Why Aren’t More Girls Getting the HPV Vaccine?


The invention of the HPV vaccine should have been treated as nothing short of a miracle. Here was a shot that, if administered properly to every girl in her pre-teen/early teen years, would effectively wipe out cervical cancer and all attendant problems with diagnosing and treating it. Unfortunately, doing that means making sure girls actually get the series of three shots, and that’s where we as a society are falling down on the job. Research reported in the American Cancer Society journal Cancer found that the share of girls who completed the three-shot series declined dramatically from 2006 to 2009, from 50 percent of girls getting the initial shot to 20 percent of girls, leaving 80 percent of girls who initiated the course of treatment still vulnerable to contracting HPV and the possibility of developing cervical cancer.

There’s a number of reasons for this decline, some of which could be addressed pretty easily with simple interventions. Researchers found that girls who started their series with ob-gyns instead of pediatricians did a better job of completing the series. This is probably in part because girls around this age are often transitioning out of seeing a pediatrician regularly, making it harder to remember the shots. Additionally, gynecologists have to deal with the effects of HPV as part of the job, so the importance of finishing the series likely weighs more heavily on them. The fact that the Gardasil ads don’t mention that it’s a three-shot series isn’t helping matters.

Part of it probably has to do with anti-shot propaganda from the religious right anti-choicers, who are willing to use any angle they can to make sure that girls don’t have access to prevention, period, even for cervical cancer, and are willing to punish sexually-active women with pain and even death for having sex. All vaccines hurt and all vaccines have side effects, but to hear people carry on, you’d think Gardasil was somehow the scariest and worst ever. And that’s not even to mention the pure misinformation, with claims of side effects that aren’t even attributable to the vaccine. 

In my experience, some of the apathy towards the vaccine is also due to the fact that people are confused about what exactly it prevents. The vaccine was touted as prevention for cervical cancer, but most people assume that we already have prevention for cervical cancer, the Pap test, which is actually a diagnostic tool that can reveal early signs of cervical cancer and lead to early treatment; it is not truly a prevention method. Though Pap smears do allow doctors to find identify pre-cancerous cells and remove them before they metastasize, it does not prevent future recurrences. But when these two are confused, it can seem like the vaccine isn’t that necessary for prevention.

Let’s not mince words here: The Pap test is not an adequate substitute for the HPV vaccine, and medical authorities need to be more adamant about this. I can personally attest to how true this is. I’ve been good about getting Pap tests, something I have to do every year because I’ve had some bad ones. Regular Pap tests are why I’m almost certainly not going to develop cervical cancer, much less die from it. But that doesn’t mean that illness and suffering has been adequately prevented. Pap tests didn’t prevent me from developing abnormal cervical cells from HPV. The Pap test just helped detect them. Now they have to be removed, with an outpatient surgical procedure that isn’t a big deal in terms of surgery, but is in fact a big deal compared to the mild pain and side effects of the HPV vaccine. 

Knowing what I know personally about what can happen to you if you don’t get the vaccine — even if you have access to medical care that prevents HPV from turning into cancer — I’m pretty sad that I didn’t have a chance to get a vaccine and prevent this disease. I’m also baffled that anyone would neglect to get their daughters these shots, all three of them. Unlike some diseases like measles and whooping cough that are now rare because of widespread adoption of vaccines, HPV is as common as dirt. If you don’t get the vaccines, you can basically count on getting one or another strain of HPV at some point in your adult life. But once you do get it, there’s no way really to make sure you have not contracted one of the strains of HPV that causes cervical cancer or other problems, as opposed to a more benign strain. The only real prevention is the vaccine.

Perhaps education about the vaccine needs to be more expansive. Parents don’t just need to be told it prevents cervical cancer, which may seem alien and far off compared to some of the more immediate effects of HPV. Doctors could also explain how the vaccine prevents the development of abnormal cells that lead to painful surgeries, and in some rare cases, infertility. Dangling the carrot of grandkids in front of parents to remind them to get their daughters vaccinated couldn’t hurt. It also couldn’t hurt to point out that the ill effects of HPV can often show up in relatively young women, even as cervical cancer tends to be more common in middle age. Parents need to have full information about what this vaccine provides in order to be vigilant.

Additionally, pediatricians need to be more mindful of the gap in a girl’s care between when she eases out of being a child but before she’s really old enough to see a gynecologist. It’s easy to see how that ambiguity can cause girls to fall through the cracks. Perhaps the low uptake rate of this vaccine can create an incentive for the medical community to address the larger problem of handling care for this group that’s in between childhood and physical maturity. 

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  • bess

    I don’t know about most girls, but my girls won’t be getting the vaccine, and here’s why:  

    1.  Length of efficacy–right now only 4 to 5 years.

    2.  Lack of long-term research into the vaccine

    3.  It only works with 4 strains of HPV

    4.  Side effects

     

  • anonymous99

    Amanda,

     

    I took my daughter to the doctor a couple months ago.  The doc was pushing this vaccine.  I called my wife while in the doctor’s office to see what she thought.  In no uncertain terms did she want my daughter to get the vaccine.  She has a co-worker whose daughter got the vaccine and hasn’t been “right” since.  She described the problems this girl was having, but I can’t remember the details.

     

    We have always been very up-front and open with our daughter re: sex and safe-sex.  I know the concept of using a condom is far from fool-proof, but we feel this is the best we can do for her at this time.  We just feel like the vaccine is too dangerous.

     

    Hope this sheds some light on what’s happening.

  • h2ogirl

    These are the same reasons my daughter will not be getting Gardisil either.  It is *not* because I think the vaccine will cause her to become promiscuous, like I’ve read in right-wing propaganda.  

  • crowepps

    Is sure does shed some light — people are making medical decisions based on gossip they heard from somebody at work instead of science.  And then spreading the gossip further as ‘advice’ to other people.

  • jennifer-starr

    It’s rather convenient that you ‘can’t remember the details’.  You couldn’t be bothered to call or text your wife and ask before posting here?  Using a co-worker of your wife as evidence without anything to back it up smacks of the kind of misinformation that urban legends are made up of.  This is just fear-mongering, plain and simple.

  • amanda-marcotte

    I am so incredibly sorry for your daughters. I honestly question why people have kids if they don’t think they should grow up to be normal adults who do things like have sex. 

     

    I’m sorry you’d rather have your daughters suffer what I’m going through than do something simple to care for their health. That strikes me as short-sighted and mean-spirited.

  • amanda-marcotte

    Is the fear of female sexuality. I think on a certain level, people think women have it coming if they suffer and even die from preventable illnesses caused by sex. Even if they won’t admit it. Believe me, if everyone had to get a cervical scraping before developing an opinion on this, we’d have no opposition.

  • donnag

    to display sudden personality changes. Why, that never happens! Must be the vaccine. 

  • jeff-fecke

    Well, sure! She hasn’t been “right.” There’ve been, um, details and stuff that aren’t important. Ooh! Maybe she became “retarded” like the the daughter of that woman that didn’t actually talk to Michele Bachmann!

     

    I’m sorry, but I’ve been through testicular cancer, and it sucked. And cervical cancer makes testicular cancer look like a mild cold. Am I going to risk my daughter’s life because someone’s brother’s cousin’s sister’s aunt’s hairdresser knew this guy who knew this guy who knew this guy who knew this gal who turned into a werewolf after getting this vaccine? No. I’m going to trust the actual science.

  • bess

    I’ll stick with teaching my daughters the importance of regular PAP screening.  I have had an ASCUS PAP indicating HPV.  The next year, normal PAP. 

     

    This has nothing to do with sex for me.  This has to do with the reasons I stated above.  I like how you go to the “You’re a shitty parent” right away though.  Nice. 

     

     

  • anonymous99

    I appreciate your point.  My wife doesn’t know I post here, which is the main reason I’m “Anonymous”.  I owe this board the details and I’ll try to get them.

     

    But, to be fair, I’m not using this as evidence for anything.  Amanda asked why girls aren’t getting the vaccine and I told her – we think the vaccine is too dangerous.  If she didn’t want answers from parents she should have said so.  Isn’t this shooting the messanger?

  • jennifer-starr

    I’m not attempting to shoot the messenger, but I’m more than a little skeptical of the ‘friend of a friend/relative’ tales–and there are more than a few regarding this vaccine.  Funnily enough, they all start with ‘friend of a friend’, ‘daughter of a co-worker’, ‘my second-cousin’s niece’ and so on and so forth, and they don’t have much in the way of details that would prove their veracity. This stuff gets passed around generally with the best of intentions and before you know it, people are co-opting and embellishing on the tale–hypochondriacs  jumping on the bandwagon, and so on.  And you have to admit that saying someone was ‘never quite the same’ is more than a little vague.  

    So if I seemed a bit harsh it wasn’t intentional, and if you have details I’d be eager to hear them. 

  • cags2606

    I’d like to share my experience of the HPV vaccine. I consented to my 13 year old daughter having the HPV vaccine because cancer is very prevalent in my family and I believed that I was doing the right thing by protecting her with the ‘Cervical Cancer’ vaccine. Unfortunately my daughter was one of the many, many girls who suffered adverse reactions to this vaccine. Prior to the vaccine she was a high achiever academically, she played competitive sports and danced competitively. She was happy, popular and extremely healthy. She became ill after the second dose and is still ill, eighteen months on. She regularly suffers from severe headaches, sore throats, chest and abdominal pain; some days she can barely walk due to joint pain, particularly in her knees; she suffers from muscle weakness, pain and uncontrollable twitching; she becomes exhausted after small amounts of physical or mental effot; she constantly feels dizzy and nauseous, has developed new allergies (to our pet dog of 12 years and some foods) and has little control over her body temperature, often feeling cold when it’s warm and too hot when it’s cold. But the most distressing of all her ailments is the deterioration of her cognitive abilities which is affecting her education. Her short term memory is vastly impaired and she find it very difficult to concentrate for any length of time. She is convinced she is becoming dyslexic because she often struggles to read the correct words, to get the letters in the correct sequence when writing and sometimes she even struggles to use the correct words when speaking. This points to neurological damage and as a previous straight A student, this is what she finds the most difficult to deal with. Pain can be managed, neurological damage is something totally different. All this started immediately after the HPV vaccination, which has never been adequately tested on this age group. The safety and efficacy trials were undertaken on adults and ‘bridging’ studies done to confirm that younger girls would produce antibodies – safety trials were not conducted.  Having spent hundreds of hours researching this vaccine in an attempt to try to find someone who could help my daughter, I now bitterly regret giving my consent without doing the research first. The vaccine was fast-tracked through the approval process and the science behind it very weak. The pharmaceutical companies admit in their own studies that if the girls have already been exposed to the strain of HPV against which they are vaccinated, their risk of getting cervical cancer actually INCREASES. HPV has been found in primary school children and can be transmitted in non-sexual ways. There were no studies done to assess the effect of vaccination on the other strains of HPV, not contained in the vaccine to see if they will become more virulent, as many scientists believe. There have been no long term studies to assess the effect on the fertility of the girls vaccinated. There have been no long term studies on the duration of protection from the vaccination – the best estimates at the moment are about 7-8 years. Our children are basically guinea pigs in this grotesque experiment because so much is not yet know about the effects of this new vaccine. Unfortunately, although the vaccine appears safe for the majority of girls, for a minority of (but still numerous) girls the side effects are devastating and life changing. The incredibly sad irony of this is that my daughter may never graduate college, may never have a family and may never secure a fulfilling career and she could still get cervical cancer. I urge everyone considering consenting to this vaccine to do your own very thorough research.

  • anonymous99

    Got the details – the girl began having seizures after she got the vaccine.

     

    You do realize, btw, that the maker of this vaccine is the same “trusted” company that developed Vioxx, right?  I think Amanda asked a good question.  She now has what is likely a large part of the answer – people don’t trust it.  Or do you think we parents are “afraid of female sexuality”?

  • anonymous99

    Amanda,

     

    Please stop.  Really? 

     

    YOU asked the readers of rhrc.org why our daughters aren’t getting the vaccine and I told you.  I’m just the average dad.  I’m not a doctor.  If the risks are overblown people like yourself and the medical community need to do a MUCH better job of getting the word out.  This is a failure on the medical community’s part, not the concerned parents who are just trying to do the right thing.  You do know the medical community has fucked up before, right? Don’t shoot the messanger or accuse me of being “afraid of female sexuality”, whatever that means.  I love my daughter more than you can possibly imagine and I’d do ANYTHING for her if I thought it was safe and would help. 

     

    YOU are WAY over the top here!

  • anonymous99

    Got the details – the girl began having seizures after she got the vaccine.

     

    You have your answers as to why the vaccine has been poorly received.  For us, we just don’t trust it.  Knowing that Merck, you know, the makers of Vioxx, developed it doesn’t help.  Continue to believe this is about bad parenting if you wish, but that won’t help anyone, most of all the girls you’re advocating for.

     

    Your welcome.

  • jennifer-starr

    I have two friends who developed seizure disorders around that same time when they were in their pre-teen/ early adolescent years in the mid-eighties– I’m told that epilepsy often picks that age to manifest itself.  I’m not saying it’s impossible, but the fact that the seizures followed the vaccination doesn’t prove that one caused the other. It could be entirely coincidental. 

  • anonymous99

    Of course.  But you’re not going to convince me of anything.  Call Merck and tell them to get their ass in gear and convince parents that it’s safe.  They have failed.  This is their failure.  They need to fix it.

  • cmarie

    judgemental much Amanda?   Please reread the first two comments.  Both parents state that after researching the vaccine they decided not to use it.  How do you take that and twist it into not wanting their kids to grow up… and wanting them to suffer?  I’m only at the early stage of the gardisil research myself.  I may end up agreeing with Bess and h20 girl or I may end up agreeing with you, but I won’t accuse any of you of apathy or negligence of your children.  We’re all doing the best we can as parents.  You raise yours, I’ll raise mine and let them raise theirs.  Now you want to use forced cervical scraping for reeducation?  You sound like a baby (not even a toddler) throwing threats around and taking it for granted that adults will indulge your behavior and not hold you responsible for it.  Grow up.

  • goatini

    It only DETECTS it.  

    This has nothing to do with sex for me”- BS.  You’re just here to troll, and to deliberately be disruptive with utter and complete BS.  You freaks are all hung up on some idiotic idea this Gardisil is some kind of “sex vaccine”.  Because, of course, if women have sex outside of Church-approved male ownership, for any other purpose but being a breeding container, they deserve to suffer miserably from a PREVENTABLE disease.  You make me sick.


    And I think that ANY parent that doesn’t protect their child with this vaccine IS a **VERY** SHITTY PARENT.   Based on the screeching of vicious trolls like you, it’s obvious that all YOU want to do is LIE.  


    All of you anti-sex freaks just make it up as you go along.  The above is a perfect example of how you just make up utter nonsense as you go along.  

  • goatini

    I don’t believe your concocted LYING bull story for a second.

    So, tell us, did you have your children vaccinated when they were young?

    Of COURSE you did.

    You’re just regurgitating LIAR Michelle Bachmann’s LIES about Gardisil.  Don’t insult US and presume we are idiots who haven’t done the research.  We HAVE done the research, and we know you are a LIAR.

    You are posting utter and complete BS with a BS wrapper around the completely made-up BS story.  There is no liimt to the depths you will sink to, to push your LIES.  

    Gardisil has a very good safely profile.  YOUR problem is that YOU think that females who YOU think are “sluts” should DIE from cancer because of their “sluttishness” in engaging in sex outside of Church approved male ownership.  We’ve seen your other posts, and we know this is one is a LIE to attempt to make a vicious misogynist like you seem “concerned” about women’s health, when the reality is that it is the LAST thing on your mind.  All YOU are interested in is LYING to attempt to continue to crush innocent women under your feet.  

    You LIE, and may God have mercy on your ignorant, venal, vicious soul for telling LIES in your attempt to LIE and let women DIE.   You and your kind should do us a favor and decline ANY vaccine or drug that might save your miserable life.  

     

     

  • karen-haack

    My daughter has suffered from long term disabilities because I did not do the research into this new vaccine.  It is the first vaccine of it’s kind.  It was created in a lab and is made up of Virus Like Particals.  I am not going to get into all of the problems however she is not the same girl that she was.  She has suffered paraplegia, heart problems, liver problems, visual problems, memory problems.  She also developed peripherial neuropathy after the vaccines.  Bloody stools, ulcerative colitis, vomitting blood.  Passing out all the time and horrible migraines.  This is a small list she was actually found at school in the hallway unresponsive without a pulse.  Luckily an EMT who worked at the school was there to revive her otherwise she would not be here today.  It has been five long years and she also has not had a menstrual since her first shot.  Ovarian failure.  You can not say I was anti-vax all my children received there vaccinations and I always listened to the doctors.  They fear mongered me into giving Samantha this shot before it was even made available.  They were talking about it and giving me information.  Everyone must do their own research and judge if they are willing to take a risk with this new vaccine.  Go to vaers or medications.com and see what other people are saying also a good source is sanevax.  Educate before you vaccinate…I wish I had.  Last week Samantha could not walk for three days and was feeling sick.  It has been almost five years.

  • karen-haack

    I guess I am a shitty parent…she almost died. She is still sick five years later…damn shitty.

  • bess

    Look, I’m as pro-choice  and sex-positive as they come, and that includes when it comes to vaccinations. Aren’t you pro-choice?  I don’t give a shit what you think about my parenting skills, by the way. 

    It mystifies me that many people who are totally on top of what is going into their kids’ bodies are just fine with all the toxins in vaccines.  No junk food, no food dye, no high fructose corn syrup, but vaccines are fine?  I really don’t get that. 

  • crowepps

    You “really don’t get that” because you’re ignorant of both the science and history.

    My mother had polio in the ’40s when she was a teenager.  She watched many other people die from it, spent a year in the hospital, and was permanently crippled her entire life.  She wept tears of joy when she was able to take my sister and I in for our Salk vaccine and was assured neither one of us would ever die or suffer that horror.

    Polio had been around for centuries, with epidemics sweeping through countries at about 50 years intervals, but it became widespread and more likely to kill in the early 20th century.  It was slaughtering a half million people, mostly children, annually throughout the ’40s and ’50s.  Now some people are falsely claiming there was some connection between those deaths and vaccination, even though the vaccine wasn’t actually developed or distributed until 1959.  To repeat an obvious historical truth, the vaccine was developed IN RESPONSE TO 5 million deaths that had already occurred, and therefore COULD NOT have caused them.

    You might want to thoughtfully consider just why it is that there is a concerted propaganda effort to scare parents so they will refuse to have their children vaccinated, leaving a large pool at risk of epidemic and death just at the time when big companies no longer need masses of first world factory workers.  As I recollect, when the 1% decided to switch their use of Scottish and Irish Highlands from labor intensive farming to pasturage for sheep, they allowed the population who didn’t voluntarily leave to starve to death without distinction, the brilliant and talented along with those they now considered ‘useless’.  Perhaps this time around they’re using a plan that will winnow out the children of those who are ignorant and low intelligence?

  • bess

     There is no history for Gardasil.  It hasn’t been around long enough for that.  Are doctors and Big Pharma infallible?  I don’t think so, and I don’t think my doctor’s word is gospel.  I use my judgment as a parent.  And I read the package inserts. 

    I have had an abnormal PAP with the presence of HPV indicated.  Next year, I followed up, and got a normal PAP.  So as far as anecdotal evidence, there you go.  Again, I’ll stick with regular PAPs and teach my daughters to do the same.  You do what you like with your own kids. 

  • h2ogirl

    I am so sorry this happened to your daughter.  Stories like yours (and there are sadly too many) are why I am not vaccinating my child.  Yes, I am aware she will become a sexual being, and yes, I vaccinated her for everything else, but I cannot in good conscience subject her to this vaccine when it only protects against a handful of strains of HPV and when there are still no long term studies.  Like someone else here said, I am as pro-choice and as sex-positive as they come.  People can call me all the names they want, I don’t care.  Amanda asked why aren’t more girls getting this vaccine, and this is my answer.  

     

  • maiac

    …that polio and HPV are in no way epidemilogically analogous.

    Polio is a frequently deadly and crippling illness which is readily transmitted through casual contact. (This is also true of, for example, measles.) HPV can be deadly or crippling, but the reality is that the majority of those with HPV will develop neither genital warts nor cancer, nor is it readily transmissible through casual contact. While an HPV vaccine may be a smart health choice for some, my choice to vaccinate my hypothetical child or not does not have the same impact on YOUR hypothetical child’s safety as it does with illnesses like polio, measels, diptheria, and other mandatory vaccinating diseases.

     

    Next thing, you’re going to tell me that Rick Perry pushed for mandated HPV vaccines because he cares about women’s sexual and reproductive health!

     

    You know, I actually have a fairly positive view of Gardasil and HPV-vaccinating. But people are NOT crazy to have reservations.

  • maiac

    I am shocked at how the author of this post & other frequent RH Reality posters have flamed folks giving honest answers to explain legitimate medical decisions about the risk-benefit calculations we all make when considering any medical intervention – and about which GOOD, INFORMED people can disagree. Since when is it okay to ignore the entire substance of a person’s post, put words into their mouth to create a position they haven’t stated, and accuse them of mailicious trolling for not whole-heartedly agreeing with you?

     

    By god, none of you has even responded to the simple points that “Bess’ originally made in her points of concern – most of which are TRUE!

    1. Merck has NOT established any efficacy beyond 4 years. (It may well be effective beyond that. It may not. We don’t yet know.)
    2. There has NOT yet been any long-term research on safety or efficacy. (Keep in mind “long-term” safety usually looks at least 10 years out.)
    3. It DOES only work on 4 strains of HPV. (Though, to be fair, two of these four strains of HPV are associated with the majority of cervical cancer vcases and the other 2 strains are the ones most commonly associated with genital warts. )
    4. There ARE some very serious side effects associated with this vaccine. (Though of course ALL medical interventions and/or refusals of medical interventions carry risk and have potential side effects.)

    None of that means “this is dangerous – stay away!”. This vaccine may prove to be overall safe in the population; but we don’t have the data yet. And certainly not the data to support the notion that folks with reservations about this vaccine are kooks.

    The truth is that this vaccine is, like most others, ACTUALLY tested in the population. That’s the dirty reality of vaccine/drug safety we don’t like to talk about. We can conduct all the double-blind, placebo-controlled studies in the world and test vaccine/drug safety for years before market…. But we never REALLY know what’s going to happen when it interacts with the infinite bio-diversity that is the human population. 

    Are the anecdotal experiences shared by these people empirically based evidence that Gardasil is unsafe? No, certainly not. And if I had a daughter, I think I’d probably choose the vaccine for her, given the evidence available. But in the absence of long-term data, it is not insane for a person to be cautious about a new vaccine/drug.

    Shame on you, Amanda Marcotte, for treating those who disagree with you in such a way.