The HPV vaccine

This story about HPV and its vaccine is from a couple of weeks ago, but it needs to be read.

The vaccine that blocks a sexually transmitted infection that causes cervical, oral and other cancers was hailed as a home run when it was approved seven years ago, but, given usage rates, doctors still aren’t sure if it’ll ever live up to the promise and render any of the diseases a shadow of their current lethality.

Instead, doctors are huddling to determine how to improve inoculation rates that hover at 33 percent, a figure attributed to controversy that beset the vaccine from the beginning. The controversy included concerns that the vaccine would encourage premarital sex and Gov. Rick Perry’s 2007 attempt to require it of Texas school girls.

“It’s just wrong that politics should play a role in this,” says Dr. Lois Ramondetta, a University of Texas M.D. Anderson Cancer Center gynecologic oncologist who treats cervical cancer, the cancer for which the vaccine initially was approved. “This is the only cancer for which we know an infection is the cause and have a vaccine that prevents it. Getting vaccinated should be a no-brainer.”

The virus also is associated with a number of other cancers that researchers have begun finding are spiking – oral cancers that involve the back of the throat, tonsils and base of the tongue, and cancers of the vagina, vulva, penis and anus. Dr. Otis Brawley, chief medical officer of the American Cancer Society, recently referred to the increase as “one of the epidemics of the 21st century.”


Two vaccines – Gardasil and Cervarix – have been shown to protect against the strains of the virus that cause cervical cancer. Because neither provides any therapeutic benefit once an infection takes hold, the Centers for Disease Control recommends a series of three shots to girls at 11 to 12 years of age.

But it was that recommendation that roiled the waters. A Yale study found parental concern the vaccine could make adolescents less wary of casual sex was the biggest single factor in the decision not to vaccinate.

When Perry issued his order – overturned by the Texas Legislature later that session – making the vaccine mandatory for public school girls, the outcry included not just members of the religious right, but the leadership of the Texas Medical Association, who argued that it should stay voluntary until safety and liability issues were vetted.

“Education needs to come first,” said Dr. Joseph Bocchini at the time, then the chairman of the American Academy of Pediatrics chairman of infectious diseases. “Much of the public doesn’t know about HPV and its link to cervical cancer and other diseases. You can’t put a mandate ahead of that.”

The whole controversy over Perry’s order – you can see my blogging about it here was bizarre to me. It’s always strange to see Rick Perry do the right thing, though of course in this case he was motivated in large part by helping one of his cronies, who had a large piece of the company that was going to provide the vaccine. I suppose the backlash was predictable, and Lord knows it would probably be even worse today, but it was still depressing to watch. I remain grateful to Rep. Jessica Farrar for being a voice of reason and compassion throughout the debacle. I wonder how many lives might have been saved if sanity had prevailed. I can only hope the next time this comes up, the needs of the kids will come first.

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