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What Doctors Are Telling Patients About HPV Vaccine

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The Centers for Disease Control and Prevention have recommended that girls around the age of 11 get the Human Papilloma Virus vaccine to protect them against strains of virus that can cause cervical cancer. The idea is to get them vaccinated before they become sexually active and possibly infected with HPV. But some research shows that doctors aren't advising their patients to get the vaccine — at least not until they are briefed on the research.


The Centers for Disease Control and Prevention recommends that girls around the age of 11 get the vaccine that protects them against strains of the human papilloma virus, or HPV. That virus can cause cervical cancer. The idea is to get girls vaccinated before they become sexually active and possibly infected with HPV. Still, some doctors are reluctant to administer the vaccine at such an early age.

NPR's Brenda Wilson has this report on what doctors are telling their patients about the vaccine.

Dr. ARTHUR LAVIN (Pediatrician, Case Western University): Well, thanks so much for coming in today. There's a new vaccine called HPV vaccine. One of the things I can tell you about it is, it was designed to prevent a very serious illness, which is cervical cancer. But some questions have been raised about how well it does that.

BRENDA WILSON: That's how Dr. Arthur Lavin, a pediatrician and professor at Case Western University in Ohio, typically begins a consultation with a parent of one of his patients. He tells them the CDC recommends the vaccine, but he also thinks parents should know his concerns.

Dr. LAVIN: One is, how long will it last? If the vaccine only lasts a few years -let's say three years - then a young, adolescent girl - say, an 11-year-old, like your daughter - might not get much protection when she reaches the age of her peak of sexual activity, which hopefully will be more than three years from now.

WILSON: It isn't yet clear how long the vaccine remains effective. He says knowing that, parents might want to wait until the girl is older before she gets the vaccine.

Dr. Jessica Kahn specializes in adolescent medicine at the Cincinnati Children's Hospital. She surveyed the attitudes of more than a thousand doctors in Texas and found…

Dr. JESSICA KAHN (Director of trainee research, Cincinnati Children's Hospital Medical Center): Physicians seem to be waiting. They're not all following the national recommendations to vaccinate 11- to 12-year-old girls, but instead, some of them are opting to delay vaccination until girls are a little bit older.

WILSON: Two-thirds of the physicians surveyed had no problem offering the vaccine to girls between the ages of 13 and 17. Other national studies had similar findings. But Kahn says physicians may not realize that the three-shot regimen has to be done before the girls are sexually active.

Dr. KAHN: They don't understand how common HPV infection is in adolescents, and how often adolescents acquire HPV within a few months of sexual initiation. And they may not understand that the vaccine is not effective in girls who are already infected with vaccine-type HPVs at the time of vaccination.

WILSON: And other doctors have even more serious worries. Dr. Diane Harper is a professor of family medicine and obstetrics and gynecology at the University of Missouri-Kansas City. Harper was involved in reviewing the research conducted by Merck, but didn't see any problems with the vaccine until after it had been licensed.

Dr. DIANE HARPER (Family Medicine and Obstetrics and Gynecology, University of Missouri-Kansas City): I had concerns when I started to be contacted by parents whose children had neurologic problems.

WILSON: She thinks parents and young women should weigh the decision very carefully.

Dr. HARPER: What I tell them is that the vaccine is proven effective. And I tell them that for most women it is safe, but there are real risks associated with it and that there have been some young women, a very small number, that have died. And so, they need to understand that it's not a risk-free vaccine.

WILSON: The CDC has reports of at least two deaths related to neurological events not usually found in young girls that are now being investigated but have not yet been linked to the vaccine.

Dr. Jessica Kahn says the number one reason pediatricians gave for not vaccinating the girls is that the parents wouldn't let them.

Dr. KAHN: We found that 60 percent of the physicians said that parents had refused the vaccine because of negative media reports. And I think this is really unfortunate because all the evidence that we have so far has shown that this vaccine is safe.

WILSON: Some doctors are depending on the girls having another option for preventing cervical cancer, regular pap smears for HPV, which they will still have to do even with the vaccine because it doesn't protect against all strains of HPV.

Brenda Wilson, NPR News.

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