At my 12-year-old daughter’s last check-up, the pediatrician asked if I wanted to give her Gardasil. I said no. I knew that Gardasil, the cervical cancer vaccine, works by providing immunity against the human papillomavirus (HPV), which is primarily shared through sexual contact. Why on earth would I need to protect my child against a sexually transmitted bug? While it might make sense for an older teen or woman in her early 20’s to take a needle in the name of warding off a virus she might catch from someone she’s sleeping with, sticking it to a seventh-grader (or a fourth-grader: Gardasil is approved for males and females ages 9 to 26) seems tantamount to giving her permission to start hooking up.
On the other hand, we are talking about the third most common cancer in women, and since January is National Cervical Awareness Month, it seems a good time to get the facts straight. Here’s what one of the developers of the vaccine, Diane M. Harper, MD, a professor in the department of biomedical and health informatics at the University of Missouri-Kansas City, told me about the HPV vaccine for girls:
Did I make the wrong decision in not giving Gardasil to my daughter, who I know isn’t having sex?
Not at all. Vaccinating kids against HPV at age 9 or 10, or even 11 or 12, would be fine if we knew that they would be protected for 30 or 40 years, but Gardasil stays effective at most for seven years. You want to have protection throughout the years she’ll be most sexually active, which according to national surveys is between ages 16 and 26.
So when should girls be vaccinated?
Gardasil and a newer HPV vaccine, Cervarix, work best before a girl starts having sex and gets exposed to HPV. So the best time to consider the HPV shot is when she starts asking about birth control or showing other signs that she’s interested in having sex.
If you’re already having sex, it’s too late for Gardasil. But Cervarix can still be effective in preventing cervical cancer for women who’ve already been exposed to the virus.
How is Cervarix different from Gardasil?
Cervarix got FDA approval for females ages 10 to 25 in 2009 and is, in some ways, a better option. It lasts longer than Gardasil -- 10 years rather than 7 -- and protects against four high-risk strains of HPV in addition to the two in Gardasil. For Gardasil to be completely effective it has to be given in three carefully timed shots; the FDA recommends that Cervarix be given in three doses too, but you’re really protected after just one. Plus, it’s about five bucks cheaper.
Are the HPV vaccines safe?
Whether or not the HPV vaccines are safe
depends who you ask. The Institute of Medicine says there’s a significant risk of anaphylaxis
. There’s been concern about neurological problems, but there’s not enough data to say whether or not Gardasil causes these. The Centers for Disease Control and Prevention (CDC) has an ongoing study of 400,000 girls and is seeing neither side effect. You should discuss all this with your child’s doctor -- or your own doctor if you’re thinking about getting the HPV shot.