Families with young girls are faced with Gardasil questions
By Chelsea Parrish, 17, with contributions by Ben Harris, 13 and Erin Bozek-Jarvis, 15

If there were a vaccine available that could protect your daughter against a virus believed to cause cancer would you give it to her? What if it hadn’t been around very long? This is a question families across America are pondering with the distribution of the relatively new Gardasil vaccine.

Gardasil is a vaccination consisting of three shots given over six months that prevent four strains of the Human Papilloma Virus (HPV), which is sexually transmitted. Two that protect against seventy percent of cases of cervical cancer and two that protect against ninety percent of cases of genital warts. The maker of the vaccine, Merck, has had it approved by the Federal Drug Administration for use in women and girls ages 11 to 26.

According to the Center for Disease Control and Prevention (CDC), one in five American girls under the age of 18 has received the vaccine, which is a rate not unlike other newly-developed voluntary vaccines throughout history.

Megan Maas, fifteen, of Marquette received the vaccine early on as a safeguard.

“ I think that my mom wanted me to get the vaccine because she wanted me to be protected against cervical cancer and HPV in the future,” Maas said.

Katy Martin, also fifteen, of Marquette, received the vaccine as well, and feels that her parents thought of it as a preventative step against cancer.

“ I think they want to do everything they can to protect me from illnesses,” Martin explained.

The majority of doctors believe that the vaccine should be given before girls become sexually active, Dr. Randall Johnson, who retired within the past year after serving many years as the director of the Marquette County Health Department is one. According to Dr. Johnson, there are about 10,000 women every year in this country that develop cervical cancer and about 3,000 to 4,000 of them die every year

“ That’s largely preventable with this vaccine,” he said. “It’s not one-hundred percent, it’s about ninety percent effective in preventing getting infections with that virus, and it does reduce (the chance of contracting) about seventy percent of the cervical cancers.”

While Dr. Breanna Pond of OBGYN Associates in Marquette had concerns about the vaccine initially she now feels at ease administering it.

“ I didn’t want to give it right when it became available, a couple of years ago, but now that they have given millions of doses and a lot of follow-up on any potential side effects I’m real comfortable right now that it’s a safe vaccine,” she said.

Pam Popper, Ph.d., the Director of the Health-Wellness Forum, a chain of health and wellness centers located throughout the United States, is one who is against giving out the vaccine. Popper doesn’t recommend its’ use.

“ Its benefits are dubious, its side effects, particularly in the long term, are not well understood, it is expensive, and certainly should not be mandated for young girls,” said Popper. “The 1600 possible adverse reactions include dehydration, headaches, hyperventilation, muscle spasms, speech disorders, loss of consciousness, blurred vision, vomiting, central nervous system disorders, impaired tactile sensitivity, burning skin sensations, muscular weakness, and increased red blood cell sedimentation rate. These reports were characterized as ‘not serious’ and I suppose compared to death they aren't. But in my view that this vaccine's usefulness is questionable at best, why would anyone knowingly take these risks, let alone subject minor children to them?”

Dr. Johnson is in favor of the vaccine but also feels that families should do their own independent research if they have concerns.

“ I would tell them to look at reputable sources of information because there are lots of people that, for whatever reason, think this is the worst thing that’s ever happened,” he said. “I would recommend people look at the CDC recommendation when they make that decision and try to be as objective about it as possible.”

Popper not only questions the vaccine’s necessity, but also questions its continued effectiveness.

“ Merck has no idea how long the vaccine lasts and whether or not a booster shot will be required,” she said. “The Food and Drug Administration concurs that it cannot vouch for how long the vaccine will remain effective.”

Dr. Pond agrees that follow-up research needs to continue on the vaccine’s long-term effectiveness and safety.

“ The only issue is we don’t know a lot of the long-term outcome on it,” she said. “We don’t know if there’s any thing unsafe about this vaccine. We don’t know if there will be any long-term side effects.”

One issue with the vaccine for some families is that their insurance may not pay for it; it costs between four hundred and six hundred dollars total for the three vaccines.

Because of the cost, and accompanying profit, the manufacturer, Merck, is pulling out all of the stops for marketing since it is one of the most expensive vaccinations ever, with sales expected to reach $4 billion by 2010. Television, and radio commercials have young girls singing the catchphrase “I’m going to be one less, one less!” That of course refers to the hope that they won’t contract the virus.

Dr. Johnson suggests that despite the fact that it protects against sexually transmitted infections parents need not say anything more about this vaccine than they do any other.

“ I think it’s just like any other [vaccine], measles, mumps, rubella, it’s just a vaccine designed to protect them against a viral infection that can be fatal and can cause cancer,” he said. “You don’t have to get into any more detail, especially with young children about why they’re giving it at 11 or 12, hopefully before they’re sexually active.”

Another controversial aspect of Gardasil is whether or not it should be made mandatory. Under a 1996 immigration law it is required for immigrants coming into this country. That is because it is on the CDC’s recommended list. This has caused some backlash because of both the cost and the concerns connected to it. A last report that requirement was under review. The possibility of the vaccine being made mandatory has caused some concerns within the country as well. Texas, for example, once required it, but has since rescinded that requirement.

Maas feels it should be a personal decision.

“ I do not think that the vaccine should be made mandatory because girls should have a choice about whether they want to get the vaccine or not,” she said. “I think that making the vaccine mandatory would be taking away women's rights.”

Martin supports everyone getting the vaccine, but also doesn’t feel it should be mandatory.

“ I think it would be good if everybody would get it, but I don’t think we should force people to get medication that maybe doesn’t fully protect them,” she said. “It might just keep them from doing things that they still should do.”

While the American Cancer Society has hailed this as the first vaccine targeted specifically for preventing cancer, the group cautions that if vaccinated women decide to skip regular screening for example, regular pap smears, in 10-20 years, we could actually see an increase in Cervical Cancer.
If you would like more information about the prevention of cervical cancer and Gardasil please visit the CDC website at www.cdc.gov.