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. Tony

    First off. A number of studies have shown that MANY vaccines have no effect on preventing disease (including cancer), despite what the government says (they have been caught misrepresenting facts so many times). When Perry implemented this law, this vaccine was untested and since then it HAS been proven to cause health problems. The drug companies will do and say anything to make money including pushing vaccines and drugs that are addictive only and are detrimental to health. Cancer is already a multi-billion dollar industry and they are pushing drugs to cause it. Wake up people. Big government is not your friend.

    September 14, 2011 at 6:41 pm | Report abuse |
    • Captain Nemo

      >Big government is not your friend.

      but unrestrained anarchy is?

      the EPA keeps you from breating soot and prevents our rives from catching fire (cf Cayahoga River, IL)
      the GI Bill created the technological and economic boom that started in the 1950s
      the Labor Department keeps you from working six sixteen hour days a week in sweatshops.

      not all government is bad, either. learn to discern the difference instead of parroting Koch brothers propaganda...

      September 15, 2011 at 11:44 am | Report abuse |
  2. Larry L

    Vaccines are the reasons we're not suffering from polio, yellow fever, and small pox anymore. For a disease to best get eradicated the entire "herd" needs the vaccine. The right-wing needs to stop getting their science and medicine information from conservative radio or internet "articles" sent to them by their crazy brother-in-law. Separate the issues – Rick Perry's greed is not related to the efficacy and safety of the vaccine.

    September 14, 2011 at 6:42 pm | Report abuse |
    • acdMD

      Larry you are so right! Unfortunately many people seem to have forgotten how horrible many of these diseases are. Still today we get cases of rubella and yellow fever and unvaccinated children die because someone lied about there being a link in vaccines to autism.

      September 14, 2011 at 6:45 pm | Report abuse |
    • agonyflips

      We're talking about an actual cure for a certain type of cancer.

      Having actually had a family member die of cervical cancer, like all cancers, I wouldn't wish it on anyone. It's a horrible death. So Moms & Dads, imagine how you'd feel if you child dies of cervical cancer when you could have prevented it. How selfish of you.

      September 14, 2011 at 7:06 pm | Report abuse |
  3. Rose from the City

    The problem is that many side effects of any drug are not known for years after the drug has been given. Think of the drugs given to pregnant mothers in the 50's and 60's to prevent nausea that were found to cause birth defects later. So every parent needs to wade through the data. And, every parent needs to teach their children that sleeping with anyone will likely increase the possibility of contracting a STD, so if you choose to sleep with someone, be very selective and ask tough questions about his/her history.

    Two of my cousins' children have had serious side effects (lyme-like illnesses) that the children's doctors (two different physicians in different geographic regions have attributed to this vaccine. Neither have been in school for over two years due to the disabling illness. They are 16 and 18. Perhaps it is something in our genetics? I don't know. And yes, they have been told that these side effects are rare. But, if it is your child, the statistics don't really matter. These children are losing their youth.

    Personally, I won't take the chance since close blood relatives have had such significant issues and it should be my choice for my children. And, I am a liberal democrat.

    September 14, 2011 at 6:43 pm | Report abuse |
    • american citizen


      September 14, 2011 at 6:51 pm | Report abuse |
    • Really???

      Maybe you should call in an infectious disease specialist for Lyme symptoms rather than following the Jenny McCarthy bandwagon.

      September 15, 2011 at 1:37 am | Report abuse |
  4. SLIM

    To the FDA: When are you all going to demand big-money drug companies to stop giving us "treatment", and start giving us "cures"? In the meantime,as for HPV, our daughters, sisters, mothers, aunts, grandmothers, and friends are dying unless they buy into "treatment", even if they can't afford it or are all-together against the chronic side-effects that the drug companies like to play down. "Treatment" is a "temporary" fix that requires "long-term" financial and emotional sacrifice. When was the last time we had a "cure" for any disease, polio was probably a big problem last time we had one. WE NEED "CURE"! At least mandate that these scientists create '1 cure' for every '5 treatments'. Whose side are you on,FDA? If you say the sick people side, we are not that dumb because we ARE the sick people, living sick people lives, and seeing sick results from drug-companies and the FDA.

    September 14, 2011 at 6:43 pm | Report abuse |
    • Bill

      We actually don't have a cure for polio, we have a vaccine that prevents it's acquisition and thus transmission. The same can now be said for HPV (at least the majority of cancer causing strains). Merck has done exactly what you are looking for.

      September 14, 2011 at 7:09 pm | Report abuse |
    • Ph.D. from M.I.T.

      SLIM – Same thing for small pox. No cure for small pox. Evidence of small pox going back to 10,000 B.C.! But, now due to vaccinations – which prevented anyone from catching it – so no homes from the disease – it has been erradicated from the earth forever (last case was in 1973). That is, unless it escapes from the CD or whatever lab in Russia has the last known samples. I have a small pox vaccination scar on my arm. Because of that program, my kids did not need to get the vaccine. That is progress made because people then were smart enough to know the great good of the majority of the people outweighs the few negative cases. I don't know why people today fail to understand what people 50 years ago understood.

      September 14, 2011 at 7:42 pm | Report abuse |
    • ardis

      As a ten year cancer patient (NED) with ongoing treatment, I would have loved a vaccine. A cure would be great, but not dealing with a certain form of cancer sounds like a cure to me. Hopefully, this can work with vaccines for other cancers. There are so many different types of cancer.

      September 15, 2011 at 4:15 am | Report abuse |
  5. JimF

    September 14, 2011 at 6:44 pm | Report abuse |
  6. Tanker Ray

    Michelle Bachmann needs to take a Comp I class. Her logic is shockingly bad. A total stranger in Tampa (false authority fallacy) tells her that her daughter became retarded after receiving this injection (post hoc ergo propter hoc fallacy). Mental retardation is not something you "get" like a cold...unless, evidently, you are Michelle Bachmann.

    September 14, 2011 at 6:46 pm | Report abuse |
  7. John

    It obvious that Michelle Bachmann does not care about this county or the people in it. This is not birth control of any sort, it does not have negative side effects. Also, the mandate does not require girls to be vaccinated, only that they have the option and that there is advocacy for it. This is a prevention method for a disease which can have horrible consequences. When the method has no negative effects, nor is it being forced on anyone. For Michelle Bachmann to argue against it for obviously political reasons is immoral and wrong.

    Also, there is no link between autism and vaccination. Claiming that there is is like claiming that the earth is flat, it is an outdated claim that most people know is not true. I am a microbiologist, I have read the scientific journal articles on this and fact checked the biological claims made and interpreted the statistics. I get my information from reliable sources and do my own verification of it, vaccination is great, get your children vaccinated for any disease for which there is a vaccination that could affect them, to not do so, in my eyes, is neglectful.

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

      So if you do your own research why did you not read this article? It is NOT obvious that MBachman does not care about people (in your eyes maybe – they have glasses and surgery to help folks like you). You are wrong in that there are states that mandate (read "force") your young daughter to get the shot and many more trying to do so.

      Let's try something that used to work for most of the population – since it is an STD, maybe a little abstinence is called for. Then find someone else with the same values – problem solved. Works for a lot of people I know...

      September 14, 2011 at 7:03 pm | Report abuse |
    • Ph.D. from M.I.T.

      Thank you John for providing a well thoughtout and INFORMED reply. Unfortunately, facts don't seem to carry the weight they once did in American society (as many replies here show). The skewed logic here seems to be because there isn't a perfect (100% safe solution) we should not implement programs with benefits that greatly outweigh their negatives. Wake up people! There are no perfect solutions! Nothing works 100% of the time. And yes, there should be responsibility taken to address the rare negative consequence. That said – what about the hundreds of thousands of lives saved from polio, etc. because mandatory vacinations?! We have wiped small pox off the face of the earth due to vaccinations. Unfortunately, people in Amerca today don't understand what our forefathers did – that there must be some sacrifice to advance the good of the majority.

      September 14, 2011 at 7:16 pm | Report abuse |
    • ardis

      Re nwatcher, Note the abstinence comment. Just say NO Good luck with that plan! She read that in the Sarah Palin Motherhood Book.

      September 15, 2011 at 4:20 am | Report abuse |
  8. norman

    offical is dumb and hearing nomore dumb and deaf .... Jesus Christ ll come quickly and He has new jerusalem first place is jerusalem have to destroy with people flee.

    September 14, 2011 at 6:49 pm | Report abuse |
  9. Communist News Network

    1. I thought you CNN folks said Michele Bachman was dumb....
    2. So you guys are now learning about the issues from the candidates? I thought you guys were in charge of creating and driving the important issues, like gay marriage, immigrant rights and other stuff.

    September 14, 2011 at 6:50 pm | Report abuse |
  10. Anotheralt

    I think the real problem here is that you can't really run as a tea party/small government candidate having issued a mandate for government intervention to help save lives through prevention. You might as well say "yes, I'm for universal healthcare."

    September 14, 2011 at 6:50 pm | Report abuse |
    • nwatcher

      and what's wrong with that?

      September 14, 2011 at 7:05 pm | Report abuse |
    • Anotheralt

      There's nothing wrong with saying you're for universal health care...unless you're a small government candidate and don't want to be labeled as blatant hypocrite and possible moron. Then it's problematic.

      September 14, 2011 at 7:06 pm | Report abuse |
  11. DoWhatYouWill

    Cancer is no joke – if you don't want to vaccinate your kids, fine. Just don't take any money out of my pocket to pay for their treatments down the line. Health insurance shouldn't have to cover the treatments either – I'd like to keep my rates down. Good luck with that.

    September 14, 2011 at 6:55 pm | Report abuse |
  12. Karen

    I know my statistics very very well, I have studied actuarial math. Give me any two things you want statistically linked, and I can interpret the data in such a way that to the layman they would appear to be so. Anyone who wishes to be informed on the manipulation of statistics used in the media and politics today, read the book "How to Lie with Statistics" by Darrell Huff. If everyone in America read this book we would live in a much better country, or at least a better informed one.

    September 14, 2011 at 6:55 pm | Report abuse |
    • barlowdm

      Yes, who was it that said "there are lies, damn lies, and then there are statistics"? I have taught research methods and statistics at the college level and one of my most favorite lectures is the debunking of statistics. Any so-called researcher can manipulate statistics to fit their needed outcome.

      September 14, 2011 at 7:17 pm | Report abuse |
    • Ph.D. from M.I.T.

      Karen – Thank you for the reference. Unfortunately, it seems most Americans do not want to be informed. They only want to listen to once source of information that tells them what to think – instead of thinking for themselves. Maybe they are too lazy – or maybe they never learned how to think critically. I do not know the answer. But as someone trained in the scientific method, it scares me when I hear so many people say they only believe people who tell them what they want to hear. Wake up America. Try to find some facts and then draw your own conclusions. Do not be driven by fear and ignorance. Opinions are fine – as long as they are recognized as opinions. Sometimes the truth is messy and complicated – and does not make a good slogan – but we need to start with the facts or our great country is doomed to failure.

      September 14, 2011 at 7:23 pm | Report abuse |
  13. contessa

    Its so funny how even people's welfare can be twisted and drawn into political turmoils. WOW for that i applaud you BASTAR**

    September 14, 2011 at 6:58 pm | Report abuse |
  14. Joe

    Michelle Bachmann needs to stay out of health care and focus her attention to something she knows best– nothing.

    September 14, 2011 at 7:01 pm | Report abuse |
  15. knievel m.d.

    most of these comments dishearten me as a physician. i think, 'hey i can educate my patients so they can make an informed decision.' then i see parents saying they wouldn't get vaccines because they will force abstinence (with a 1% success rate!) on their children. and they say a mystical God will protect them from disease. i want badly to help these children, but their parents stand in the way of their welfare. i would fully support all mandated vaccines as well as making alcohol and, fast food, and cigarettes illegal because the general public isn't educated enough to do what is good and right.

    September 14, 2011 at 7:01 pm | Report abuse |
    • nwatcher

      i was going to disagree with you till you threw in the part about alcohol, fast food and cigarettes. At least you're consistent.

      September 14, 2011 at 7:07 pm | Report abuse |
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