Gardasil Vaccine and HPV Prevention for Girls (and Maybe Boys) - Good or Bad?

In 2007, a very successful TV ad campaign for Gardasil, a vaccine which protects against the human papilomavirus (HPV), featured girls and young women chanting, "I want to be one less one less...I want to be one less." The implication was that each would be 'one less' victim of cervical cancer - which strikes an estimated 10,000 women each year and kills about 3,700 - since HPV is linked to the disease.

Three years after the Food and Drug Administration approved Gardasil for girls and women, perhaps its manufacturer Merck & Co. needs to shift the mesage to "one more" as in "one more gender." The company is now seeking approval from the FDA to sell the drug to boys. According to the Washington Post:

For males, the vaccine is aimed at protecting against genital warts and less common malignancies that HPV can cause, such as penile and anal cancer, as well as cancer of the mouth and throat. The virus causes at least 250,000 new cases of genital warts and an estimated 7,500 cancers in males each year, causing perhaps about 1,000 deaths. Vaccinating boys and men would also help prevent the spread of the virus to their sexual partners....The relatively pricey vaccine costs about $500 for three shots and the associated office visits.

This comes amidst "one more" concern about Gardasil - that the vaccine may have caused paralysis in a handful of young women. The CDC is doing an initial review, according to Deborah Kotz, who writes the "On Women" health blog at US News & World Report. Kotz, who has been covering the story of Jenny Tetlock, a teen who developed a degenerative muscle disease (which resembles ALS) after her Gardasil vaccination, writes that Tetlock died on March 15.

Kotz first reported on Jenny Tetlock in July of 2008. At that time, thousands of complaints had already been lodged against Gardasil involving a range of health problems, and Merck was named in two lawsuits.

As a mother and a health reporter, Kotz acknowledges her own fears for her daughters:

I haven't decided yet whether I want to have my own teenage daughter vaccinated. The arguments for Gardasil are compelling: It protects against viruses responsible for 70 percent of cervical cancers, which still kill many women in this country. Since the vaccine is so new, until more evidence emerges I think it may be prudent for concerned parents to consider holding off until their daughters reach the verge of sexual activity.

As a mother of two teens myself, I asked about having my daughters vaccinated with Gardasil last fall. Although my family practitioner didn't discourage me exactly, she didn't jump on the wagon and schedule the vaccinations. My daughters have yet to receive the Gardasil vaccine, and like Kotz, I am hesitating, unsure of what to do.

I'm not alone.

Barbara Shapiro, an ALS expert and associate professor of neurology at Case Western Reserve University School of Medicine, is the mother of an 11-year-old girl and has decided not to give her daughter the Gardasil vaccine. She argues, ""Let's say it causes just one or two cases of ALS every year out of a million doses that are given. What if your daughter is the one?"

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