HPV Immunization Rates Low Due to Controversy

Vaccinations against the human papillomavirus (HPV), which are highly recommended for both pre-teen girls and boys, have been proven to help prevent cervical cancer and genital warts. Yet, according to a 2012 study conducted by the Centers for Disease Control and Prevention (C.D.C.), only 53.8% of girls aged 13-17 and only 20.8% of boys aged 13-17 have received at least one dose of the vaccination. The vaccine, which is administered in three doses over a course of about seven months, is recommended to be completed by age 13.

HPV is the most common sexually transmitted infection (STI). Almost all sexually active women and men contract the infection at least once in their life. While many strains of the virus can usually be cleared by the body’s immune system, those that are not can manifest into cancer. The C.D.C. reports that HPV can cause “cervical cancer and other cancers including cancer of the vulva, vagina, penis, or anus. It can also cause cancer in the back of the throat, including the base of the tongue and tonsils.” Oftentimes, a person with HPV does not show symptoms until years after an infection. Shannon Stokely, an epidemiologist with the C.D.C., told NPR, “We don’t know who is going to develop cancer or who will clear infection, which is why it’s so critical to protect adolescents with the vaccine long before they’re ever exposed to the virus.”

Currently, there are two types of HPV vaccinations offered: Gardasil and Cervarix. Gardasil, which was FDA approved in 2006, protects against four HPV types and genital warts, whereas Cervarix, which was FDA approved in 2009, protects against two HPV types.

A vial of the Gardasil vaccination photo courtesy of Wikimedia Commons

A vial of the Gardasil vaccination
photo courtesy of Wikimedia Commons

So, if HPV vaccinations are widely available in America, why are so few people actually receiving it?

One reason is that the vaccination has received opposition from many concerned parents. In a 2012 National Immunization Survey, 23% of parents surveyed responded that they did not intend to immunize their daughter in the next year. The top five reasons were that parents believed the vaccine was unnecessary, their healthcare provider did not recommend it, concern over safety, lack of awareness and lastly because their daughter was not sexually active. Many parents also worry that the vaccination will give teens a false sense of security and will thus encourage riskier sexual behavior.

The stigma around HPV being a sexually transmitted infection discourages many from realizing the benefits of getting vaccinated. Parents shudder at the thought of their child (particularly their daughters) having sex, even though the point of receiving the vaccine at such a young age is to protect a person before they are ever exposed to the virus. At the same time, the possibility that sex occurs without consent remains the elephant in the room. As stated earlier, HPV is the most common STI, which unfortunately means that anybody can transmit the virus to anyone they have sexual contact with, consent or no consent. It is crucial to focus on how the HPV vaccination can prevent diseases, rather than shaming women for their sexual behaviors.

Much of the so-called controversy surrounding the HPV vaccination has been in part caused by biased and anecdotal media coverage. Award-winning journalist Katie Couric hosted an episode on her daytime talk show, Katie, devoted to addressing the HPV controversy. However, the guests on the episode, which included mothers who believed their daughters had been harmed by the vaccination, only served to increase the divide between those that support the vaccine and those that are completely against it. The episode received so much criticism that Couric published a mea culpa on the Huffington Post to clarify that the episode “simply spent too much time on the serious adverse events that have been reported in very rare cases following the vaccine. More emphasis should have been given to the safety and efficacy of the HPV vaccines.”

As for safety concerns over the vaccination, the most common issues have been cases of fainting, dizziness, headache, fever, soreness and pain near the injection site, but there have been none that pose a significant health hazard. Two deaths were reported after the vaccination, but the Institute of Medicine, an independent, non-profit organization, did not find any evidence linking the cause of these deaths to the vaccination. The C.D.C. also investigated other reports of death but could not find any evidence that could conclude that the vaccine was the cause.

In the past, another deterrent could have been attributed to the vaccination’s price; a single dose costs roughly between $100-$140 and a few insurance companies didn’t offer coverage. With the Affordable Care Act, insurance companies are now required to cover the HPV vaccination. Additionally, the Vaccines for Children program run by the C.D.C. offers the vaccination at no cost for those who are eligible.

In order to increase immunization rates across the country, there has been a push for legislation that would require the HPV vaccination for attendance at school. Currently, Washington D.C. is the only state to have passed a law that requires girls to receive the vaccination before they are 13, although parents may choose to exempt their child. However, according to the National Conference of State Legislatures, “At least 42 states and territories have introduced legislation to: require the vaccine, fund or educate the public or school children about the HPV vaccine.”

Although it’s natural to react strongly to the horror stories being circulated, it’s important to understand that scientific research has proven the vaccine to be helpful, not hurtful. Studies have shown that infection rates have dropped significantly since the introduction of the HPV vaccine—the only problem is that not enough people are getting vaccinated. Women, men, girls and boys, regardless of current sexual behavior, need to fully understand the risks of HPV and the benefits of becoming vaccinated in order to protect their health.

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