Ask RESTONMOM - 3/13/08

Dear Restonmom,
"As a mom of an almost-12-year-old daughter, I've been really bothered by the TV commercials for Gardasil (the vaccine being promoted for young girls to guard against Human Papillomavirus). Several states currently have bills trying to make this a mandatory vaccine for girls entering 6th grade (with, in most, if not all cases a parental opt-out). I know you often address medical issues, and specifically vaccine related ones. I've been doing some research on it myself and was wondering if you had looked into this at all or had any thoughts on the topic." Jessi

Dear Jessi,
This is a great question and one that could be addressed from many angles.  For my readers who don't know, Gardasil is a vaccine recommended to girls from 9-26 years of age for the prevention of HPV, a disease which is transmitted sexually, and which may cause cervical cancer or other cancers. It is the most common STD, over 50% of all sexually active people acquire HPV at some point in their lives. The really great thing about this vaccine is that it is a huge medical breakthrough in preventative medicine against cancer - and that is amazing and worth celebrating.  The debatable issue is safety - as for now, it appears safe and lacks any evidence which really critically holds up against that.  However, being very new, there is much more research that needs to be done. The downside to this vaccination is that the disease it addresses is totally preventable with abstinence or in the context of a faithful marriage, and perhaps that is the issue upon which more attention and education should be applied.  As far as making the vaccine mandatory within schools, this may seem a new issue because of the targeted age....however, it is really quite in line with the already implemented practices of having elementary school children required to be vaccinated against certain infectious diseases such as measles.  The general idea is that by implementing mass vaccinations some diseases can eventually be completely eradicated or made to be extremely rare throughout large populations.  There are so many things we could talk about surrounding this topic, but I'll simply leave you all with a final story: I went to high school with a young woman who later fell in love and got married with the hopes of starting a family.  Sadly, she experienced a rape and she was infected by HPV. Due to the cancer, her chance of ever having children was lost.  Her cancer is terminal, and right now she is dying.  She is just 30 years old.

Dear Readers,  please feel free to comment with your own thoughts or feelings.

Comments

[Kitty]

One quick medical note: even if a girl remains abstinent and then later marries someone and has a faithful marriage, her husband can still pass on HPV to her if he carries this asymptomatically from previous sexual encounters that occurred before the marriage, even if they are both faithful after the wedding day.
I'm so sorry to hear about your HS friend, that is truly tragic.

[B]

One hopes that your children make the right decisions and the choices that you have encouraged them to make regarding sex. But, you cannot control everything in your child's future and guaranteed they will not have sex before they get married. You also cannot control whether they will marry someone that has done the same. I understand there may need to be more research regarding the side effects of the vaccine but in general I think it is a good thing. I have HPV without any symptoms but have already had one surgery to removed pre-cancerous cells. My parent taught me to wait until marriage but as a young adult I chose otherwise. I don't wish cancer causing HPV on anyone and if I have a daughter there is no doubt she will be vaccinated.

[Kirsten]

While this vaccine may be a big breakthrough, I find issue with it being made mandatory. Here in Texas a few years ago they tried to make it mandatory for girls as young as first grade. I have had several people in my life contract HPV, and it's not something I would wish on anyone. But I also have a problem with the government requiring all parents to vaccinate their girls. I think that this should be a parent's choice. Whether or not parents decide to vaccinate their daughters, I hope that they should make the risks and consequences of sex a point of discussion. The "one less" commercials for Gardisil especially disturb me--the girls of varying ages saying they'll be one less because of the vaccine. It's great if the vaccine can prevent HPV, but I think that the campaigning and the government mandates sort of presume to depend on a vaccine rather than teaching responsibility, when BOTH are necessary. Obviously, as in Tricia's friend's story, it's not just about being responsible, but I do feel like the advertising and mandating present only half the solution.

[Jessi]

Thanks for addressing this Tricia. It's been very helpful to me to hear about other people's stories and experiences. I, like Kirsten, have been particularly disturbed by the commercials and the way the vaccine has been promoted. I am MOST disturbed by the push to make it mandatory - especially for girls so young. I understand the value of the medical breakthrough, and for that I am thankful that many women will be spared much suffering. However, I think it should be a decision to be made once someone decides to become sexually active. It should be a responsibility that accompanies the responsibility of sexual activity, and I believe we should put much more emphasis on the aspect that sexual activity is for RESPONSIBLE adults, and make young people VERY aware of the dangers of sexual promiscuity.

I would love to see much more emphasis placed on an abstinence campaign, but I understand that is rooted in my own personal beliefs and moral standards, which others have the freedom to NOT agree with, and that kids often make the decision not to wait, even if abstinence is taught (as B pointed out above). However, I feel it would still be valid and valuable to teach it, rather than give up on it totally; I believe it is vital information that should be presented as an option - part of the (hopefully INFORMED) choice that young people will make.

[Kate]

This may be too late - I was away for the weekend - but just in case anyone is still reading...

I too find the idea of mandatory "new" drugs a bit concerning. But that's more linked to fear of the unknown than offense at the idea that I am not able to encourage responsible behavior in my children (or even at the young age being recommended for girls' vaccination).

I remember seeing an episode of ER a long time ago in which a mother refused to allow her daughter to receive a prescription for accutane since she would be legally required to take birth control pills as well (bad bad bad birth defects linked to accutane). Obviously the problem was that the mother linked sexual activity to the pill regardless of the fact that her daughter claimed to have no intention of becoming sexually active. Should the birth control pill’s use with accutane not be mandatory, but instead based on whether the patient claims to be sexually active or not? Hmmmm. This little piece of (oh-so-realistic) fiction really illustrates the issue of parents trying to control their children’s decisions regarding sex and relationships. Whether it's mistrust in our children's ability to make the right decisions or well intentioned advice within the context of respect and trust, we all want to have input. And why wouldn't we? We were all teenagers once and we know it's not all church picnics and ice cream socials.

This is something that I have given a lot of thought to lately since I now have a daughter. I wasn't the most rebellious teenager, but my lack of sexual activity wasn't at all based on convictions regarding abstinence. Even though I didn't personally feel ready, I didn't see anything unusual about my peers’ choices to have sex with their boyfriends (see from what I remember - you're not a slut if you are doing it with your boyfriend). I think we all remember how much we were influenced by our social environment as teenagers, and our parents really couldn't compete with that (I mean - they were living in Leave it to Beaver land when they were 16). So why would our kids view us any differently?

We thought the "Let's Get Physical" video was pretty racy in the 80's - and remember how shocking the lyrics of Prince's "Darling Nikki" and ANY 2 Live Crew song were? All of that is pretty tame in comparison to today's standards. I would assume that sexual activity in high school (and middle school) would follow suit. I thought that my friends having sex with their boyfriends at age 15 was perfectly normal (cause you know - they were "in love"). So what is normal now? I know lots of teachers, and the stories that they tell are pretty shocking. I just started writing a list - but it all just looks too unbelievable in print (as the modern day June Cleaver - I just can't believe that girls would have such low self esteem). Let me know if you want to hear details (this comment is already ridiculously long). But we have to have wide open eyes when it comes to our kids. Their safety comes first – and the other comments bring up too many important safety issues to get mired down in principle. If all girls are vaccinated and a lethal STD isn’t passed around, I would have to lean toward the better safe than sorry approach. I’ll do the best I can to talk to my daughter about sex, love, abstinence, pride and self worth – but in the meantime, I see nothing wrong with doing everything we can to create a safer environment for the decisions she does ultimately make.