Stephanie Wade wasn't worried about human papilloma virus, or HPV, until she saw some TV commercials warning that the sexually transmitted virus was the leading cause of cervical cancer.
After all, with four young daughters whose ages ranged from 6 to 15, the specter of sexually transmitted diseases seemed a long way off.
But with Thursday's Food and Drug Administration's approval of the first vaccinedesigned to protect against cervical cancer, parents like Wade must now decide whether to vaccinate their adolescent daughters against the STD.
"I would hope that my daughters would remain virgins until they’re married, but the reality is, that with four daughters, at least one probably would not," says Wade. But the 42-year-old San Diego mom will probably follow the recommendation of their family doctor. "If he says it’s what they need, then I’m going to do it," she says. "I got them vaccinated for chicken pox, so why wouldn’t I vaccinate for this?"
HPV may be the most common STD — at least 50 percent of sexually active people will get it at some point in their lives — but there's little awareness about the different types of HPV or of the virus' link to cancer. A recent study from the University of Michigan found many parents were confused about the difference between HPV, HIV (the virus that causes AIDS) and herpes simplex virus, or HSV.
The American Cancer Society estimates that in 2006, over 9,700 women will be diagnosed with cervical cancer and some 3,700 U.S. women will die from the disease.
Even though the shots could prevent up to 70 percent of cervical cancer cases, it's expected to be an uphill battle convincing parents to get yet another vaccine for their preteens, especially one that's connected to sex.
That's how Rosemary Owens of New Freedom, Pa. feels. The mother of two daughters, ages 23 and 13, is already leery of vaccines. She probably won't have the younger girl vaccinated, even though she understands that if she waits, it might be too late to protect her daughter against the STD.
"Maybe it’s naïve of me to think my daughter won't be sexually active at this age, but I just don't see it," says Owens. "I think that 13, at least in [her] case, is a little young. At a later date, by the time she's out of high school, then yes."
Dr. Suzanne Corrigan of the Children’s Medical Center in Dallas and spokesperson for the American Academy of Pediatrics, says it will be up to individual pediatricians to teach parents about HPV.
"It’s going to be a thorny problem, especially with parents who have never had [genital warts] and don’t understand the prevalence nowadays, " she says.
It's unclear what the best age for vaccination would be, although HPV infections are most common in people in their late teens and early 20s.
On the heels of FDA approval, it's expected that the Advisory Committee on Immunization Practices will likely recommend later this month that the shots be given to girls around 11 or 12, an age before most are sexually active and at a time when they are receiving other routine immunizations. Pediatricians could start administering shots next year. The vaccine would be delivered through three injections over six months.
Even with the vaccine, women still will need to have regular Pap tests beginning at age 21 or within three years of becoming sexually active, doctors say.
Dr. Ed Pont, a pediatrician in the Chicago suburb of Elmhurst, Ill., compares concern over the HPV vaccine to controversy when the government recommended that every infant be immunized against the hepatitis B vaccine, a liver infection transmitted through contact with infected blood and unprotected sexual intercourse.
"Parents were saying, 'My baby isn't going to be at risk for hep B,'" he says. "It's kind of the same buzz."
Pont says he'll explain parents that with the HPV vaccine, "it will one less thing you'll have to worry about as a parent."
Joyce Weckl, a certified nurse midwife from Thousand Oaks, Calif., frets that many teens are irresponsible about practicing safe sex, so she won't hesitate to have her 9-year-old daughter vaccinated.
"Parents don't want to think of their kids having sex, but I would love my daughter to have an HPV vaccine before she becomes sexually active," says Weckl. "I feel really strongly about it."