Eva is a 20-year old college student on the East Coast. In 2007, she and her mother visited their family doctor for Eva's pre-college physical.
While they were there, Eva got the first in a series of vaccine shots called Gardasil, which has been found to greatly reduce the risk of contracting HPV in young women ages 9 to 26.
The HPV virus (human papillomavirus) has no known cure and many strains, some of which can cause cervical cancer. Eva and her mother both agreed that getting vaccinated was the right thing to do; just a year earlier, Eva's older sister had lost a close friend to cervical cancer.
"I figured if there was something I could do to prevent getting cervical cancer, why wouldn't I do it?" Eva said. (Personal Interview conducted by Dresden Quinn Jones).
1 in 4 women who are eligible are getting the vaccination but recently, some health experts have questioned whether Gardasil's marketing is creating more risks than benefits.
HPV is a confusing and tricky virus. It is the most common sexually transmitted disease, mostly because many of those who are infected have no idea. While certain strains of HPV can cause genital warts, most strains have no symptoms whatsoever. Prevention of HPV is difficult; experts recommend that individuals limit their number of sexual partners and always use condoms to prevent contracting the virus. There are 40 known strains of HPV and the strains which cause warts are different than the strains which can lead to cervical cancer. Some women with HPV face difficulties for years (such as wart outbreaks); some women develop cancer in the cervix, vulva or vagina but 90% of women infected with HPV who have healthy immune systems test negative for the virus within two years of being diagnosed.
Gardasil, the HPV vaccine, was approved for women ages 9 to 26 in 2006 and sexual health experts were excited; researchers have been working on various vaccines for sexually transmitted diseases, including HIV, for many years. The prospect of a vaccine that could prevent the most common STD was thrilling. However, in the three years since its approval, Gardasil has been marketed as cervical cancer prevention, which is a narrow and dangerous approach.
There are concerns among health experts that the marketing of Gardasil is minimizing the importance of regular pap tests and the use of condoms during sex ("HPV shot found safe, but some experts question its benefits" by Denise Mann. CNN.com). While Gardasil protects against the four main strains of HPV, it is not a guarantee that those who are vaccinated will never contract HPV or develop cervical cancer. For many years, women have been encouraged to get yearly pap tests, which is a procedure that collects a sample from the cervix to look for abnormalities. Cervical cancer is often diagnosed this way and pap tests continue to be the most effective means of early cervical cancer detection. Additionally, young women need to be encouraged to practice safer sex regardless of their vaccination status.
There are also some parents of teenage girls who are concerned that giving their daughters the HPV vaccine will give them false security to have unprotected sex and/or multiple partners. As of now, Texas became the first state to require young women to get the vaccine. Conservative groups argue that the shot encourages premarital sex, which is what some have said about giving condoms to teens for years. Other parents worry about vaccines in general; there has been a push against vaccines for years due to the side effects and the belief that there are long term complications.
Other parents like Eva's mother believe that any measure to protect their daughters against the threat of cancer is worth the risk.
"I have talked to her about continuing to make smart decisions about sex", says Eva's mother. "It's up to the parents to make sure their kids know that this vaccine is not a license to throw personal responsibility out the window."
Written by Mark Riegel, MD
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