By Syrila Bossert, RN, WHNP-BC
Women’s Clinic of JCMG
I’ve always liked the idea of prevention, especially in health care, so vaccines always made sense to me. Before having children, it never crossed my mind that my children would not be vaccinated. My first child was vaccinated without second thought, and I intended this to be the case with any other child I would have. However, around the time that my second child was delivered in late August 1998, there was much discussion among us moms about whether to vaccinate our children. The debate in the medical community started in February 1998 when a research paper was published linking the measles mumps and rubella vaccine and autism. Without having full knowledge of the research paper, we moms concluded that all vaccines were implicated as responsible for autism.
Syrila Bossert, RN, WHNP-BC
My second child was different than my first. He had projectile vomiting and cried 23 out of 24 hours (a slight exaggeration), and after that research came out, I was apprehensive about adding anything to the mix that would compromise his development or health. After having him examined by the pediatrician and discussing vaccines, I was reassured that this was a small study and that vaccines were still being recommended. I then squeamishly gave consent for my child to be vaccinated.
Fast forward to my three, healthy elementary school-aged children who all had vaccines without any problems. I survived those vaccine fears to be faced with new ones. While living in the state of Texas in February 2007, Governor Rick Perry signed an executive order that human papillomavirus (HPV) vaccine be given to middle school girls. My oldest child, a girl, was going into middle school in two years. At that time, there was little public knowledge regarding the role of HPV and cancers. Since Gardasil, the first vaccine against HPV, was approved only a year prior in 2006, there was little public knowledge about the vaccine.
This mandate prompted a great deal of controversy and debate. To some, it appeared that getting the vaccine insinuated that their middle school girl was sexually active, or worse, promiscuous. A group of Texas families quickly sued to stop the executive order. The order was overturned by the legislature May 2007 and did not go into effect. It was speculated that Perry’s mandate was motivated by a political and financial connection to the pharmaceutical company that produced the vaccine. What an unfortunate way to introduce a vaccine that offers protection against cancer!
HPV can cause cancer and/or genital warts in both men and women. Genital warts are not life-threatening but can cause anxiety and discomfort when treated. Cervical cancer is one form of cancer caused by HPV. Cervical cancer can be screened for by pap smear and HPV test, but there is no test for the other cancers caused by HPV. According to the Center for Disease Control (CDC), about one in four people in the United States are currently infected with HPV. HPV is a virus passed from one person to another during skin-to-skin sexual contact, including vaginal, oral and anal sex. HPV is most common in people in their late teens and early 20s. Almost all sexually active people will get HPV at some time in their lives, most will never even know it. Most of the time, the body naturally fights off HPV before it causes any health problems. But in some cases, the body does not fight off HPV.
Condom use with every sexual act or encounter can offer some protection against HPV. The HPV vaccine recommendations are based on age and not on sexual experience.
When deciding to receive this vaccine or forego what is medically recommended, start by arming yourself with knowledge. Foremost, the HPV vaccine does not protect against every cancer-causing strand but against the ones that are more likely to cause cancer. It is recommended that the vaccine be administered prior to any sexual contact. The vaccine has been approved for females and males 9 to 26 years old; CDC recommends vaccination between ages 11 to 12 years old. Individuals under 15 get two doses and those 15 to 26 get a series of three doses.
You can still receive the vaccine if you are sexually active or have already had HPV. Some gynecologists suggest the vaccine to patients more than 26 years old depending on their exposure risk. Your health care provider should be the primary source for helping you decide. They are up-to-date on current research and can point you to reputable resources.
As far as safety, millions have received the vaccine during the 12 years it has been approved. CDC considers the vaccine to be “extremely safe.” HPV vaccination has been studied very carefully and continues to be monitored by CDC and the Food and Drug Administration. Minor side effects include pain at the injection site, fever and fainting. No serious safety concerns have been linked to HPV vaccination. It is your choice whether to receive the vaccine or not, and you can make it an educated choice.
So, what about my children? Our girl was in her late teens and had not received the vaccine in Texas. I had some confidence in that we, her parents, had had multiple discussions regarding sex during pre-teen and teen years, and that we valued abstinence, mostly for spiritual reasons, but for STD prevention, as well. This was her opinion also.
So, it’s crunch time again. I had been biding my time (aka squeamish). She is a senior in high school and about to go off to college. The world away from your parents’ house is a different world and your choices are most definitely your own. We discussed the pros and cons of receiving the vaccine. She didn’t think twice about getting the vaccine and at no time did she think I was questioning her moral compass. She completed the series. Our conversations with our boys were close to what we had with our girl, and their opinions strongly reflected hers. Therefore, around the same time in their lives we had the conversation regarding HPV vaccine. They also thought the vaccine was a no-brainer.
Just as I did after my first personal fear of vaccines, I took some time to research and mull over the facts when considering the HPV vaccine. In the end, the evidence was clear. I concluded that HPV vaccine is safe, and that the rewards of vaccine outweigh the consequences of disease.
Syrila Bossert is a registered nurse and women’s health care nurse practitioner at JCMG Women’s and Children’s Center, located a 1241 W. Stadium Blvd. in Jefferson City. To make an appointment or to find out more information, call 573-636-5248.
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