility? Fact is the CDC and FDA have a superior history, and the liability on releasing a drug without years of clinical testing assures they are doing their job. I would trust the scientists. They're kind of smart

      September 14, 2011 at 6:46 pm | Report abuse |
    • Chris

      ANDREW, you do realize that Paul Offit is a vaccine manufacturer right? Nope, didn't think so. Sheep.

      September 15, 2011 at 12:09 am | Report abuse |
    • Barry

      Have you any idea of the levels of testing required by the FDA on the both the safety and efficacy of all medications including the vaccine?

      Are you really trusting science related issues to luddites who give voice to the idea that the world was created in 6 days and is only 5000 years old and the center of the universe?

      September 15, 2011 at 12:29 am | Report abuse |
    • footnotegirl

      You show a massive lack of understanding of how vaccines work. Vaccines must be mandated (btw, you can opt out, mandates just make it so that you HAVE to opt out) because for vaccinations to become successful you must reach a point of 'herd immunity'. If the polio vaccine hadn't been mandated, polio would still be killing people! Now it's pretty much wiped off the face of the earth BECAUSE VACCINATION WAS MANDATED.

      September 15, 2011 at 11:29 am | Report abuse |
  11. GOP Logic

    judging from the other comments, my first wasn't far off base.

    If there were an HIV vaccine that had to be taken in middle school, parents would STILL opt out... because you know the vaccine would only prevent HIV and not necessarily AIDS, plus my little Jr. would NEVER be at risk, EVER.

    but... thats the logic of these tea-pots

    September 14, 2011 at 4:35 pm | Report abuse |
  12. AthensGuy

    those weighting mandated vaccination against some "privacy concerns" and favoring the privacy, have their priorities upsidedown... Sure, those who applouded execution, death by lack of health insurance, certainly then favor that their daughters die of cervical cancer... makes so much sense...

    September 14, 2011 at 4:35 pm | Report abuse |
  13. allanhowls

    Everybody look up the term "herd immunity," and don't report back until you actually understand it.

    When I read the comments on here, it makes me sad for just how uneducated, backwards, and simpleminded the American public has become. The complete lack of basic scientific literacy here is stunning and depressing.

    September 14, 2011 at 4:38 pm | Report abuse |
    • sugartaste81

      The worst part is, people are PROUD that they "don't trust scientists". But if Limbaugh, Hannity, et al say something-it's gospel. Because they have less of an agenda than those evil librul scientists ::smh::

      September 14, 2011 at 6:49 pm | Report abuse |
  14. Kevin

    True about the boys issue, I know I'd be worried about my chances of developing cervical cancer.

    September 14, 2011 at 4:39 pm | Report abuse |
    • Beadlesaz

      HPV has also been linked to penile cancer. You can research this subject on the CDC website.

      September 14, 2011 at 6:20 pm | Report abuse |
  15. GOP Logic

    yet, even with herd immunity, kids with crazy mothers who didn't get them vaccinated are winding up with shiite like rubela and whooping cough. Have you ever heard what an infant with whooping cough sounds like?

    September 14, 2011 at 4:40 pm | Report abuse |
    • Captain Nemo

      Medical outcomes are better and it is orders of magnitude cheaper to vaccinate than to treat a preventable disease. If you're lucky, pertussis (whooping cough) puts your child in the Intensive Care Unit ($$$$$ do you have enough?) and weakens the kid. If you aren't lucky, the kid dies. Horribly and slowly. Polio sucks, too; measles is a killer (especially in unvaccinated adults), tetanus is a painful death (or permanent maiming), you don't want to know about diptheria (even if the kid survives, the heart may be permanently damaged which leads to a diminished life).

      Please please please do NOT believe that "all vaccines are bad". They aren't. They are carefully tested before use, administration is carefully prescribed and monitored, and adverse outcomes are given detailed review. No vaccine contains the mercury compound (thimoseral) that used to be used (even though there is no evidence linking that mercury compound to adverse outcomes).

      Injecting or injesting ANYthing can cause idiosyncratic physiological responses (swelling, fever, injection site pain, malaise, etc., etc.). Such a response ususally has little or nothing to do with the vaccine itself (people with egg allergies react to vaccines incubated in eggs for example, a reaction has nothing to do with the vaccine but is caused by egg proteins). The vaccine itself generally does NOT cause the minor side effects of vaccination.

      Untold hundreds of millions have been vaccinated all around the world for decades: where is the epidemic of damaged people? Where are the many millions (hundreds of millions times even one tenth of one percent is many many millions) of autistic or otherwise damaged humans whose injury can be directly linked to a vaccination? They don't exist, which is another reason the English quack who tried to connect MMR/PDT vaccination with autism was discredited: there is no such damaged population, there is no such link, even for vaccines that DID contain mercury (thimoseral).

      Please please please vaccinate your children. You have a far higher risk of losing them to disease than to adverse effects of vaccination.

      Please!

      September 15, 2011 at 10:01 am | Report abuse |
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