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Old August 27th, 2006, 07:09 PM   #1
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HPV vaccine creates parental challenge


Sun Aug 27, 12:24 PM ET


GRIFFITH, Ind. - What they thought would be a routine physical for her volleyball team found 14-year-old Amanda Zaborowski and her mom facing a big question: Did they want Amanda to get a new vaccine that would protect her against the common and serious sexually transmitted disease HPV, or human papillomavirus?



The vaccine, Amanda's doctor told them, could prevent potentially deadly cervical cancer. He also explained that the three-dose inoculation would work best if she had it well before becoming sexually active.

This was a doctor that her mom, Linda Zaborowski, had trusted since Amanda was a child. She thought the vaccine sounded like a good idea. But she ultimately wanted her daughter to make the decision.
"If you think this is right for me, you know what's best," the high school freshman told her mom and doctor. "I'll do it."

HPV is a weighty topic that more parents are addressing with their daughters, since the Food and Drug Administration recently approved the vaccine for girls as young as age 9. Some parents, particularly those with preteen girls, are wondering just how much information to share.
Do they simply say it's a vaccine against cancer and leave it at that? Or should they also explain that HPV is a sexually transmitted disease that, among other symptoms, causes genital warts?

Linda Zaborowski says it was clear that she needed to give Amanda, her eldest daughter, more information than less.

"When I was young, my mom said, 'Here's a book.' That's how we learned about sex," says Zaborowski, who is a cafeteria bookkeeper and recess aide at her children's schools in Griffith, Ind., a suburban town near Chicago. "But it's not like that now."

She started to realize that when she sat in on Amanda's fourth-grade lesson on reproductive anatomy a few years ago and discovered that some girls were already menstruating.

Government surveys also have found that about 7 percent of children have had sexual intercourse before age 13, while about a quarter have done so by age 15. And while teen pregnancy rates have steadily dropped since the early 1990s, millions of teens and young adults are contracting sexually transmitted diseases HPV among the most common.
Researchers at the federal Centers for Disease Control estimate that more than 6 million Americans many of them teens and young adults get a new infection of HPV each year.

Theresa Rohr-Kirchgraber, an adolescent and internal medicine specialist at the Emory University School of Medicine in Atlanta, says parents need to take those statistics seriously when deciding how to address the HPV vaccine.

"Cervical cancer is real. Sex is real and even though we believe our kid is different and will never have sex until they are married, it is not reality," Rohr-Kirchgraber says.

During medical visits with girls and their parents, she discusses HPV along with routine vaccines for meningitis, as well as the DTaP shot for diphtheria, tetanus and pertussis (also known as whooping cough).
"When you just put it on the list and make it one of the many they need, it becomes less of an obstacle," she says.

Dr. Kenneth Alexander, an associate professor of pediatrics and an infectious diseases expert at the University of Chicago's Comer Children's Hospital, also is a proponent of fully explaining the HPV vaccine to teens.
"Parents only want to talk about cancer prevention. When they talk about STDs, they get pretty uptight," he says. "Teenagers are often more savvy. They're willing to talk about the two issues together."
Alexander has had frank discussions with his own daughters, ages 14 and 17, about the consequences of HPV.

"You can get three doses of the vaccine," he tells them. Or, he says, they might eventually have to deal with a colposcopy close examination of abnormal cells in the cervix that can be caused by HPV and that often require a biopsy. He also explains various treatments for cervical cancer.
"It's your body," he tells his daughters. "The decision is yours." Alexander and others concede, however, that deciding how much to tell preteens is trickier, even for parents who feel like they have good communication with their children.

Karen Hales, mother of an 11-year-old girl in Slidell, La., is one of those.
"She's a pretty aware child and asks a lot of questions," Hales says of discussions she and her daughter, now a seventh-grader, have had about sex. "It's never been that sit-down talk that you dread. It's kind of been natural."

Even so, while she plans to have her daughter vaccinated for HPV in January when the shots will be available at their clinic, she's still wondering how to broach the subject. Most likely, she says, she'll handle the part about cancer prevention. "And our pediatrician will manage the rest with me in room," she says.

Doctors say parents often think their daughters don't need the vaccine because they're not sexually active. While he wholeheartedly encourages abstinence, Alexander reminds parents that the vaccine is a preventive measure that should be given early so even if teens aren't sexually active now, the inoculations guard against future problems.

"It's a little bit like putting money in the college fund. You don't put money in the bank when they're already in college," says Alexander, who also believes the HPV series of shots is "the most important vaccine to come along since the measles vaccine, in terms of the misery it will prevent."
Susan Rosenthal, a pediatric psychologist at the University of Texas Medical Branch at Galveston, says several surveys have found that parents' most frequent concerns are with the seriousness of the illness and whether the vaccine works. "They're much less concerned how the infection is transmitted," she says.

But, Rosenthal believes, parents should still explain how genital HPV is contracted. To that end, she favors the so-called "apprenticeship model," encouraging parents to let teens make increasingly independent decisions about their health as they get older.

"You meet the kid where they are in terms of what information they're ready for," Rosenthal says. Deciding whether to fully explain the HPV vaccine to an 11- or 12-year-old girl, for instance, may depend on whether she is menstruating or showing other signs of puberty.
Rosenthal says a parent might begin by saying, "This is a vaccine for a disease that you can get in your vagina or your cervix. If you get it, it can cause warts and sometimes it can cause cancer."

"If they ask, 'How does it get to your vagina?' then you explain that," Rosenthal adds. "It's a great time to talk about sexuality to demystify the pap smear and talk about reproductive health."

Back in Indiana, Amanda Zaborowski is getting set for the second of three shots this fall and has been telling her friends about HPV and the vaccine.
"Most of them have never heard of it," she says.

She and her mom hope parents and teachers will help them learn more.
"If you inform them," her mom says, "they understand the consequences."
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Old August 28th, 2006, 08:08 AM   #2
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GRIFFITH, Ind. - What they thought would be a routine physical for her volleyball team found 14-year-old Amanda Zaborowski and her mom facing a big question: Did they want Amanda to get a new vaccine that would protect her against the common and serious sexually transmitted disease HPV, or human papillomavirus?
How could there even be a question here? Why wouldn't you have the child vacinated immediately?
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Old August 28th, 2006, 08:21 AM   #3
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How could there even be a question here? Why wouldn't you have the child vacinated immediately?
Right-winger fought the FDA approving it - seems the Christian Fundie base pressured the Bush Admin NOT to approve it, because they felt it would promote sexual activity.

The fear of Cervical Cancer was a major component of the Bush Adminstrations FAILED abstinence only Sex Education approach, and Fundies did not want to lose that.
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Old August 28th, 2006, 08:27 AM   #4
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still think this is a no brainer - the number of females who have this stuff is staggering - if there is a way to eradicate this and cut down on the spread of STDs and even more importantly cancer then you do it, regardless if it makes you feel uncomfortable - parenting isn't always about doing the comfortable easy thing

also it's disgusting to think that fear of STDs is the main thing pushing the abstinence movement and that to remove an STD would encourage sexual activity amongst teens - how many teens do you know who actually feel they are at risk for anything?!
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Old August 28th, 2006, 08:28 AM   #5
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A thread about this from last year - Only the first and fifth pages are good - the rest devolved into abortion/choice fighting and KOC PWI...

http://www.arizonasportsfans.com/vb/...light=cervical
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Old August 28th, 2006, 08:29 AM   #6
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Three quotes from that thread....

This was the response of Leslie Unruh of the National Abstinence Clearinghouse: "I personally object to vaccinating children against a disease that is 100 percent preventable with proper sexual behavior."

The honchos at the Family Research Council said tepidly that they "welcome medical advances," but with a very frayed welcome mat. FRC's Tony Perkins said he would not inoculate his own daughter: "It sends the wrong message. Our concern is that this vaccine will be marketed to a segment of the population that should be getting a message about abstinence."

Meanwhile, Gene Rudd of the Christian Medical and Dental Associations acknowledges the worries of fellow travelers: "I've talked to some who have said, 'This is going to sabotage our abstinence message.' "
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Old August 28th, 2006, 09:28 AM   #7
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Originally Posted by Dback Jon
Three quotes from that thread....

This was the response of Leslie Unruh of the National Abstinence Clearinghouse: "I personally object to vaccinating children against a disease that is 100 percent preventable with proper sexual behavior."

The honchos at the Family Research Council said tepidly that they "welcome medical advances," but with a very frayed welcome mat. FRC's Tony Perkins said he would not inoculate his own daughter: "It sends the wrong message. Our concern is that this vaccine will be marketed to a segment of the population that should be getting a message about abstinence."

Meanwhile, Gene Rudd of the Christian Medical and Dental Associations acknowledges the worries of fellow travelers: "I've talked to some who have said, 'This is going to sabotage our abstinence message.' "
I don't know why it is so hard for adults to understand that kids are going to have sex no matter what they do. How hypocritical can you be in thinking today's kids aren't going to do the same things you did as a kid? The most powerful human force is the urge to procreate and with the advent of the net, kids are more informed than we ever were and more aware of the consequences. Try to keep them as safe as you can and hope they choose the right partners.
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Old August 28th, 2006, 09:33 AM   #8
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Old August 28th, 2006, 09:41 AM   #9
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Quote:
Originally Posted by 40yearfan
I don't know why it is so hard for adults to understand that kids are going to have sex no matter what they do. How hypocritical can you be in thinking today's kids aren't going to do the same things you did as a kid? The most powerful human force is the urge to procreate and with the advent of the net, kids are more informed than we ever were and more aware of the consequences. Try to keep them as safe as you can and hope they choose the right partners.
Well said.

Do you now understand why some of us have great concerns about the company the Bush Admin keeps/listens to?
An issue that should be a no-brainer becomes a political football, just like every other environmental/public health issue. As rabid a Bush supporter as you are, hopefully you can see the position that some of us are in, and why we mistrust his Administration so much - this is a glaring example of what has been occuring regularly since he took office, where sound science has taken a back seat to politics, religious influence and corporate donations.
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Old August 28th, 2006, 09:55 AM   #10
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Originally Posted by me, in the thread jon linked to
maybe i missed it somewhere in this thread, but does it say when the vaccination has to take place? can't it be given when the kids are young, like with their year old shots? that way they get it and are none the wiser as to its purpose, then everyone wins.
i still don't see why this would be a problem.
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Old August 28th, 2006, 10:01 AM   #11
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i still don't see why this would be a problem.
The vaccine has only been approved for women/girls 9 and older.
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Old August 28th, 2006, 10:04 AM   #12
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Do you now understand why some of us have great concerns about the company the Bush Admin keeps/listens to?
The problem Jon is that you immediately jump to the conclusion that these people are on the leading edge of policy for the whole Republican party. Nothing could be further from reality. They are a fringe group that seeks (and the media is more than happy to provide) publicity at every available opportunity. They are loud but that certainly does not translate to powerful.

99.9% of all Republicans with daughters will have them vaccinated. We amy not be in agreement with political standpoints but I can assure you, Dems and Pubs are in lockstep when it comes to the well being of our children.
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Old August 28th, 2006, 10:11 AM   #13
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The vaccine has only been approved for women/girls 9 and older.
9 years still seems like a good compromise. kids don't ask why they're getting vaccinated. you just know you have to do it because the school asks.

my bet, a 9 year old with parents who would think the vaccine might promote premarital sex doesn't even know what sex is yet.

/was that 9 year old
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Old August 28th, 2006, 10:17 AM   #14
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The problem Jon is that you immediately jump to the conclusion that these people are on the leading edge of policy for the whole Republican party. Nothing could be further from reality. They are a fringe group that seeks (and the media is more than happy to provide) publicity at every available opportunity. They are loud but that certainly does not translate to powerful.

99.9% of all Republicans with daughters will have them vaccinated. We amy not be in agreement with political standpoints but I can assure you, Dems and Pubs are in lockstep when it comes to the well being of our children.
You are downplaying the importance of these people - OPEN YOUR EYES.

Why did it take so long for the FDA to approve? Because of these people? Why are reports on the environment, evolution, etc changed? Because of these people. You may want to delude yourself into thinking that these people have NO influence in the Bush Admin, but you are dead wrong - they have a LOT of influence.
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Old August 28th, 2006, 10:20 AM   #15
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This is all very promising and interesting (especially since I have a daughter who is 8 years old), but I'm wondering what the other shoe is, you know? I mean, one day milk is safe, then the next day it causes cancer of the eye or something absurd. One day, eggs raise cholesterol, the next day, they lower it. What is the backside of this HPV vaccine?
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