Download One common complaint that children have about Pediatricicians is

One of the cornerstones of Pediatrics is prevention of diseases through the use of
vaccinations. While many children are fearful of “shots”, these immunizations play a
vital role in maintaining the health of both individuals and the community. In a
development that might make more children unhappy but please their parents, some new
vaccines have been introduced in the past several years including vaccines that aim to
prevent a type of cancer and as well as warts.
Gardisil was the first vaccine for general use that targets a virus that causes cancer.
Cervirix is another HPV vaccine is another that was subsequently licensed.. Gardisil is
designed to prevent infection by four strains of Human Papilloma Virus (HPV) that is a
causative agent of cervical cancer in women; Cervarix protects against two strains.
Gardisil vaccine is licensed for males and females ages 9-26 and is a three part series.
Cervarix is not yet licensed for use in males.
HPV is a sexually transmitted virus that is extremely prevalent in society—the Centers
for Disease Control and Prevention (CDC) has reported that as many as 80 percent of
women will get a genital type of HPV by age 50. In fact, one study from the United
Kingdom showed that young women who had only one sexual partner had a 46% risk of
contracting HPV within three years of their first sexual encounter.
In many, if not most people, HPV lies dormant and causes no problems. In others, it can
cause genital warts in both males and females. In some women it can cause abnormal
cervical pathology or cervical cancer. The American Cancer Society estimated that in
2006, about 9710 women in the United States developed cervical cancer and about 3700
died from it. Simply having a positive HPV test in any individual does not mean HPV
will cause any of these conditions. However, without HPV infection, cervical cancer
and genital warts will almost never occur. Hence, an effective vaccine to prevent HPV
will prevent cervical cancer and genital warts.
Unfortunately, there are many strains of HPV and in order to prevent all cases of the
infection, a vaccine would have to protect against all strains. Neither vaccine protects
against all strains, Gardisil protects against 4 strains of HPV—the two most commonly
associated with cervical cancer and the two most commonly associated with genital
warts. Studies suggest that receiving this vaccine will reduce an individual’s chances of
contracting cervical cancer by 65-70%. The indication for males is to prevent genital
warts since males can not get cervical cancer. Cervarix protects against the two strains
most closely associated with cervical cancer.
Some people express concerns about these vaccines. For one thing, vaccination is very
expensive—well over $100 per dose--and it requires three doses to complete a series.
Fortunately, most HMOs are covering the vaccine and the Federal Vaccines for Children
program (which provides vaccines for children enrolled in Medicaid) is including the
vaccines.
Another worry is that vaccines are new—Gardisil was only licensed in 2006 and Cervarix
more recently. People worry that a new vaccine might have side effects that did not
appear in clinical trials before licensure. This concern is legitimate. There have been
some reports of patients who have had neurological problems with Gardisil that first
appeared during the six month time period over which the three shot series was
administered. However, there is no evidence that these problems were actually caused
by the vaccination. The CDC and the American Academy of Pediatrics strongly endorse
the vaccine.
Finally, some feel that since HPV is sexually transmitted, vaccinating against it will
signal approval to girls and boys to engage in sexual activity. Physicians counter this
argument by pointing out that this vaccine in no way protects against all strains of
HPV—much less the many other sexually transmitted infections—so it is hardly approval
to have sex. Giving a child an HPV vaccine is no more permission to have sex than
giving someone a Tetanus vaccine is permission to step on a rusty nail. It is simply
protection. Physicians are not advocating these vaccines to enable children to engage in
any sexual activity or to encourage patients to engage in unsafe sex; we are advocating
vaccination to protect them in the future from a cancer that kills women every single day
in the US and from genital warts which can be life long..
If an individual has questions about these vaccines or is interested in receiving either of
them for him or herself or for a child, one should contact one’s personal physician to
discuss the vaccines.