In a previous Pediatric Points column I wrote a few years ago, I made
the case for offering the (then new) HPV Vaccine against Human Papilloma Virus
(HPV) to girls. HPV is the most common sexually transmitted infection. Within two years of first having sex,
nearly 40% of young women are infected with one or more types of these viruses.
Younger women are more susceptible to infection with HPV for several reasons
including a lack of adequate cervical mucus production and incomplete immune
systems. The good news is that they will very often clear these viruses on
their own. But for those young women in whom infection persists, the risks of
eventually developing cervical cancer increases.
Cervical cancer is the second leading cause of cancer deaths among women
worldwide. Over 1/4 of a million women die from this disease each year. 70% of
all cases of these cancers are caused by two especially high risk types of HPV
numbered 16 and 18. Gardasil is the name
of the shot that protects against these two HPV types as well as against types
6 and 11 which are responsible for 90% of genital warts. These kinds of warts
affect both men and women.
The Food and Drug Administration approved HPV vaccine for boys in 2009.
The Advisory Committee on Immunization Practices voted in October 2011 to
recommend the routine vaccination of boys between the ages of 11 and 21.
Although women are affected
in larger numbers by HPV-related cancer (approximately 15,000 HPV 16- and
18-associated cancers each year) men are also affected by this
sexually-transmitted virus. Approximately 7,000 cases of HPV-associated
cancers, including anal, penile and oropharyngeal, occur each year in men. The
HPV vaccine has been found to be very effective in males. In studies of men not
previously infected who received all three shots, efficacy for prevention of
HPV-related genital warts approached 90%.
HPV vaccine for girls, in my opinion, is essentially a vaccine against
cancer and I recommend it whole-heartedly to my patients. If I had girls of my
own, I would vaccinate them in a heartbeat. But currently fewer than 50% of
girls have completed the three-dose series. Many pediatricians I have spoken to
are reluctant to tackle this new recommendation for boys when we haven’t yet
been successful with the population many of us feel would benefit enormously
from vaccination. Some of us are skeptical that the vaccine for boys is truly cost-effective.
Some also point to the Australian experience where mandatory vaccination of
girls led to a decrease in genital warts in both men and women, suggesting successful
Also, we pediatricians are spending increasingly more of our time
defending proven, effective, life-saving vaccines to nay-sayers, reluctant
parents, and media pressure. To quote Dr. Stacey Humphries from a recent issue
of Consultant for Pediatricians, “To add controversial vaccination of boys to the mix with limited data available
may only further taint vaccine acceptance.” So for now, while Dr. Moran and I
will certainly give the HPV vaccine to any boy whose family requests it, for
now, we’re now going to be pushing this one.
"Jesus told his followers they needed to be wise as serpents and harmless as doves, but most churches are not wise about the mentality and tactics of evildoers, nor are they aware of how evildoers masquerade as believers in the church. The abuser typically has a Dr Jekyll persona that depicts him (or occasionally her) as a wonderful and godly man, so that no-one would suspect the truth … If the victim reports the abuse to church leaders, the abuser is skilled at shifting blame, evading accountability, and pretending repentance and reformation. The vast majority of church leaders aren't discerning enough to detect these tactics of abusers for what they are: lies [and] often advise the victim to remain with or return to the abuser."
Caron, et. al. (2008) conducted a cross sectional study among college women, the study reveals that cervical cancer is primarily caused by the human papillomavirus (HPV) and is the second most common cause of cancer-related mortality among women. Purpose: College women may be at risk for contracting HPV based on their sexual behavior. An exploratory analysis was conducted, following the release of the HPV vaccine, Gardasil[R], the am of the study is to (1) determine awareness of HPV and Gardasil[R], (2) assess attitudes, behaviors, and beliefs about the HPV vaccine, (3) identify information sources that college women are accessing. Methods: A cross-sectional study of college women (n=293) enrolled in a Northeastern university voluntarily completed a self-administered questionnaire regarding knowledge, attitudes, behaviors, and beliefs about correlations, and paired sample t-tests. Results: Sexually active respondents would recommend the HPV vaccine to others and disagree that HPV vaccination would encourage risky sexual behavior. Yet, "need more information" is the predominant reason respondents would not get the HPV vaccine if it were offered for free. Discussion: Correlations are identified on how self-reported knowledge influenced attitudes, behaviors, and beliefs regarding the HPV vaccine. These findings should assist health educators in developing integrated public health education efforts for HPV vaccination that are targeted towards this at-risk population.