Dr Dillner's health dilemmas: should my daughter have the cervical cancer vaccine?

The dilemma

More than 2,800 women are diagnosed with cervical cancer in the UK each year. Nearly all (99%) of cervical cancer is caused by infection with human papillomavirus (HPV). If you could protect your daughter from getting it, why wouldn't you? For the past two years all girls aged 12 to 13 years have been offered a vaccine against HPV, specifically against HPV-16 and HPV-18, which cause over 70% of cervical cancers. It is given before most girls are sexually active (they won't have been exposed to HPV which is transmitted through sex) and requires three jabs over six months. So far, studies show the vaccine prevents 99% of the changes in cervical cells that are classified as early cancer. It may offer some protection against other HPVs that cause cervical cancer but the studies have not yet shown this. It also protects against cancers of the anus, vagina and penis caused by HPV. The Department of Health estimates the vaccine will save 400 lives a year.

But as usual with vaccination programmes, there have been safety concerns: media reports of girls developing chronic fatigue syndrome after the jab, and quotes from experts suggesting that vaccines have been aggressively marketed, have made some parents cautious. Also, three jabs that won't even protect from all cervical cancers seems a bit steep, when women will still have to have cervical screening, starting from age 25. Women will still need to use condoms if they want protection from other sexually transmitted diseases - so the vaccine shouldn't make anyone feel invincible. Besides, isn't vaccinating everyone to protect a few overkill? It's not even clear how long the vaccine lasts, so a booster may be needed later on. So is it worth your daughter missing three lessons to be vaccinated?

The solution

The benefits outweigh the risks. HPV is divided into two main types - the high risk ones that cause cancer and the lower risk ones that cause genital warts. At least half of all women who are sexually active will catch it and while most cases resolve, or could be caught through screening, neither condition is recommended. HPV can be caught from hand- or mouth-to-genital contact as well as intercourse.

Cervical screening already reduces the risk of cancer, but if you vaccinate as well, women are less likely to develop early cancers, needing treatment that can affect the cervix and in rare cases, make pregnancy more risky.

All vaccines have the risk of side effects but 4m doses have been given in the UK since 2008 and the Medicines and Healthcare Products Regulatory Agency say the risks are minimal and that there is no link with Chronic Fatigue Syndrome, which is already common in adolescents. If there was a link, it says that cases would have risen noticeably as so many girls have been vaccinated.

In America, the Centers for Disease Control and Prevention is now recommending the vaccine be given to boys between the ages of 11 to 12 to prevent genital warts and anal cancers in men. So the next question may well be: should your son have the vaccine?

Thanks to guardian.co.uk who have provided this article. View the original here.


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