Cervical Cancer Vaccination
Moms View Message Board: The Kitchen Table (Debating Board): Cervical Cancer Vaccination
The FDA recently approved a vaccine for cervical cancer, and the state of Michigan is very close to passing a law that would require all girls entering the 6th grade to be vaccinated. While supporters herald the vaccine as a major breakthrough in the fight against cancer, critics worry that this is a moral issue and that requiring young girls to be vaccinated may undermine parental rights (although parents can opt their child out) as well as the consideration of abstinence as a way to prevent the transmission of sexually transmitted diseases.
Any thoughts?
Detroit Free Press article
From the Kalamazoo Gazette:
Health, morals at center of debate over cancer vaccine
Friday, September 15, 2006
By Linda S. Mah
Two members of the Kalamazoo-area medical community say they hope the new cervical-cancer vaccine and a state Senate bill that would require Michigan girls to receive the vaccination before entering the sixth grade will have a significant impact on the spread of the disease.
``Speaking as a public-health physician who has seen and managed and treated and worked very hard to prevent cervical cancer, I think this is a tremendous opportunity,'' said Dr. Richard Tooker, chief medical officer for Kalamazoo County Health and Community Services.
Sen. Tom George, R-Texas Township, who also is a medical doctor, co-sponsored the bill, which passed the Senate Health Policy Committee on Wednesday.
``As a physician, I've seen, unfortunately, my share of women die from this disease,'' George said. ``This can be a life-threatening illness, and to be able to prevent it is a great step forward.''
The vaccine, approved by the Food and Drug Administration in June, prevents infection by some strains of the sexually transmitted human papilloma virus, which can cause cervical cancer and genital warts.
The FDA approved the vaccine's use in girls as young as age 9, and a government advisory panel has recommended the three-dose vaccine be given to girls before they become sexually active.
While no one questions the benefit of the vaccine's ability to prevent cancer, concern has been raised that it might encourage sexual promiscuity among young girls.
Bill Kiewiet, executive director of Alternatives Women's Care Center, said he has nothing against preventing cancer but that the vaccine may undermine the consideration of abstinence as a way to prevent the transmission of sexually transmitted diseases.
``We feel like this is an area that the family needs to address and that it's an issue of morality,'' Kiewiet said. ``The concern would be at one end of the spectrum that we would be giving license for young women to have a physical relationship with anyone she wants.''
The vaccine could be used by parents as a way to initiate conversations about sexual activity and their rules and expectations for their children, he said.
Even beyond the issue of sexual activity, Margy Hunter, a teacher and mother of an 8-year-old-girl, said the vaccine raises questions about how far the government should go in mandating heath treatments.
``Don't get me wrong, I think it's a great vaccination,'' Hunter said. ``But it harkens to more controlling times by the government.''
George and Tooker both noted that under the bill parents could opt out of having their children vaccinated for religious or philosophical reasons.
Tooker said the matter is really quite simple: ``I think parents need to ask themselves, given the opportunity to vaccinate your child against the development of cancer in the future, do you want that or don't you?''
Tooker said this is not the first vaccine for a disease spread through sexual contact. Infants receive a vaccine for hepatitis B, which is a well-known cause of liver cancer. Hepatitis B frequently is transmitted through sexual contact, he said.
``I've never encountered tremendous controversy about vaccinating individuals, including infants, for cancer prevention related to a virus that is often sexually acquired, meaning hepatitis B,'' Tooker said. ``So one could say, `Why the controversy now?' We've already done the same thing anticipating that babies will be sexually active at some point in their lives.''
I don't think getting a shot, would change the way that my girls already behave.
Like Dawn says I don't think it would change my child's behavior. But so if I have a child that chooses to be abstinate then why vaccinate? There are side effects, things do go wrong, why would I put my child at risk? To me with every vaccine you have to measure benefits vs risks. So my children didn't get the pox vaccine, it didn't pass my risk/benefits test. My kids also don't have hep b or pertussis...so to each their own. My doc and I recently discussed this test for my dd (she is 12) and I just told her that I could justify having it done at this point. She agreed.
While I believe there is (or SHOULD be) a limit to what a governing body can force us to do as regards to health matters, I WILL just say that *if* this vaccine truly works, it is worth considering. HPV is NOT something new but it HAS become so incredibly common and apparently 1 out of every 3 or 4 women are infected and most don't even know it.
Jen talks about this all the time. And as Dawn said, I don't think a shot is going to change anyone's sexual behavior for the better or the worse either. It certainly is something more people should be concerned about. Just reinforces my saying that when you sleep with someone, you are TRULY sleeping with everyone THEY have slept with too.
Back to the original point - I don't know at what age I'd consider it appropriate, but I can see how educating parents & sexually active (or soon-to-be sexually active) teens might make them more inclined to take advantage of a protective measure.
Kaye, reread your last line...from the way your post was going I assumed you were going to say you COULDN'T justify it at this point. Is that a typo, or did you decide to have your daughter vaccinated?
I am against making this a required vaccination. I think we already have too many required vaccinations, and this should be left up to the parents or patient, as the situation requires. I think sex education is much more valuable than just vaccinating everyone, and hoping for the best.
I think that if I can lower my daughter's risk for cervical cancer that it is really worth looking into. I haven't looked at the risks but if they are low I will be getting both of my DDs vacinated in the next couple of years. My DDs will probably never know what it is for. I am not going to tell them that it will prevent them getting this virus but that it will help to prevent it. Sorry but even those that abstain until they are married could end up with HPV. What if the person that they marry has it? Sorry but I would much rather be safe than sorry with this. My grandmother had cervical cancer among other cancers (breast was her primary). I don't want my DD to go through that if I can help prevent it. I will not change the way I teach her to act and I will still have her educated about things but I see no reason (unless there are a lot of bad side effects) that will prevent me from having my DDs vacinated.
As far as what age. I would think the younger the better. If you do it before they are wanting to have sex it is just another shot at the dr office. And not a big issue. But that is JMHO.
Tarable, the recommendation is to start the vaccine series young for just the reason you state: If you do it before they are wanting to have sex it is just another shot at the dr office. And, it is a three shot series given over a 6 month period. There may be a need for boosters - at this time, it seems it has certain efficacy for 5 years but it is not known if that period of efficacy may be longer. It also appears, from a study of 11,000 young women, that in almost all cases, the only side effect is pain at the injection site for a day or two.
Here is a link to the Center for Disease Control extensive article: CDC HPV
And, I agree - you should continue to teach your children that the only certain way to prevent STDs and pregnancy is abstinence untiil marriage. And all the moral reasons for abstinence - not to mention the emotional/psychological reasons.
I don't agree with making this vaccination mandatory, although the proposed legislation does seem to have an opt-out provision for both religious and philoslphical reasons, which should cover all possible parental reasons for objecting.
In general, I think vaccinations should be mandatory for diseases that are transmitted by involuntary and less than personal contact (coughing, for example, or touching hands). And not mandatory for diseases which require deliberate, close personal contact - behavior that is a matter of choice, not accident.
An important reason for mandatory vaccination for some diseases is that, given the global world we live in, we and our children run a much higher risk of being exposed to diseases - such as measles, pertussis (whooping cough), mumps, and the like, than we did 15-20 years ago. More and more people from countries which do not practice nearly universal childhood vaccination are coming to this country, and expecially in college/university settings, we and our children are being exposed. Because the U.S. has nearly universal childhood vaccination for such diseases, the risk for an unvaccinated child wasn't so great 15-20 years ago, because the risk of exposure to unvaccinated people and potential carriers was so much less. Sadly, if you chose to not have your child vaccinated and s/he is exposed by a home visit from an unvaccinated college student, your child may catch the disease, and the unvaccinated college student is another vector for spreading the disease outside the college/university community.
Having said that, I still have mixed feelings about the chicken pox vaccine. All three of mine had chicken pox, and while my middle child was extremely uncomfortable, it was not a big deal. But, my then husband caught it from our oldest because he had not had it in childhood, and was very sick - as well as being at risk for meningitis, which is a potential side effect of chicken pox in adults. Now that so many children are being vaccinated against chicken pox, I would recommend that any adult who did not have the disease in childhood and did not receive the vaccination, and is at a higher risk for exposure (teachers, child care workers, pediatric medical providers) should get the vaccination for their own protection. (Of course, your co-worker, who didn't have chicken pox in childhood and was not vaccinated and whose child catches chicken pox, could bring it into the office - and if you didn't have it and were not vaccinated, you are at risk.)
And, I expect that my son and dear dil will add this vaccination to the list of those my dear granddaughter will receive - even though her father presently intends to send her to a convent boarding school at age 12 - LOL!
kate, I did not have her vaccinated, it was a typo 
Tarable, this won't prevent all cervical cancer, only cervical cancer from HPV.
Um, if it lasts for only five years, why the urge to vaccinate at age nine? That gets them up to age fourteen...
Because some kids are sexually active that early? Kids do get pregnant, at less than 14. I think you'd have to know your kid. 9 does seem early, though.
Yes I know this will not prevent all cervical cancer, but I would rather have her risks lowered if possible. My grandmother had cervical cancer so any way to cut down on the risks is a good idea in my opinion. Especially when so many people have HPV. And about 70% of cervical cancer can be traced back to some kind of HPV, from the research that I have done.
I would also not vaccinate at nine. I will wait until 12 or 13 so it lasts until 17 or 18.
This is just my opinion. And IF the most common side effect is just a sore injection site I really will have to look further into this. My ped has already asked me about Alexis (almost 12) and I told her I would like to wait until I research it a little more so we will talk more in Jan when her yearly checkup is.
I kind of skimmed all the posts so I'm not sure if this was mentioned. If it was, sorry. I do agree that this should not be a mandatory vaccine. Once again, this is an example of the government dictating to all of us because some of us may not be responsible enough to make good choices. That said, there are many cases of rape and molestation, especially of very young girls. Perhaps this vaccination will help prevent a child who has been abused from getting the cancer caused by the HPV.
Ame
I agree with eveyone who said that I don't think it should be mandated by the government. And, I actually agree with Crystal that the better weapon in the fight against STD's of any kind is more education.
I just wanted to see what ya'll thought.
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