Give daughters a shot at avoiding cervical cancer

March 13, 2007|By Susan Reimer | Susan Reimer,Sun Columnist

It is hard for me to believe that medical science has given us the great gift of a vaccination against cancer and we are arguing about whether our daughters should receive it.

But that is exactly what is happening with Gardasil, found to protect against the human papillomavirus that is responsible for 70 percent of all cervical cancers.

HPV is a sexually transmitted disease that also may cause genital warts. A woman's immune system can often defeat it in a couple of weeks, but the virus can also insinuate itself into cervical cells where it can cause malignancy years later.

I hate to bore you with numbers, but here are a few from the Centers for Disease Control and Prevention that matter.

Nearly half of all American women ages 20 to 24 have HPV. There are two strains of that virus which cause cervical cancer in older women. About 7,500 will contract that cancer this year, and 40 percent of them will die.

And the number of cancers and deaths should only increase as those infected 20- to 24-year-olds age.

A series of three shots over eight months -- costing about $360 if you don't have insurance -- has been shown to protect against those HPV strains.

And we are arguing about whether this vaccine is a good idea.

After a number of states acted immediately to require the vaccination of girls about 11 or 12 years old, before they are likely to be sexually active, a backlash set in causing a number of states, including Maryland, to back down.

There is some legitimate worry because the long-terms effects of the vaccine are not known, but I am not sure what long-term effect trumps cancer.

The underlying dynamic here is clear. Conservative parents got to their government leaders because they believe that such a vaccine will encourage their daughters to be sexually active.

These are the same parents, church and civic leaders who think access to birth control causes sex.

Any parent who believes their teenage daughters will consider the possibility of cancer at age 40 when they are deciding how far to go with their boyfriend in the darkened family room is absolutely kidding himself.

"Two things are at work here," said Sarah Brown, director of the National Campaign to Prevent Teen Pregnancy.

"How do we feel about our children being required to receive a vaccine without a lot of long-term data on its effects? I understand that. That is something to think about very seriously.

"But the idea that a vaccine is going to change a young woman's calculus about whether to have sex or not strikes me as intensely unreasonable," said Brown, who studies the sexual decision-making of young people.

"The connection is so tenuous that I don't think it merits serious discussion. The reasons that young people do and don't have sex have zero to do with the perceived risk of cervical cancer at the age of 40."

Brown's colleague at the organization makes another point.

Deputy Director Bill Albert wonders whether parents are hoping that such a vaccine gives them an easy way out of the difficult responsibility of guiding their children's sexual development.

He asks whether such a vaccine, administered to 12-year-olds, would relieve parents of the awkward and intense discussions they should be having with their children about what sexual behavior is appropriate and at what age.

"I can only wonder how many parents are waiting for a vaccination against casual sex or one that provides young people with a soup-to-nuts sex education," Albert said.

If there is a reason to go slow on the HPV vaccine, this might be it: not that such a vaccine would give our children permission to have sex, but that it would give parents permission to put their feet up on the coffee table.

It is a good point, but it is beside the point. We have a vaccine that can prevent a cancer that results from sexual activity. That is like having a vaccine that prevents fatal car accidents involving teenage drivers.

What parent would deny their child that kind of protection?

Instead of fussing about whether to inoculate our daughters, we should be upset that there is nothing for our sons.

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