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What do you consider a "high risk" group for needing Gardasil?
Sexually active teen = high risk group, IMO. Nothing else (income level, race, IQ, religion) really matters - those are just statistics about McPeople.
I prefer to make decisions about my child's health, based on what my own child is/is not doing. While I believe in being proactive, 12 seems very young...
If you've already been infected, it's not going to do you any good. I'll answer your question about the boosters later. I have to go to the dentist in a few minutes.
If you've already been infected, it's not going to do you any good. I'll answer your question about the boosters later. I have to go to the dentist in a few minutes.
Guardasil does not prevent cervical cancer. It reduces incidence of HPV which is believed to cause one kind of cervical cancer. I'm not sure how many strains of HPV Guardail is supposed to work against but it's nowhere near the 100+ strains out there. Looked it up. It's four.
Women who have been inmmunized against HPV do not get dysplasia, which is well established as the precursor to cervical cancer. By detecting dysplasia with Pap smears and treating it, cervical cancer can be prevented. So, yes, if Gardasil prevents dysplasia, it prevents cancer.
And 2 of the 4 strains in the vaccine are associated with most of the cervical, vaginal, vulvar, anal, and throat cancers. Only about a dozen of the HPV strains are associated with cancers.It is not necessary to prevent all of those strains to successfully reduce the risk of cervical cancer. At some point, we may see a vaccine that includes more strains, but that would increase the cost. There comes a point when adding more strains produces little increased benefit.
And the evidence is that HPV does cause cancer. It is not just a "belief." The guy who demonstrated the connection won a Nobel Prize in Medicine:
You are trying to rationalize your decision not to have your daughters vaccinated by saying if the vaccine only prevents 90% of cervical cancer and not 100%, then it's not good enough to bother with.
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I'll have to see actual reductions in HPV caused diseases before I believe this one. I don't think we'll see a reduction in deaths from cervical cancer at all. I think too many women will see getting the shot as a license to take risks they wouldn't take otherwise including not getting pap smears.
You know, you have been given link after link showing these reductions. Did you read any of them? Here is another one (the vaccine was probably Cervarix rather than Gardasil, but the 2 strains studied are the same as in Gardasil):
"Vaccine efficacy against CIN2+ containing HPV16/18 DNA was 90·4% (97·9% CI 53·4—99·3; p<0·0001). No clinically meaningful differences were noted in safety outcomes between the study groups."
CIN means dysplasia. This is a Phase III study. That means it is done in real patients who have not been tested to make sure they have not already been infected with HPV16 or 18. The vaccine was still 90% effective. That shows why the vaccine needs to be given at an early age.
Your assumption that women who get the vaccine will not get Pap smears has no basis in fact. And if a woman is vaccinated and does not get Pap smears, her risk of getting cancer is still lower than it would be if she did not get the vaccine and does not get Pap smears. There are virtually no financial barriers to getting a Pap smear. Even uninsured women can get one for free or at reduced cost at almost any public health department on the country. Any woman who gets prenatal care will also most assuredly get one.
By the way, if you believe in Pap smears, by extension you believe treating dysplasia prevents cervical cancer, because that is why we do Pap smears. Why, then, do you not believe that preventing dysplasia with the HPV vaccine will not prevent cancer? You cannot believe one and not the other.
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I don't see the point in immunizing the herd here. If my daughters were in a high risk group, I might consider it but they're not.
The only low risk group for HPV is men and women who choose to be totally celibate.
You may have convinced yourself that HPV vaccines will not prevent cancer. The scientific evidence says they will.
"In girls and young women ages 9 to 26, GARDASIL helps protect against 2 types of HPV that cause about 75% of cervical cancer cases, and 2 more types that cause 90% of genital warts cases. In boys and young men ages 9 to 26, GARDASIL helps protect against 90% of genital warts cases."
Again I ask, why are we only experimenting on our girls here? I swear, the more I look into this, the more it looks like a conspiracy against our daughters. If garadil is so great and HPV so bad, and gardasil is approved for both genders, why are they NOT pushing on our sons like they are our daughters? IF HPV is such a problem, you'd think they'd attack it from both directions with a vaccine approved for both genders but they only push this on our daughters.
If a 12 year old child is vaccinated now with the Gardasil vaccine and a year down the road, a newer vaccine that covers more strains of the virus comes out - can (or should) the child then receive that vaccine, too?
If you think that the odds of your 12 year old child having sex at 14 or 15 are very low, would it make sense to wait a little while and see how the HPV vaccine evolves?
We are not going to see new vaccines in the space of 3 years. A 12 year old should get what is available now. Those who are 12 when the newer vaccines come out will get the newer vaccines.
What evolution are you waiting for? If it a concern about safety, the safety is well established. The controversy about safety is, by and large, internet inspired and fueled by the claims of parents with children with serious illnesses who believe their children were harmed by the vaccine. The scientific evidence is that those children were not harmed by the vaccine.
Q. #1: From experience with other vaccines, e.g. Prevnar, a booster would be required.
Q. #2: Probably not. It is better to be protected before one becomes sexually active.
The problem is that by the time a new vaccine comes out, the current cohort of 12 year olds will be older and include a significant number who are sexually active, so getting immunized against additional strains would be less effective.
Of course, by the time a new vaccine comes out, those older girls would hopefully be able to have a frank discussion with their doctor and if they truly have not yet started to have sex, take the newer vaccine.
I guess my concern would be in having to get a new shot every time a better vaccine becomes available - would that happen every 3 years, every 2, every 1 or every 6 months? How often and how many Gardasil type shots can a person really have - safely?
Getting immunized against additional strains would be safe. The issue is whether it can be done before the onset of sexual activity. We are not likely to see new vaccines too frequently. They are too expensive to develop. Adding a couple of strains might be cost effective, more probably not.
I guess my concern would be in having to get a new shot every time a better vaccine becomes available - would that happen every 3 years, every 2, every 1 or every 6 months? How often and how many Gardasil type shots can a person really have - safely?
suzyq_10 did a pretty good job with this, but I will add.
With Prevnar vaccine, the first vaccine released in 2000 immunized against seven strains of pneumococcal vaccine. In 2009, the vaccine was improved to immunize against 13 strains. A booster was recommended for kids under 5 who got the 7 strain series. I don't want to hijack this thread talking about this vaccine, just pointing out, it's not likely to be every 3 years, let alone every 6 months that a new HPV vaccine comes out. As suzy explained, vaccine development is expensive.
Katiana and Suzy_210: I just wanted to thank you both for your very informative posts. You've done a great job answering questions/clearing up facts for everyone, and I appreciate that.
I'm still on the fence about the need to vaccinate children against an STD at such young ages. Next thing you know, they'll be giving proactive bc shots to 12 year old girls...It all just seems so very early to me.
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