Your Health

DAVID GREENE, host: This is MORNING EDITION from NPR News. Good morning. I'm David Greene.

STEVE INSKEEP, host: And I'm Steve Inskeep. Good morning.

Today in "Your Health," we're going to talk about teens and vaccines. First, we'll talk about a controversial vaccine against HPV, a virus that causes cervical cancer. It's become a hot topic again after it came up in a Republican presidential debate. NPR's Richard Knox looks at what the scientists say.

RICHARD KNOX: This vaccine gets people riled up because it has to do with sex and 11-year-old girls. It protects against a sexually transmitted virus. That's why Julie Stewart was shocked when the pediatrician said her 11-year-old should get it.

JULIE STEWART: My daughter is so not sexually active that it seems very premature to even think about protecting her from cervical cancer.

KNOX: Now, Stewart tends to have faith in doctors. So she thought about why she reacted that way.

STEWART: I realize it's probably more about my squeamishness with the thought of her becoming sexually active than the vaccination itself. It's not the science. I think it's my own issues around, you know, her developing sexually.

KNOX: Stewart lives in Washington, D.C., which requires the vaccine for middle-school girls. Virginia is the only other place to mandate it. Both let you opt out with a doctor's note.

Cervical cancer kills 4,000 women a year. And the American Academy of Pediatrics is backing the vaccine. So is the Academy of Family Practitioners, and the Centers for Disease Control and Prevention. Milwaukee pediatrician Rodney Willoughby says there's a very good reason for this big push.

Dr. RODNEY WILLOUGHBY: This vaccine is aimed at a transmissible disease. It's sexually transmitted. In some sense, it's just the timing. This is being timed just before you start to have those discussions about the birds and the bees.

KNOX: The idea is to vaccinate girls well before their first sexual encounter. Studies show that by the time they're 15, nearly 10 percent of American girls are infected with HPV. Studies also show that many parents are clueless about when their children start having sex.

WILLOUGHBY: Ideally, none of our children is going to be sexually active until they meet Mr. Right or Mr. Wrong and that's the end of the story. But it happens and sometimes, you're not aware of it. And we can't prevent it once that exposure's occurred.

KNOX: Willoughby says his daughter will get the vaccine next year, when she turns 11. But Dr. Diane Harper, of the University of Missouri at Kansas City, says the vaccine is being way over-sold. That's pretty striking because she worked on the original vaccine studies. And she accepted grants from the manufacturers, although not anymore. Harper changed her mind when the manufacturers lobbied to require school kids to get vaccinated.

Dr. DIANE HARPER: Ninety-five percent of women who are infected with HPV never, ever get cervical cancer. And it seemed very odd to be mandating something for which 95 percent of infections never amount to anything.

KNOX: That's not her only objection. Studies so far show the vaccines protect for four or five years. Scientists hope protection will last 10 years or more, but young women may need a booster shot later. Harper says vaccinating an 11-year-old girl might not protect her when she needs it most.

HARPER: It may actually wear off before she's finished her most sexual-active years.

KNOX: And the vaccine can be expensive - three shots costing several hundred dollars, and not all insurers cover it. Another reason parents balk is worry the vaccine could be dangerous. Two children have died of a rare neurological disorder after getting the vaccine. Last month, the independent Institute of Medicine found no good evidence the deaths, or any other serious side effects, were caused by the vaccine.

Dr. JOSEPH BOCCHINI: This is a very safe vaccine.

KNOX: That's Dr. Joseph Bocchini of Louisiana State University, who chairs the CDC's working group on HPV vaccines. But as much as he believes in the vaccine, Bocchini doesn't think the government should require kids to get it yet.

BOCCHINI: We want to get some experience with it. We want to educate physicians and other providers about the benefits of the vaccine. We want to educate the public about the infection and its consequences.

KNOX: So for now, the lead CDC adviser thinks the decision should be left to parents. Some parents, like Dr. Willoughby, will go ahead and get it.

WILLOUGHBY: If in 20 years' time my daughter, with two children at home, develops cervical cancer and I didn't give her the vaccine, I'm going to be looking pretty hard in the mirror at myself.

KNOX: And some parents, like Julie Stewart, will think about it some more.

STEWART: Our doctor plans to talk to us about it at my daughter's 12-year wellness visit. So, you know, maybe we'll do it then.

KNOX: For her, it's not really a question of whether. It's a question of when.

Richard Knox, NPR News.

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