Sept. 19--Last year, Kimberly Sebeck received a recorded phone call from the principal of her daughter's middle school.
It alerted her that Gardasil, a Merck-produced vaccine against some strains of human papillomavirus, was now recommended for girls as young as 11. Sebeck's daughter also brought home printed material, she said.
Sebeck expected to discuss the vaccine, which protects against some strains of the virus that causes certain kinds of cancers and genital warts, with her family doctor or husband. She wasn't prepared for a school administrator to bring it up.
When it comes to HPV vaccines, public health and parents sometimes diverge. Health officials cite studies that indicate that the vaccine, while still relatively new (it was first FDA-approved in 2006) and very expensive, is extremely effective in preventing several types of cancers, as well as genital warts, linked to HPV. If it becomes a standard of care to have girls vaccinated before they're sexually active, some think, it could eliminate up to 70 percent of certain types of cancers, and up to 90 percent of genital warts.
"It's very safe and effective," said Dr. Martha Buchanan, director of Knox County Health Department. "It's the only vaccine we have that is proven to prevent cancer."
Yet she doesn't foresee it becoming a required vaccination for school entry, as shots that protect against measles, diphtheria, chickenpox and a host of other ailments that once routinely killed children now are. While the viruses that cause the diseases most immunizations are meant to stave off can be spread through casual contact -- in the classroom, on the playground -- HPV is a sexually transmitted disease. Some parents find discussion of even their children's future sexual activity to be none of the government's business.
Gardasil and Cervarix, the only other FDA-approved HPV vaccination, work only if a person hasn't yet been exposed to the virus, which the national Centers for Disease Control and Prevention estimate at least half of sexually active adults will contract in their lifetime. The majority will clear the virus from their bodies without effects, although they could first pass it to sexual partners. But more than 17,300 women a year get cancers thought to be related to HPV; almost 7,600 men do. HPV is though to be linked to at least 65 percent of vaginal cancers, 50 percent of vulvar cancers, 35 percent of penile cancers, and 90 percent of anal cancers.
Gardasil targets two strains of HPV thought to cause 70 percent of cervical cancers (as well as other cancers) and two strains thought to cause 90 percent of genital warts. Two years ago, the FDA gave Mereck permission to market Gardasil for males ages 9-26, not only to protect them, but to prevent them from spreading HPV.
Stephanie Hill's son won't be old enough to get the vaccine for a few more years. But Hill, who once worked for a cancer center, plans to get him vaccinated, as long as it's safe.
"I do believe in the vaccine as long as there aren't any major side effects that come down," Hill said. "Males are carriers, so if he can prevent giving (HPV) to someone when he is (someday) sexually active, I am all about it."
Sebeck, on the other hand, read the CDC's report on adverse reactions and decided against vaccinating her daughter, now 14. Although some people who got the vaccine died, suffered blood clots or developed Guillain-Barre syndrome, a neurological disorder, the national systems that track vaccine reactions found those problems weren't caused by the vaccine. But Sebeck doesn't feel the vaccine has been studied long enough to be certain of either its efficacy or harmful effects.
"I'm not anti-vaccination, but I do want to be informed about each of them," she said.
Earlier this month, Republican presidential candidate Michele Bachmann said she met the mother of a girl who suffered mental retardation after receiving an HPV vaccine, which Bachmann's Republican opponent, Rick Perry, once recommended requiring for all Texas girls. But no record exists of any such case, and two scientists have offered $10,000 if that family comes forward.
Buchanan said local parents have been fairly receptive to the vaccine. The health department gives 100-200 doses each month, mostly to girls, she said. The vaccine is given in three doses over six months. At the health department, it costs around $150 per dose. TennCare covers it, as do most insurance companies.
"In my opinion, it's a revolutionary vaccine to prevent a pretty predominant cancer of women," Buchanan said.
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