How should you decide whether the human papillomavirus vaccine, sold as Gardasil, is right for you or your daughter? Here are five things to consider:
1. Immediate risk of getting infected with the HPV virus. There's a general consensus that the vaccine's benefits far outweigh the risks in girls and young women who are thinking about becoming sexually active with a new partner. (Both intercourse and oral sex spread the virus.) Older women on the dating scene may also benefit, but there are not enough clinical data yet to state that definitively, which is why the vaccine is approved only in women up to age 27. If you have a daughter who's years away from becoming sexually active, you might want to think about delaying vaccination since some data suggest that the vaccine's protection may wane after three to five years.
2. Whether you make a point to get annual Pap smears. If you're vigilant about getting Pap smears, you're already slashing your risk of cervical cancer by making it a point to catch abnormalities before they become malignant. On the other hand, if you do opt out of vaccination and get infected with HPV, you might wind up undergoing more invasive procedures to diagnose and treat cervical abnormalities. Note: Gardasil doesn't protect against all strains of HPV that cause cervical cancer, so even vaccinated women need those Pap smears.
3. Cost. Though the vaccine's list price is $360 for the three-dose series, the real cost is $400 to $1,000 once you factor in markup and office visits, according to this recent New York Times article. Although most girls can get adequate insurance coverage because of government vaccination programs, adult women often have only partial coverage or none at all.
4. Allergies. The Food and Drug Administration says anyone allergic to yeast shouldn't receive Gardasil. You should also avoid it if you know you have reactions to certain vaccine components like polysorbate 80. Previous allergic reactions to other vaccinations could mean you're at greater risk of having a reaction to this one; your best bet is to talk to your doctor about this.
5. Tolerance to pain. Gardasil is quickly getting the reputation as the "most painful childhood shot." Merck, the vaccine manufacturer, acknowledges that the sting can be bad, most likely because the viruslike particles generate a strong immune response at the injection site, causing temporary swelling and inflammation. Fainting, among teen girls, is also more common after this shot compared with others, which could be linked to the pain. Though discomfort should hardly be the deciding factor, some experts believe it should be weighed, especially for young girls who aren't yet at risk for contracting HPV.
Click here to learn about growing concerns over potential side effects from Gardasil.