Wednesday, June 28, 2006
Vaccine holds promise, not promiscuity
Luanne Traud
Recent columns
- Marking a difficult anniversary
- My daughter, the voter
- A few new Voices would be nice
- A rush to legislate
From the RoundTable blog
My siblings and I were probably over-inoculated for polio. We had the shots, then stood in line at a fire hall three Sundays in a row to pluck vaccine-laced sugar cubes from a Dixie cup. My parents feared the disease that had crippled my father's beloved Aunt Mary; they would take no risk with their children.
After suffering through childhood bouts of various strains of measles, a new vaccination -- one that could be delivered by a "gun" -- for German measles made its way to our elementary school.
As the big shot sixth-graders, my class was the first to face the firing squad stationed in the nurse's office. Every child from large to small stepped through her doorway that day, pulled up his or her sleeve to expose skinny or plump arms. All were shot. One of my classmates passed out. It was a small price, we were told, to protect ourselves and to keep from spreading the disease to other people, especially mothers who were expecting. On being further told that if we gave them German measles we could hurt their babies, we figured out what they were expecting.
OK, so we were a bit naïve. Perhaps those times were too, because I doubt there was much debate over mass inoculation of schoolchildren and whether it was necessary.
The arrival of new vaccines had dramatically changed our childhoods from those of our parents and grandparents. Hope remained strong for even more breakthroughs.
I recall in my teens watching a television program in which Dr. Jonas Salk, the creator of the polio vaccine, was interviewed. He said that one day there would be a vaccine to protect against cancer.
That day has arrived. Not for the universal cancer as we understood it several decades ago, but for a specific type of cancer that is caused by several strains of the human papillomavirus, commonly referred to as HPV.
We should marvel at the stunning work that has gone into painstakingly indentifying the underlying cause of a particular cancer and celebrate the implications of a vaccine, an actual vaccine, that can attack a cancer-causing virus before it attacks its human host. We should turn cartwheels over the chance to save 240,000 women worldwide from needlessly dying from cervical cancer.
Instead, the Federal Food and Drug Administration's approval earlier this month of the first cancer vaccine is mired in controversy that might limit its widespread and routine use.
Some of the debate could spill over this week when the Centers for Disease Control's advisory Committee on Immunization Practices decides whether to recommend the routine use of the new vaccine.
The controversy isn't over its safety. The vaccine, Gardasil, developed by Merck & Co. and tested on 11,000 women, can carry the side effect of soreness at the site of injection, a fairly common complaint from inoculations. And it is quite possible that in the future some unforeseeable consequence may develop, such as the deterioration of its effectiveness, but the risk is no more so than with any new vaccine.
The controversy arises out of the type of cancer it aims to prevent. HPV is the most common sexually transmitted disease, infecting 6.2 million additional Americans each year. Most have no idea they have it, nor will they experience symptoms.
But in some women the virus causes changes in the cervix that, if left untreated, lead to cancer. Some 9,700 American women are diagnosed each year with cervical cancer; 3,700 women die. Worldwide, the disease is far worse -- the second most common cancer in women -- especially in developing countries that lack the capability or facilities to administer annual Pap smears and treat early signs.
Gardasil is effective against four cancer-causing HPV strains. For it to work, it must be given in three doses to girls after they turn 9 years old but before they become sexually active.
There is a misguided concern that by giving the vaccine to girls it will somehow give them the idea that it is OK to engage in sex, and that it will counter the message that parents wish to promote with their daughters: sexual abstinence until marriage and sexual faithfulness thereafter.
The thought is that virginity and monogamy offer complete protection. And it would if no one deviated from that plan. In the real world, people mess up.
Parents who worry that this vaccination extends permission for their daughters to act promiscuously should ask themselves: If a vaccine to prevent lung cancer were developed, would I hesitate to protect my child because she would think it's OK to smoke?
Wouldn't I consider that she might not ever smoke but still be exposed to the carcinogens through other's actions? Wouldn't I want to protect her?
