A Cautious Approach to Gardasil Shot

1 in 4 teens has had the HPV vaccine, which means many parents are waiting—and that's a good thing.

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News today cheering the fact that 1 in 4 teen girls has received the Gardasil vaccine sounds to me like some serious spin from the Centers for Disease Control and Prevention, the government agency pushing girls as young as 9 to get the shot. The CDC's Lance Rodewald said this rate was "very good," considering it's a new vaccine. But the Los Angeles Times points out that just 1 percent of Latina teens have gotten the vaccine, and they're a population with particularly high rates of infections with the cervical-cancer-causing human papilloma virus. What's more, the 25 percent figure refers to those who had just one of the three shots required to get full immunity; many teens, especially those who've had painful swelling at the injection site, opt not to get the second and third shots.

Although the CDC certainly wants to get the word out that all teen girls should be vaccinated, I think many parents—myself included—are taking a sensibly cautionary approach. This is, in fact, a new vaccine, which means no one knows exactly how long its protection lasts. No one knows, either, what sorts of side effects are associated with the vaccine, according to pediatrician Catherine DeAngelis, editor-in-chief of the Journal of the American Medical Association, as I reported in my previous blog post detailing a relatively high rate of allergic reactions associated with Gardasil. DeAngelis also told me that she thinks that Gardasil manufacturer Merck was too aggressive in marketing the vaccine in commercials and magazine ads before it was allowed to slowly filter into the population. As New York Times writer Elisabeth Rosenthal recently put it, "the lightning-fast transition from newly minted vaccine to must-have injection...represents a triumph of what the manufacturers call education and their critics call marketing."

This is not to say that young women and girls on the threshold of sexual activity should avoid Gardasil. It's been shown to protect against genital warts and 70 percent of the HPV viruses responsible for cervical, vulvar, and vaginal cancers. The question is: Should this new vaccine be given routinely to all young girls years before they become sexually active? Perhaps we'll know better in the next several years as more becomes known about its duration of effectiveness and safety profile. I'm still of the opinion that parents should apply a little common sense. A recent survey of 10,000 nurses who were also mothers found that about half opposed giving an 11-year-old the vaccine, while 90 percent agreed it should be given to 15- to 18-year-olds. Instead of rolling out the simple-minded "get vaccinated" message, I'd like to see the CDC look at surveys such as this one and get a bit more nuanced in its recommendations.