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. Suzanne

    CNN is guilty of very lazy journalism. The article says "some journals retracted studies linking the two." The Lancet, the prominent British journal that originally published Andrew Wakefield's "research" was the journal that retracted it! CNN presents the pro-vaccine case as though there were debate within the scientific community.–there is not a shard of evidence linking autism and vaccines. This is not without consequence...when vaccination rates drop, EVERYONE becomes at risk–other kids, adults whose immunity is declining. My heart goes out to parents of autistic kids, but this is no favor to the kids, as it directs money down a blind alley.

    For the conservative wing of the Republican Party to now be using HPV vaccines as a litmus test for candidates is beyond irresponsible. How about some principled reporting, CNN folks?????

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

      Thank you for yoru comment Suzanne. And for putting in references that can be checked by people if they do not believe you. Or even if they do, BUT want to be certain of their facts rather than repeating something someone else told them. Facts are neither liberal or conservative. Facts are facts. I admit the truth can be complicated and messy and sometimes we don't yet know or have all the facts. But it really scares me when again and again people say whatever they want to pander to those they think are their supporters (such as the famous "not meant to be a factual statement" incident)! No treatment is going to be perfect, but if it will work 90+ % of the time, and save hundreds of thousands of lives and millions of dollars, then it must be implemented for the greater good of socienty. And – because of that good – society should provide whatever is needed to those very few that suffer negative consequences. And guess what – the only way to do this is through government. That is what government is for. If you don't like government then go live on an island by yourself. Oh – and don't take any benefits of roads, police departments, military, consumer protection laws (for food, drugs, etc.), etc., etc., etc.! Don't be selfish and take (demand) all the benefits of living in America but not want to pay your fair share.

      September 14, 2011 at 7:34 pm | Report abuse |
  2. TexanAgainstPerry

    I am a big believer in vaccination, my kids have had every one available without any side effects. The older two were spared chicken pox due to their vaccination, my 10 month old was not as lucky since that vaccine isn't given until 12 months. My daughters will get the HPV vaccine when they are older. HOWEVER, Rick Perry is no altruist and his push for mandatory vaccination was for his buddy the lobbyist, not to save lives. Anyone that has a clue in Texas knows that Perry likes to reward his buddies (read up on the Technology Fund issue). So I agree with the poster above – this is not about the benefits of the HPV vaccine, it's a political issue.

    September 14, 2011 at 7:06 pm | Report abuse |
    • DP

      Here. Here.

      When people are forcing other people to do something "for their own good", I'm not worried about whether it's really good or not. It's the forcing and then it's the question of why are they really doing it.

      September 14, 2011 at 7:18 pm | Report abuse |

      This article fails to mention ALL OF THE SIDE EFFECTS. I refused to allow the females in my family get the shots. And will continue to refuse. There's more to the story than what is written and it would be advisable for parents to research more these side effects NOT MENTIONED. I agree...political and money in the pocket for politicians who make this mandatory.

      September 14, 2011 at 7:27 pm | Report abuse |
    • Tony

      What we have lost sight of here and in so much of our political life these days is any notion of the common good and of the virtues of sacrifice. It's not simply "I have the right to not vaccinate my kid." Well, you if don't and the infant (who is too young to be vaccinated) next door dies, YOU are responsible. So it's not just about you, it's about all of us supporting and taking care of each other, and sacrificing some of our opinions to what is best for others.

      September 14, 2011 at 7:42 pm | Report abuse |
    • moderate1982

      @ CBREEZE-i really hope the women in your family never get HPV or cervical cancer. it is a deadly cancer that can be prevented by a vaccine.

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

      There are many articles available from this link, some dating as early as 2007.

      You must be VERY careful what is in vaccines, and what are the possible side effects. I do not get ANY vaccines-not even the flu shot-unless I absolutely have to.

      September 14, 2011 at 7:45 pm | Report abuse |
    • Ph.D. from M.I.T.

      to @CBREEZE if you are not a "female," then (IMHO) you should not be dictating to the "females" in your familiy what they can and cannot do to protect themselves from disease. Should you wear a seatbelt or not? Sure, in maybe one one hundredth of a percent of accidents the seatbelt causes harm, but in the 99.99% of accidents the seatbelt lessens injury and saves lives. So you are saying not to wear the seatbelt because you might be in the one out of 10,000 accidents?! That is faulty logic driven by fear and ignorance. Wake up, there are no 100% perfect solutions. But if I have something with better than 90% odds in my favor, I am going with it.

      September 14, 2011 at 7:50 pm | Report abuse |
    • SK

      My 15 year old daughter had a horrible reaction to the vaccine. It is not proven safe.
      Firm believer that CDC and vaccine manufacturers are all in each others business financially and politically.
      Please, choose your vaccines wisely. Consider how many our children are getting and the total assault to their immune and neurologic systems. HPV is a disfiguring, painful issue....cervical cancer can be identified early and treated. Tough decision here...

      September 14, 2011 at 8:11 pm | Report abuse |
    • patrix

      For all those folks avoiding childhood vaccinations, you'll face the music when your grandchildren are born blind, deaf or with serious heart defects when your daughters transmit measles to them in the womb. My sister got the first measles/ mumps vaccine in 1964 and is 51 with an IQ of 146 and manages a large insurance brokerage firm. I did not get it because I spent three months of second grade having all three forms of measles and chicken pox. As to Mrs. Bachman's claim that a parent told her that it caused mental retardation, there is absolutely no evidence that the vaccine has ever triggered such a problem. Parents grasp at straws. As to the claims of Autism being linked to childhood vaccinations, the issue is coincidental in that the syndrome manifests at about the same time as the last in the series of infant inoculations – and always has. The 'increase' in autism is actually due to redefining Autism as a spectrum disorder that includes a very wide range of other than average behaviors, most cases of which would have been previously defined as quirky or shy or a loner and many of which may shortly be reascribed to early symptoms of OCD or eidetic memory or other, normal, human mental variants. Again, parents with socially inept or reclusive children want comfort labels and current educational funding programs make parents feel empowered by forcing schools to modify school life to meet their child's perceived special needs. While this has been a good thing for children truly effected by autism (or ADD,) it has resulted in treating normal human variant as deviant or pathological. Mrs. Bachman can join Jenny McCarthy in the devil's playpen for the great disservice they are doing to future generations.

      September 14, 2011 at 8:12 pm | Report abuse |
  3. Pandora

    I think that the makers of the drug should sue Michelle Bachman for slander since she stated in very public forum that getting the vaccine would cause mental retardation.
    If she is going to run for the most powerful position in the world then she needs to check her facts before opening her mouth. Going on hearsay is not a good policy when you are speaking on camera during a highly publicized national debate.

    September 14, 2011 at 7:09 pm | Report abuse |
    • Carol

      Over 60 young women have died after getting this vaccine and others developed permanent debilitating disabilities.

      Michele may not have all the facts (and might not be PC with her words) but a quick internet search will list plenty of problems with this vaccine

      September 14, 2011 at 10:20 pm | Report abuse |
    • popejon

      OK Carol, did you make that up? Sounds like it. A credible source please. And not from a website selling herbal remedies and the likes....

      September 14, 2011 at 10:37 pm | Report abuse |
  4. jesse

    well bachmann is an idoit thats the first thing you need to know

    September 14, 2011 at 7:11 pm | Report abuse |
  5. zengirlnyc

    I can't believe how much information was left out of this article. Please see these sites:

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


      I love Bachmann and will vote for her if she's nominated. I wouldn't vote Obama for dogcatcher.

      September 14, 2011 at 7:51 pm | Report abuse |
    • Sure

      Ahh...conservative links.

      September 14, 2011 at 8:00 pm | Report abuse |
  6. Darwin

    This is going to turn into one of those debates like same s3x marriage and abortion that no one will ever agree on. My position – vaccinations are good, forcing people to take them isn't. This is the United States of America and I'll die before I let anyone force me to do anything I don't want to do.

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

      Kids are being sent home from school if they don't have their shots.

      September 14, 2011 at 7:48 pm | Report abuse |
    • Ph.D. from M.I.T.

      Darwin. So I take it you drive on whatever side of the road you like – and the wrong way one one way streets when you feel like it. And you carry guns and knives onto airplanes? ANd don't pay your taxes. Etc., etc., etc. yes, this is America where we are guaranteed 3 things, life, liberty, and the pursuit of happiness. And we have a great many other freedoms not found in most of the world. But as a member of socienty you have an obligation to follow the rules of that socienty – because you enjoy the benefits from that society. Hopefully the rules are designed to provide benefit to the MAJORITY of the socienty. usually you will be in the majority, but occasionally you will be in the minority that is negatively impacted by the rule. That is the reality of societies. In order for the marjority to benefit, sometimes a few will have to sacrifice. If you don't like this then go live on an island by yourself. Stop being so selfish and demanding that you are special and should only ever get the benefits from living in America – and never have to do what is for the greater good of the society. Our founding fathers understood about sacrifice for the greater good – love it or leave it!

      September 14, 2011 at 7:59 pm | Report abuse |
    • SK

      Mr. PHD obviously never had a child with a vaccine injury. Then you'd think twice about the good of society versus your own child. And the good of society is not necessarily served by all these vaccinations.

      September 14, 2011 at 8:14 pm | Report abuse |
    • Darwin

      @Ph.D. from M.I.T. – Do you have a point, or are you just trying to p!ss me off? I "choose" to follow the laws of my country, I'm not forced to. I never said anything about having a problem with the laws in this country either. If anything my post was about "having a choice" vs "being forced" to do something. I stated my position pretty clearly, you assumed the rest, and in doing so you put your words into my mouth. Dumb @ss!

      September 14, 2011 at 8:50 pm | Report abuse |
    • popejon

      SK, you've never met someone with polio....

      September 14, 2011 at 11:01 pm | Report abuse |
  7. Jennifer

    While generally I'm for vaccines for contagious conditions, it seems like maybe this particular vaccine should be optional.

    September 14, 2011 at 7:17 pm | Report abuse |
    • MNCounselor

      I am so tired of this having to be repeated over and over because some people either can't read or are too stupid to understand.....EVEN MANDATED VACCINES HAVE AN OPT OUT OPTION!!!! Nobody is "forcing" this on anyone who doesn't want it, you just have to be informed enough when it comes time that this is on the list of vaccines that are normally given to everyone (if you're in a state that it is mandated) and opt out of that one. Stop spreading lies and mis information!

      September 15, 2011 at 9:29 pm | Report abuse |
  8. Georges Devleeschouwer

    This is about the HPV vaccines, from what I have read in "non official" newsletters is that the side effects are a lot much worse than what the FDA and/or CDC will admit, side effects are up to death!!!!!!!!!!!!!!!!!

    September 14, 2011 at 7:23 pm | Report abuse |
    • Matt

      Have you not looked at most medicines? almost all have them in some portion of the population. look at the actual numbers of people per trial. benefit vs risk, that is what it is all about. and here, the benefits completely outweigh the risks.

      September 14, 2011 at 8:04 pm | Report abuse |
    • I call BS!

      What do you think happens when you get cervical cancer? I don't know about you but I'd rather have side affects like diarrhea, nausea, or abdominal pain than getting cervical cancer. Think about it!
      The HPV Cervarix vaccine has been in use around the world for several years and has been very safe.
      However, any medicine could possibly cause a serious problem, such as a severe allergic reaction. The risk of any vaccine causing a serious injury, or death, is extremely small.
      Life-threatening allergic reactions from vaccines are very rare. If they do occur, it would be within a few minutes to a few hours after the vaccination.
      Several mild to moderate problems are known to occur with this HPV vaccine. These do not last long and go away on their own.
      Reactions where the shot was given
      Pain (about 9 people in 10)
      Redness or swelling (about 1 person in 2)
      Other mild reactions
      Fever of 99.5 or higher degrees Fahrenheit (about 1 person in 8)
      Headache or fatigue (about 1 person in 2)
      Nausea, vomiting, diarrhea, or abdominal pain (about 1 person in 4)
      Muscle or joint pain (up to 1 person in 2)
      Brief fainting spells and related symptoms (such as jerking movements) can happen after any medical procedure, including vaccination. Sitting or lying down for about 15 minutes after a vaccination can help prevent fainting and injuries caused by falls. Tell your doctor if the patient feels dizzy or light-headed, or has vision changes or ringing in the ears.
      Like all vaccines, HPV vaccines will continue to be monitored for unusual or severe problems.

      September 14, 2011 at 8:22 pm | Report abuse |
    • Carol

      Google: The Truth About Gardasil

      September 14, 2011 at 10:26 pm | Report abuse |
    • I call BS!

      @carol – I did. The Truth About Gardasil website is very one-sided and has absolutely no “proof” that Gardasil caused those ailments. "Truth" implies facts, and I saw very few of those. They should change the name of the website to The Speculations About Gardasil.

      September 15, 2011 at 8:37 pm | Report abuse |
  9. Jj

    @GOP logic they got nothing on you!!! you should post on here more. you are a breathe of fresh air! Ahh...

    September 14, 2011 at 7:24 pm | Report abuse |
  10. RUFFNUTT (kcmo , hut tub repairman & maker of disco balls)

    warts makes more bumps on the way in and feels better...

    September 14, 2011 at 7:27 pm | Report abuse |

      That's @#$%ing sick, but still funny as hell!

      September 15, 2011 at 8:49 pm | Report abuse |
  11. c

    what is truly scary, those you wish vaccines to be mandated by law.

    read the package insert, try reading the Federal Injury Compensation Fund.

    Get a clue on this what is in the needle.

    September 14, 2011 at 7:34 pm | Report abuse |
  12. Carol

    I think if my daughter was this age, has to be this age group to be effective, as I've read elsewhere, I would have her take it. I lost a dear friend in her middle thirities in the 80's, another friend in her 40's, and another friend now in her 70's has cervix cancer and is going through chemo, and radiation for it. It is insidious, and just jumps around your bodies attacking other organs, and eventually the brain. It wouldn't be allowed if it were dangerous. When you listen to the side effects stated on all the RX advertisements on TV, the side effects are horrendous, but if you need the RX and take it, most never experience any side effects. You have a choice, but cancer is not a picnic people.

    September 14, 2011 at 7:43 pm | Report abuse |
  13. RCBinTN

    Michele Bachmann is an idiot. She needs to stop wasting our time and get out of the way.

    September 14, 2011 at 7:45 pm | Report abuse |
  14. Bank Lady

    I don't understand why males are not being targeted as well. True, they don't have a cervix, but true they can carry the virus and can have genital warts.

    September 14, 2011 at 7:49 pm | Report abuse |
    • Matt

      We are not being targeted because we are only carriers, and 99.9% of the time we will only get warts.

      September 14, 2011 at 8:06 pm | Report abuse |
    • Ph.D. from M.I.T.

      I agree. For the good of the public welfare all children of the correct age should get the vaccination. Just like they now have to get measles vaccination, etc. My son got the vaccine because we want him to be part of the solution of making the world a healthier place – and not to be driven by fear and ignorance and selfishness. When will people start being so selfish and start to care about the good of society again. Love thy neighbor people, do what is right for the good of America – not just your family and few friends. America is one big family. We need to help everybody – not just those that can afford high priced lawyers and lobbyists.

      September 14, 2011 at 8:07 pm | Report abuse |
    • Really???

      My daughter's boyfriend is going to be vaccinated. I really like that boy, he wants to be part of the solution.

      September 15, 2011 at 1:49 am | Report abuse |
    • @Really??

      I'll get the shot if I get to have s3x with your daughter too. ROTFLMFAO!

      September 15, 2011 at 8:44 pm | Report abuse |
  15. Darwin

    I should also point out one important detail that most people will miss. When Bachmann used the word “mandatory” that was a strategic political tactic on her part. (In politics that’s not a big shocker) What she didn’t stress is that it’s only mandatory “if” you want to enroll a child in school. If you’ve ever enrolled a child into a school then you already know they’re “required” to have their shots (vaccinations) up to date. So, now you have three problems trying to fight this issue, (1) parents “do” have a choice, (2) we already do this with other vaccines, and (3) men in black suits aren’t going to break down your door and force your kids to take it. I’m not saying its right; I’m just saying it’s going to be yet another tough issue that no one will see eye to eye on. It should be interesting to see where this goes.

    September 14, 2011 at 8:01 pm | Report abuse |
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