Health roundup The new HPV vaccine, available to women 9 to 26 years old, promises to reduce cervical cancer by as much as 70 percent. But there are a lot of unknowns. Is it worth the risk?
They're saying it can prevent cancer, and if that were all you needed to know, you'd support it. But since this vaccine is available to girls as young as 9 and protects against a sexually transmitted disease that can lead to cervical cancer, it's just not that simple.
On June 8, the Food and Drug Administration approved Gardasil, the first vaccine developed to prevent cervical cancer, precancerous genital lesions and genital warts caused by four types of human papilloma virus, or HPV.
"Data shows the vaccine is more effective when introduced before sexual activity begins, that is, in kids," says Dr. Ken Alexander, associate professor of pediatrics at the University of Chicago and the father of two daughters, ages 14 and 17.
Still, groups including the Family Research Council, a Washington D.C.-based Christian rights association, think the act of introducing the vaccine to children is tantamount to condoning sexual activity among teenagers.
The council's official statement on the vaccine is: "Our primary concern is with the message that would be delivered to 9- to 12-year-olds with the administration of the vaccines. ... We strongly encourage the health care community to clearly communicate the medically accurate fact that only abstaining from sexual contact with infected individuals can fully protect someone from the wide range of sexually transmitted diseases."
"We're protecting against a future risk," says Dr. Stacie Geller, chair of the Illinois Department of Public Health's Cervical Cancer Elimination Task Force and associate professor of obstetrics and gynecology at the University of Illinois, Chicago. People need to think of the vaccine not in terms of preventing an STD, but in terms of preventing cervical cancer, which ranks second to breast cancer in cancer deaths among women.
"It's better to immunize early." Same virus, different result
HPV, commonly transmitted through sexual contact, can cause cervical cancer. The three-dose vaccine, developed by Merck & Co., was approved for ages 9 to 26. On June 29, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices voted unanimously to recommend all girls and women between 11 and 26 receive the vaccine and girls 9 and 10 receive it if recommended by their doctor.
HPV is in the family of viruses that includes common warts. Overall, there are more than 100 types of HPV, about 30 of which are sexually transmitted. Only two (HPV16 and HPV18) are high-risk and can lead to more serious infections, abnormal cell growth on the cervix and cancer.
"This vaccine should be given to every girl or woman who is sexually active or ever will be," says Alexander. "It has the potential to reduce cervical cancer by about 70 percent."
Is it safe? There are concerns, however. Study trials show the vaccine is effective for about five years.
"I understand it's preventive, but I don't know if I'd be open to vaccinating her yet," says Trina Allen of her 11-year-old daughter, Simone. "If I knew for sure it was totally safe and would definitely protect her, I'd get it no matter what," adds the Chicago mom.
Barbara Alexander Mullarkey, president of the Illinois Vaccine Awareness Coalition, says a lack of published safety studies and some adverse reactions in study participants should be of concern.
Mullarkey sees other red flags. "We always suggest people talk to their doctors and ask for the package insert [that comes with the vaccine] beforehand and then decide for themselves what they want to do."
"Parents have the responsibility-the obligation-to find out about this," she says.
Maayan S. Heller
Auto-injector safety Lake Forest resident Denise Bunning, mother of two and creator of The Food Allergy Project Inc., deals with the dangers of allergies everyday.
Her 12-year-old son Bryan has life-threatening allergies to egg and tree nuts. "I was overwhelmed," says Bunning. "I felt like I was hit by a lightning bolt."
Bryan has suffered four severe allergic reactions since he was a baby. Bunning has relied on using auto-injectors of the drug epinephrine.
"If it's given appropriately," says Dr. Jennifer Kim, pediatric allergist at Children's Memorial Hospital, epinephrine is "a life-saving medication."
This summer, the Illinois Poison Center advises parents and children to be careful using epinephrine auto-injectors. The emergency treatment is injected in the thigh and delivers a dose of the drug, temporarily reversing allergic reactions by constricting blood vessels, relaxing muscles and reversing swelling. Epinephrine is a short-lived medication.
The problem comes if epinephrine is accidentally injected in the wrong place, it can kill healthy tissue.
"Up to one-third of patients with food allergies require a second dose," says Kim.
But it doesn't mean people who need the drug should not use it--just be cautious.
Children with severe allergic reactions should always carry an auto-injector kit. Since each auto-injector contains only one dose of epinephrine, two should be kept on hand at all times.
A pediatrician may recommend your child wear a medical-alert ID bracelet, which alerts healthcare providers in an emergency.
According to The Food Allergy and Anaphylaxis Network, about 3 out of 10,000 people in the United States suffer from severe allergic reactions. The most extreme cases-anaphylaxis-a sudden, violent allergic reaction in various areas of the body, can be fatal.
Bunning, who also co-founded Mothers of Children Having Allergies, a support group for families of children with severe food allergies, advises parents to know what triggers their children's allergies.
Be on the lookout for symptoms of a child's allergic reaction and be sure immediate treatment is available.
"The point is to have it with them at all times," says Kim. "You never know when a serious reaction will occur."
For more information on epinephrine auto-injectors visit www.mchc.org/ipc/ or call (800) 222-1222.