Can We Just Vaccinate Our Kids Against HPV Already?

By Lindsay Abrams

It doesn't hasten girls' entrance into adulthood or turn them into sex maniacs. It protects from cancer.

litttlegirlmain.jpgDanielle Moler/Flickr

One of life's hardest lessons is learned early on. Or at least it should be. As J.M. Barrie immortalized in the opening sentences of Peter Pan:

All children, except one, grow up. They soon know that they will grow up, and the way Wendy knew was this. One day when she was two years old she was playing in a garden, and she plucked another flower and ran with it to her mother. I suppose she must have looked rather delightful, for Mrs Darling put her hand to her heart and cried, "Oh, why can't you remain like this for ever!" This was all that passed between them on the subject, but henceforth Wendy knew that she must grow up.

Profound a truth as this may be, there must be remain some who insist on trying their hardest to unlearn it. Why else would Pediatrics deem it necessary to publish a study, as it did today, establishing that the HPV vaccine does not somehow cause adolescent girls to become prematurely promiscuous? That time and money had to be spent proving this -- and that the results are being so widely touted -- is in deference to the delusional: the Mrs. Darlings attempting to convince themselves that their Wendys can, in perpetuity, remain untouched.

They do so at their daughters' risk.

HPV poses a threat as both the most common sexually transmitted disease in the U.S. -- the CDC reports that most sexually active adults will contract the virus at some point in their lives -- and as a leading cause of cervical cancer, which affects 12,000 U.S. women each year and kills one-third of them.

But as of 2011, the CDC reported in August, only 34.8 percent of girls aged 13 to 17 had received all three doses of the shot proven to protect against HPV, a tip-toe forward from the 32 percent who were immunized in 2010. 

That the vaccine associates adolescent girls with sexual activity is widely acknowledged to be one of the reasons why it has yet to catch on. When Yale modeled public compliance with the vaccination recommendations, it found that the biggest obstacle was "the dramatic perception that sexual risk among adolescent vaccine recipients would nearly double." 

Today's study, sponsored by the Kaiser Permanente Center for Health Research and Emory University, indicates that despite this association, vaccination does not encourage young women to initiate sexual activity at an earlier age.

A study from January established the same thing in slightly older girls. Although it relied on self-reporting, the new study is more difficult to dispute. Instead of asking the young girls outright if they were engaging in sexual activity, it looked for indirect signs that such activity might be going on: Were they seeking birth control advice? Had they been tested for STDs or pregnancy?

The overwhelming majority had not. These are girls, almost 500 of them, who got the shot at the recommended age of 11 or 12, and as the authors point out, only about 3 percent of high school girls report having become sexually active before the age of 13. Within three years of follow-up, the girls who did seek out birth control or get tested for pregnancy/STDs did not do so any more than their 900 peers who had not been vaccinated. 

The study didn't look at the behavior of boys who had been vaccinated, as the CDC recommends they be. The risks are highest for girls, but HPV is known to cause less common cancers in men, and vaccinating boys helps to minimize the risks for the entire population. 

Couple these results with a report that came out at the beginning of this month from the vaccine's maker saying that, in terms of things that we might have legitimate concern about, such as the risk of adverse physical reactions, the vaccine was shown to be "generally safe." In over 180,000 females aged 9 to 26, little was observed aside from incidences of fainting on the days the shot was administered and a slight risk of skin infection at the injection site.

Put aside the hysteria, and getting the HPV vaccine can easily be turned into a non-event. Girls get the shot the same time they are immunized against tetanus, diphtheria, pertussis, and bacterial meningitis, as 90 percent of the girls in the study were. The HPV shot needs to be recognized as nothing more than one addition to the standard regiment.

Responsible parents might even do well to discuss the HPV vaccine's purpose with their children, in broad if not explicitly sexual terms. But whether or not they choose to, getting their pre-teens immunized is far from the psychological equivalent of handing them condoms (which, it's worth noting, don't fully protect against HPV).

What's more, it's vital to get to them at this age, before they become sexually active. Equate sexual maturity with being "ready" for the vaccine, and we run the risk of it already being too late: the authors note that a third of girls aged 13 to 19 have contracted at least one strain of HPV.


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The results of the new study "are comforting and reassuring," lead author Robert Bednarczyk told the AP. And it isn't such a terrible thing to rest assured that the "innocent little 12-year-old girls" Michelle Bachmann claimed to be protecting last year when she opposed a government mandate for this vaccine are, by and large, still innocent.

If that's what's needed to make HPV vaccinations more prevalent, fine. Parents and politicians can go ahead and be comforted. But as Wendy managed to figure out when she was still a toddler, all little girls do grow up. The real comfort should come from knowing that when they do, they'll have one less thing to be threatened by.

This article available online at:

http://www.theatlantic.com/health/archive/2012/10/can-we-just-vaccinate-our-kids-against-hpv-already/263625/