gardasil - my research paper - rough draft

would love input - especially from those in the medical field and those with daughters and thanks to those who returned my survey, your help was appreciated! forgive the formatting, it didn't paste over right and i'm too tired to fix it.

Gardasil

Gardasil is the only FDA-approved HPV (Human Papillomavirus) vaccine available at this time, receiving federal approval in June 2006. The vaccine is used to prevent the HPV infection, but will not treat an existing HPV infection. The Centers for Disease Control and Prevention reports that HPV is the most common sexually transmitted virus in the United States. There are about forty types of HPV. About 20 million people in the U.S. are infected, and about 6.2 million more get infected each year. HPV is spread through sexual contact. Gardasil, given in a series of three shots, protects against four strains of HPV. Two of those strains cause 70 percent of the nation's cervical cancer cases, and two of them cause 90 percent of genital warts. (Houppert) The vaccine is recommended for females ages eleven to twelve years; however it can effectively be given as early as nine years of age up to age twenty-six. For the greatest benefit, the vaccine should be given prior to potential exposure to genital HPV through sex, thus the reason for starting the injections at an age many consider too young for a vaccine that prevents a sexually transmitted infection.
In February 2007, Texas Governor Rick Perry issued an order that will require all girls in Texas who are entering the sixth grade to receive the controversial Gardasil vaccine as part of their routine childhood immunizations in order to attend school. This mandate will begin in September 2008, and many other states are currently considering the same legislation. Many parents are angered by the push to require the relatively new vaccine. This potential mandate has many parents in an uproar for numerous reasons.
The most protest appears to be that parents feel that making this vaccine a requirement to attend school will condone premarital sex, giving many young girls a false sense of protection against all sexually transmitted diseases. With this false sense of security, parents fear that children will be encouraged to have sex at an earlier age. Statistics show that the number of sexually active high school students is already alarmingly high. The Centers for Disease Control reports in the Morbidity and Mortality Weekly Report: Youth Risk Behavior Surveillance – United States, 2005 that 46.8 percent of high school students have had sexual intercourse, 6.2 percent of high school students engaged in sexual behavior before the age of thirteen, and that 14.3 percent of high school students have had sexual intercourse with more than four persons during their life. It can be argued that if we are concerned that our third graders are having sex and contracting sexually transmitted viruses, we as parents are failing our children. If a parent's concern lies in whether or not their child is having sex, then they should evaluate the way they teach their children the moral principles of making decisions regarding sex and their bodies, as well as the dangers and responsibilities that come along with choosing to be sexually active. It has also been said that young girls will need to be introduced to the subject of sex earlier than they are ready for because they will questions the purpose of the Gardasil shots. Consider this, when your daughter gets a shot, whether it is for Polio or HPV, does she question what the shots are for? If she does, do you go into extreme detail? Many mothers I surveyed reported that with the vaccine being given along with other routine immunizations, the need to explain the vaccine, if asked, can be easier. They agreed that most girls will be satisfied with a simple answer just as they are with the vaccines they currently receive. Some stated they would simply tell their daughter that it is an inoculation for a virus that causes pre-cancerous cells, and that there is no specific need to bombard a curious nine year old with all the details of HPV and its roll in cervical cancer. Another mother, who works in the medical field, was more open to using this as an opportunity to open up the lines of commutation with her daughter concerning sex, answering her honestly about the vaccine, and that it is protection for only four strains of HPV, nothing more, giving way to that important and unavoidable safe sex talk – from bother her parental and her medical standpoint.
Another concern parents have is the side effects from the still new vaccine and its long term immunity. Currently additional booster doses are not recommended by the CDC. However research will continue to ensure immunity without boosters. If boosters are found to be necessary, there may come a time where a woman simply goes in for a regular routine gynecological exam which can include a Gardasil booster. (Johnson) As for the side effects, the CDC reports that Gardasil does not appear to cause any serious side effects. As with any medication, there is risk for side effects, but in clinical trials for the Gardasil vaccine, the side effects were minimal. According to CDC data, nearly 20% of the complaints about Gardasil involved soreness at the injection site and 9% involved fever or nausea. There were three cases of Guillain-Barre syndrome, which is a paralyzing side effect that has occurred with other vaccines. About 11% of the complaints involved fainting or dizziness. There have been no deaths or serious injuries resulting from fainting reported. (Johnson) It is understandable that no mother wants their child to be the guinea pig, but every great medical breakthrough has to start some where. Having access to a vaccine as promising as Gardasil can protect our daughters in this generation, and lead to the end of HPV for future generations.
The biggest controversy surrounding the HPV vaccine is the push by Merck, the company who invented Gardasil, and the government, to mandate the HPV vaccine. Many parents are upset that their child may be required to take a vaccine for an illness that can not be passed through casual contact. It is true that the vaccines children currently receive are for diseases that are easily passed through casual contact; a cough, a touch, through air. However, just because HPV is passed through sexual contact rather than casual contact does not make it any less serious or fatal. It is understandable to debate that HPV is not so easily transmitted at an early age, but in the years to come, you cannot be certain of the decisions your child will make about her body. Though she has been a responsible person, there is still a chance that she may opt to share her life with someone who has made different decisions about their body. Then, will she be protected from HPV or will she run the risk of contracting it because the person she loves did not live the same as she did in their younger years? Many parents reasonably question if it is really necessary for the government to make this decision on behalf of the parents. Many parents feel being forced to add this vaccine to what is often considered an already overload of immunizations in a short period of life is infringing on the rights of the parents. Though many would choose to take advantage of a vaccine to prevent cervical cancer after further research on the vaccine, they still want the option to make the choice of if and when on their own. Many parents feel it is not only their right to make such decisions, but also their responsibility. Another benefit to mandating Gardasil is that by mandating the vaccine, you get access for those with barriers to medical care, such as no insurance or who have insurance with no coverage for the Gardasil vaccine.
This brings about another concern. How can we eradicate HPV if the males are not immunized and are still silent carries of the virus? By 2009, the vaccine could be approved for boys as well. (Hoffman) Most mothers of boys are dismissing this, thinking that Gardasil is a girls' vaccine – after all, the "One Less Campaign" targets girls. Mothers of girls that I surveyed were supportive of mandating the vaccine for boys if it was passed as mandatory for girls. Doing so could have benefits; HPV also causes anal and penile cancers, which are rare, as well as some head and neck cancers. Though your son may not have a cervix, chances are he has more than one of the other anatomical parts at risk of the aforementioned cancers. Is there really a cancer you would not want to protect your child from if possible?
It is also important to point out that like with any immunization every state except two has some kind of opt-out clause for parents who object to the vaccine for health, religious, moral or ethical reasons. (Houppert) Just because a vaccine is mandated as a routine childhood vaccine, it does not mean that you are forced to have your child immunized. It is your right and your responsibility as a parent to make that choice; to educate yourself on the vaccinations and the conditions they are developed to prevent; and to make an educated decision for your child.
This vaccine is not about promoting sex, or about stopping HPV, but rather about protecting our daughters from cervical cancer. Just because your child is not currently having sex at nine years old, does not mean she will not be having sex when she is sixteen or sixty. Laying a foundation for a cancer free future is a profound ability that we should be grateful for taking part in. A 2004 study published in the Journal of Lower Genital Tract Disease showed that among 575 parents, only 55 percent thought the vaccine was a good idea before they read a one-page education fact sheet about HPV. Afterward, seventy-three percent of them favored the vaccine after learning more about it. (Houppert) The key to parents opening up to the idea of a HPV vaccine lies in education about HPV and cervical cancer, just as much as education about the vaccine itself.

Works Cited
Hughes, Melissa. "Mandating Gardasil: Survey for Mothers with Daughters." Blind survey via Email. 13 April 2008.
Houppert, Karen. "Who's Afraid of Gardasil?" The Nation 26 March 2007. 16 April 2008.
United States. Department of Health and Human Services Centers for Disease Control and Prevention National Center for Immunization and Respiratory Diseases. HPV (Human Papillomavirus) Vaccine: What You Need to Know: Vaccine Information Statement (Interim) Human Papillomavirus (HPV) Vaccine. Atlanta: CDC, 2 February 2007.
United States. Department of Health and Human Services Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report: Youth Risk Behavior Surveillance – United States, 2005. Volume 55, No. SS-5. Atlanta: CDC, 9 June 2006.
Johnson, Laura. Guest Speaker. Client Navigator Conference. La Quinta Inn, Macon, GA. 31 May 2007.
Hoffman, Jan. "Vaccinating Boys for Girls' Sake." The New York Times. 24 February 2008. 16 April 2008.