HPV Vaccines and Other Difficult Dialogues

In 2008, when our pediatrician at the Palo Alto Medical Foundation suggested my then twelve-year old daughter get the human papillomavirus (HPV) vaccine, I balked. It wasn’t that I didn’t want to protect her, I simply wasn’t ready to consider the issue. First, I wasn’t sure I wanted to make my daughter a guinea pig for a vaccine that had only recently come on the market and second, well, this was my baby-girl for goodness’ sake.

Apparently in my hesitation, I was not alone. According to a recent article in the New York Times, since it was introduced in 2006, only 40% of girls between the ages of thirteen and seventeen have received one dose of the HPV vaccine and less than a third have received all three of the required doses.

Reasons range from resistance to vaccinations in general to cost (a full course runs over $350 and is only sometimes covered by insurance) to moral turpitude. The HPV vaccine has become a lightening rod for conservatives who are dismayed by the vast dissemination of something that could be seen as a “license to engage in premarital sex.”

In fact, vaccine even made it into the recent presidential debates as Rick Perry was slammed for his support of a state law requiring girls to be vaccinated.

Now, the CDC wants us to expand coverage to boys as well.Just this past week they launched a campaign to advocate for vaccination of all children between the ages of eleven and twelve. Their reasons are strong.

Gardasil, the vaccine developed by Merck, has been proven to prevent four forms of the sexually transmitted disease human papillomavirus (HPV). HPV has been linked to cervical, genital, anal, and throat cancers, as well as genital warts.

A second HPV vaccine, Cervarix developed by GlaxoSmithKline, has also been approved for girls. It promises to prevent cervical cancer, but makes no claims on other cancers or genital warts.

Will parents suddenly step up to vaccinate their sons when most haven’t even done so for their daughters? The general consensus is: not likely.

I thought I’d call a few neighbors to get some input. Turns out I am the exception not the rule around Our Fair City. Most of my friends with teenaged girls have already had their daughters vaccinated. One told me, “Why wouldn’t I protect my daughter against something as horrible as cancer.”

When I asked another if she planned to get her teenaged son vaccinated, she said, “Of course. It’s the right thing to do. Not only will it protect him, but it will also protect his future partners.”

A third neighbor said, “vaccinations work best when we all do them. It is a social responsibility.” 

My friend Felice, whose son is eighteen and legally an adult, said, “I wish I had known about this back when my son was younger. I can encourage him, but now that he is a man, the decision is his to make.” 

Here I am, behind the times again. So, I spoke with each of my teenaged children. I explained why I believed getting the vaccine made sense. We discussed the issues and my concerns. These were necessary, but difficult dialogues. I let them decide what they felt was right for them

My oldest son (aged 17) began his course of vaccination last week. My daughter (now 15) is scheduled to begin hers over the holidays. My twelve year old son? I haven’t discussed it with him yet. I’m just not ready to let my baby grow up.