newjerseynewsroom.com

BY SUSIE WILSON

NEWJERSEYNEWSROOM. COM

SEX MATTERS

In 2010, when Gardasil — the human papillomavirus virus (HPV) vaccine for girls as young as nine — was approved by the U.S. Food and Drug Administration, I dropped the news into my subconscious and forgot about it. With only one granddaughter to call my own, then nine-years-old, I just didn’t want to face the fact the someday she would be sexually active and need protection against HPV, a sexually transmitted disease that can cause cervical cancer and genital warts.

But last month, when a federal advisory committee with the Centers for Disease Control and Prevention recommended that boys and young men, nine to 21, should be vaccinated with Gardasil, like Snow White, I woke up.

All at once, I focused foursquare on the current debate over whether boys and girls should receive the vaccine, a series of three shots. If so, they could be protected against different cancers caused by four strains of the HPV virus that can develop in adulthood from sexual contact that occurred at younger ages.

I have three grandsons who fall into the suggested age range for the vaccine and one, at age eight, who is on the cusp. My granddaughter will be 11 in March. They are in the crosshairs of the debate. I am not these children’s parents, but I’m their grandmother who writes about sexual health issues. So I decided to act after the committee’s announcement.

Fortunately for me, I have a pediatrician in the family (my son-in-law). When I asked him whether he would have his two sons vaccinated, he connected me to a colleague of his with expertise in the area. He said based on what she recommended, and in consultation with his wife, then decide about vaccinating his two sons.

His colleague Lydia A. Shrier, M.D., M.P.H., attending physician in adolescent/young adult medicine at Boston’s Children’s Hospital and associate professor of pediatrics at the Harvard Medical School, kindly answered my questions on the vaccine, its importance, its efficacy, and her recommendations to parents.

I asked her via e-mail for her best reason to convince parents to have their daughters and sons vaccinated when they are young.

“Vaccination is one of the most important public health initiatives, and saves countless lives, considerable suffering, and many dollars,” Dr. Shrier replied.

“[Gardasil] is only helpful for people who haven’t acquired the [four] HPV types protected by the vaccine, which is why it is recommended for girls and boys at age 11 to 12 (hopefully before they have had any kind of sexual contact that would result in HPV transmission).”

While it may be hard to believe, Dr. Shrier noted that most people who ever have sexual contact will be infected with at least one type of HPV, with many becoming infected with multiple types.

Yet despite the facts, some are against youth getting the vaccine, fearing that it will give them a license to be sexually active. I asked Dr. Shrier to respond to the charge.

“The decision to have sexual contact is a complex, personal decision. There is no evidence that the preventive health recommendation for the HPV vaccine influences that decision.

“The HPV vaccine works best for abstinent individuals and is offered along with other preventive health measures, including supporting abstinence for our pediatric patients who have not yet had sex,” she added.

I would add that if parents decide to vaccinate their children, they may use it as a teachable moment to talk to their 11- to 14-year-olds not once but often about the many good reasons to choose abstinence and avoid risky sexual behaviors like intercourse.

Parents can also teach their kids about what the vaccine does not do: protect against unplanned pregnancy and other STDs.

I asked Dr. Shrier to give parents tips on starting the conversation about getting Gardasil with their kids. She said they should talk about it in an age-appropriate way: “These shots will help your body to be protected against infection from types of a virus, HPV, which can make you sick with warts or cancer.”

They might add: “You get exposed to HPV through sexual contact, so it is very important that you have this protection in your system before the time in your life when you have this contact.”