06/24/2008 04:27 pm ET Updated Nov 17, 2011

Gardasil or Guard Your Girls?

The vaccine for the human papilloma virus (HPV) vaccine, Gardasil, was mandated for all young girls in Texas in 2006 and there were proposals for mandated vaccination in a growing number of other states. But a flurry of publicity about conflicts of interests by those who were pushing it in Texas and outcries from those who thought Gardasil shots would make girls run wild in the streets led to a shelving of plans to make it mandatory.

But is the HPV vaccine safe and effective? Since the vaccine is new we don't know about the long-term consequences of vaccination. And given the concerns parents have had about other vaccines and recent reports about a link between thimerosal, a form of mercury, in vaccines and increased risk for autism and other childhood neurological problems (i.e. the parents were probably right all along when the medical establishment was denying it), I am not surprised that some parents get nervous.

A Freedom of Information Act request to the FDA showed that as of October 2007 there were 1,824 adverse events associated with the vaccine Gardasil, including 11 deaths. Known side effects of Gardasil include pain and swelling at the site of injection. Fever occurs in about 1% of cases. There are also recent reports of girls passing out after getting an injection.

Human Papilloma Virus (HPV) is a virus that is spread by unprotected sexual intercourse that affects more than half of the population. HPV can cause genital warts and in rare cases cervical cancer. For 95% of people, however, they are asymptomatic and never know they have an HPV infection. Although almost all cases of cervical cancer are caused by HPV, since HPV is so ubiquitous it is uncommon for HPV to progress to cervical cancer. Cervical cancer kills 4000 women per year, only 1/10th the death rate of breast cancer, for example. If you do the numbers, that means that about 0.002% of women infected with HPV die each year from HPV-induced cervical cancer--not a very impressive number.

Safe sex practices, although not always realistic behavior to expect, especially in young people, are an alternative way to prevent HPV until more is known about the vaccine. However you should know that condoms won't always stop infection, since HPV can be spread by parts of the genitals that are not covered by the latex.

So should you guard your girls or give them Gardasil? What do you think?