From the New York Times:
The prevalence of dangerous strains of the human papillomavirus — the most common sexually transmitted infection in the United States and a principal cause of cervical cancer — has dropped by half among teenage girls in recent years, a striking measure of success for a vaccine against the virus that was introduced only in 2006, federal health officials said on Wednesday.
This is, of course, marvelous news. What’s even more striking about those efficacy rates is that teenagers in the United States are vaccinated well below optimal numbers, with only about one in three adolescent girls protected by the full complement of immunizations. (Strong work, America. You’re getting beaten by Rwanda in an important public health measure.) One might reasonably expect an even greater drop in prevalence once more patients (both girls and boys) are fully vaccinated.
Because that’s certainly going to be the response to this news, right? That people will see the benefit of vaccination for their children and will opt to offer them as much protection as possible from cancer? (And not just cervical cancer. Thank you for the reminder, Mr. Douglas.)
There are some signs that resistance to the vaccine may be growing. A study published in the journal Pediatrics in March found that 44 percent of parents in 2010 said they did not intend to vaccinate their daughters, up from 40 percent in 2008. Because it prevents a sexually transmitted infection, the vaccine comes with a stigma. Some parents worry it promotes promiscuity. And it has been controversial. During the Republican primary in 2011, Representative Michele Bachmann, Republican of Minnesota, said the vaccine could have “dangerous side effects,” a concern that health officials say is unfounded.
I haven’t had a chance to discuss HPV vaccination with any parents since this newest report came out. Perhaps it will be persuasive to some of the fence-sitters. The Michael Douglas coverage certainly seems to have changed a few minds, which is encouraging. And, contra the Pediatrics study, my own experience is that parents are growing gradually more comfortable with the vaccine.
But then I live and work in a part of the country where people are (thanks be to God) not particularly apt to pay attention to the likes of Michele Bachmann. And even here, discussion of the HPV vaccine unearths how rife with suspicion and misconceptions people still are about it and vaccines in general. Even in a practice that does not accept patients whose parents refuse to vaccinate them, many parents still treat them with mistrust. Many evince reluctance to vaccinate their kids when they are too young to be sexually active, which is the entire point of a measure meant to prevent a sexually transmitted disease.
Absolutely nothing confounds me quite like the persistent resistance to one of the most unambiguously good things modern medicine has ever accomplished. It is a theme I have returned to again and again. Vaccinations work and they are safe. They save lives, and the HPV vaccine will almost certainly save thousands upon thousands of people from cancers that would have otherwise killed them.
But still people refuse to get them. Maybe this new report will help. I have been grateful for the parents who have been persuaded by a clear, straightforward conversation with me. There are many people who will listen to reason. But for those who act in defiance of it, I doubt this wonderful new information will make any difference.