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Gardasil


PattiL
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My last post on birth control made me think about this vaccine. Dr. Grubb has told Chrissy she should absolutely get this vaccine asap. Normally I wouldn't even doubt a word of what he says, but after doing a search I have questions. There's a lot of information questioning its value. Most say the HPV virus is in your system anyway and this vaccine is a hoax. One of my biggest concerns is that of the side effects nausea and dizziness are at the top of the list. GREAT! Something Chrissy sure doesn't need.

Have any of you gotten the vaccine, or know of anyone who has? Any opinions?

Thanks,

Patti

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All vaccines generally have risks, but typically these are short term, like swelling at the site, feeling a bit fluish, etc.; in most cases, the diseases cause more dangers than the vaccine. Given that HPV is associated with cervical cancer (and that is NOT a hoax), it's a vaccine to at least consider.

Additionally, one need NOT have sexual contact to contract HPV--HPV is a "wart virus". According to my gynocologist, the viruses that cause warts are pretty hardy-- you could potentially contract just from borrowing a bathing suit, or even transfer the virus from hand to genitals.

How do I know the above? I got HPV before I'd become sexually active. Then, starting in my very early 20's--maybe 22? I'Ve had to go for pap smears every 3 mos, I have cervical cell changes that have required me to have biopsies many times (painful). I'm thankful that my type of HPV has been genetically typed and is not in the highest risk group, but it's still a higher risk than the general population for cervical cancer. I really don't need another health hurdle in front of me... and hope that I never end up with cervical cancer.

Nina

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hi dr grubb also suggested that i get vaccinated against cervical cancer as well.. to get the gardasil.. we where talking about other area's of my life that i needed to keep healthy in.. and this topic came up..

I dont think dr grubb would advise something that would be harmful to use.. knowing that many of us are auper sensitive to so many different things.. I have a n appointment with my obg to discuss the vaccine.. if i get it.. i will PM you and let you know i had any unruly sideeffects...

good to have all your ducks in a row tho before any new things

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I was also thinking about getting this vaccine, but my insurance doesn't cover it, so that's basically out of the question!

Jacquie

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Patti,

That is a really interesting question.

I really try to stay away from vaccines as much as possible...

This debate reminds me a little of the flu vaccine debate--i.e. my doctor is against getting flu vaccine, dr. grubb is for. They are both top specialists in the country.

However, HPV and Cervical cancer are a bit more to deal with than the flu!

I don't have an answer, but I don't know if I would feel 'urgency' to rush into getting the vaccine. It is so new.

Nina's point about getting HPV before becoming sexually active is interesting. (I'm sorry Nina that it is another thing you have to deal with. I am thankful that for you it was DETECTED since most women go without knowing they have it. And, you are very careful about staying 'up' on your check ups)

However, I wonder how common that is? I think the biggest reason doctors are pushing it is because of the sexual activity of young women. (i.e. possibly having schools require the vaccine, etc.)

I've not had my ob/gyn even bring this up with me, or my PCP who I JUST had a physical with.

In my humble opinion, if Chrissy has a good ob/gyn and is not sexually active, I'd wait and really have a discussion about the pros and cons of the vaccine with the gyn who would hopefully know more about Chrissy's risk, etc. than Dr. Grubb.

I feel like you have time to 'sit with it' for a bit....

Emily

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I have had 2 out of the 3 shots required for the HPV vaccine, Gardasil. You have the first shot, then the second one 3 months later, and the final one 6 months after the second one. Personally I had no side effects other than a sore injection site the second time and I tend to be very sensitive and get side effects from many things. Advil makes me sleepy!

My doctor talked to me about how important it was for many reasons. Obviously cervical cancer prevention, often time male partners carry it without any symptoms or knowledge, and Nina's particular case was an eye opener. My doctor had mentioned things like that to me as far as contracting in other ways which is why he find it so important to have done.

My insurance did cover it. However, we weren't sure at first if it was going to and my doctor was explaining that many programs have been created so that you can get the vaccine for free. So if you are not going to get it due to your insurance not covering, ask your doctor about ways you can get it for free.

I read the concerns about why should you do the Gardisil vaccine when you aren't even advised to do the flu shot. My doctors do not advise me to get a flu shot but were very adamant about me getting this vaccination because this is a much bigger deal.

I'd make a point to talk to your gyn and any of your specialists to make a fully educated decision about this. Personally, I've encouraged this vaccination to as many people as I know after reading up on it so much.

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Patti,

So, I have several podcasts on my iTunes, and it just so happened that one of them that I actually hadn't planned to listen to was from January, which was cervical cancer awareness month. After your post, I decided to give it a listen tonight. I LOVE this stuff. I used to do sex education stuff on campus and did an internship at a family planning clinic, so it was a good refresher course for me, since it's been a few years since I did this!

Tha entire podcast was on cervical cancer--prevention, detection, the vaccine, etc. It was VERY good and helpful.

Do you have the ability to stream shows on your computer or do podcasts? Or can one of your 'hip young sons' or Chrissy podcast it for you to listen to? If so, let me know. Otherwise, let me know if you can't...and I will type up as much as I can remember from it. I just can't right now b/c I feel really sick. Sorry.

It was a podcast of a show from our NPR station with interviews from 1. the chief of gynecologic oncology at Hershey Medical Center in PA and, 2. a microbiology professor and cervical cancer researcher at Hershey.

I was reminded of many things I already knew, and also learned some new things. If anything, it was a good 'refresher course' so that I could be more accurate in my comments on the board about cervical cancer, sexual activity, the vaccine (which btw, there is ANOTHER one coming out soon by Glaxo Smith Kline--the current one is by Merck) and HPV.

Is Chrissy able to be honest with you or her doctor about her 'risk factors'--which really come down to sexual activity?

From listening to the podcast, and what I have heard mostly before is that this is the BIG reason for the vaccine and most common way to get HPV. Once you have HPV you have it...but if you get the vaccine you don't get it. Right now it is FDA approved for ages 9-26. (The social and political controversy surrounding this and whether to require it for school children is fascinating, but not really relevant to your question!)

I do not know what strain Nina has or even if the vaccine would have protected against the one she has (Do you know Nina?). The vaccine only protects against 2 or the 15 strains out there (however these strains account for at least 70% of cervical cancers). Neither doctor mentioned other ways of getting HPV other than sexual activity as the big culprit. Number of sexual partners and age of first intercourse are considered in evaluating risk for contracting HPV. Nina, you just might have been incredibly unlucky!!! :) Cervical cancer is the third most common type of gynecologic cancer in women.

The first doctor interviewed did not even really mention the vaccine. He really emphasized the importance of regular pap smears. He said that if we all did this we could virtually eliminate cervical cancer. Paps are THE most important thing. (One fear is taht women who get the vaccine will stop getting paps). 50% of women with cervical cancer are women who never had a pap test. Paps, as we know are NOT preventative of cervical cancer, but they are a fantastic screening tool and really mean that we can tackle this cancer if women get theirs yearly (or more frequently as in Nina's case). He discussed HPV and the link to sexual activity.

The second person interviewed, the professor, focused more on the vaccine. It seems to be effective against 70% of cervical cancers--b/c most are caused by the 2 strains it protects against. He was able to explain how the vaccine is made. (Sorry, but I just didn't quite get the microbiology of it!) He basically said the way we get HPV is through sexual intercourse. The vaccine is very exciting. He talked about the other one coming out by Glaxo, the age limits on it (9-26) (so, DizzyGirl, you are almost past the time the FDA has approved it for, but it is questionable WHY the FDA has not approved it for women past age 26.

The most important time to be protected is under age 30--and this is when Paps are most crucial. As I've said before, cervical cancer is typically a young woman's cancer (ages 18-34).

Anyways, I guess after listening to the podcast I wasn't convinced yet to go for the vaccine b/c it JUST came out this past summer. And there is a new one coming out.

I would get the vaccine if I was younger and sexually active--maybe. I am not sexually active and have no risk of getting HPV so for me it seems like there is no reason to get it--plus I'm over 30. I'm not sharing towels and bathing suits with anyone so even if there is a risk of getting it that way, hopefully I won't get it. Although public bathrooms still freak me out! :)

For me, there doesn't seem to be a cut and dry answer. Plus, if Chrissy's already struggling right now so much, maybe now isn't the time to add anything else into the mix?

Honestly, I believe strongly that this is a very personal decision and mostly based on sexual activity. This is what I believed before the program and believe even more now after listening to it.

Whoops, I didn't mean to keep typing. I get so passionate about this stuff. Plus, I'd probably forget everything from the program by morning anyways!

I really hope this helps you some. I respect Dr. Grubb a lot, but I guess that I don't feel that there is a cut and dry answer for this vaccine at this point in terms of recommending it across the board for all of his young female patients. We may get to the point in time that we require it of school age girls simply b/c they ARE having sex and we can prevent HPV by doing so, but that isn't the case right now.

I certainly don't want to minimize cervical cancer or the risk of getting it. But, I do think there are clear pros and cons at this point to getting the vaccine vs. sticking to regular paps. BallroomA has it at age 19, but no HPV...so there's an unusual case in and of itself that it wasn't caused by HPV. There are always going to be those exceptions...

Chrissy is 21 and she has the freedom to make this choice for herself and what is best for her body and her belief system.

You're a great mom, and I think your gut was right to question.

Btw, thanks for the sweet, sweet post under the topic about the documentary and caregiving and guilt. Probably, another topic for another thread for another day. I think for my mom, she doesn't have the support you do--she is a single mom and her close friends RAN the other way when I got sick. Nice, I know. She's also just overhwlemed b/w work and taking care of me, so it doesn't leave time for her to meet folks. She went out tonight to the movies and dinner with a friend....YEAH!

Later alligator!

Emily

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Whenever you try to get information about the benefits and risks of vaccination, remember that there are a lot of people who are opposed to any vaccinations whatsoever, for religions reasons. Such persons are also likely to be against antibiotics, as well, but they won't mention that in their vaccine discussions, because they know it would undermine their credibility. So they pretend to be concerned about the health risks associated with the vaccinations, and they exaggerate these risks out of all proportion.

Lately, the Christian Science Monitor has published a commentary recommending that the Gardasil vaccine be kept "optional." http://www.csmonitor.com/2007/0213/p08s01-comv.html

The commentary doesn't mention that the Christian Science Church also feels that antibiotics for life-threatening infections and insulin for type I diabetes are also optional. http://www.childrenshealthcare.org/

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I generally believe in vaccinations and medication. I would not hesitate to take any medicine that would protect or mprove my health. However, I am very reluctant to try anything that hasn't been out on the market for a few years, unless necessary. Although drugs, vaccines, etc. go through FDA trials before being released, there are often side effects and reactions that we learn about later.

I think Gardasil is on many peoples' minds mostly because of the media attention and political controversy. My understanding is that the risk of cervical cancer is very low in the U.S. - it is even more rare than POTS. And, because most people get regular GYN exams, there is a high success rate for treating cervical cancer. Some of the articles I read mentioned that Gardasil is more important for people who live in third world countries where they don't have good access to health care. I also think I'd be more inclined to get vaccinated for something highly contagious through casual contact, like measles or even the flu.

I do think it's a personal decision and I'm slightly above the recommended age range. If I were in the age range, I think I'd wait a few years to see how this played out before getting this vaccine.

-Rita

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The incidence of "invasive cervical cancer" is about 14,000 women per year, and there are about 4,000 deaths per year from it, in the United States. But there are also about 300,000 women with "high-grade" and 1 million with "low-grade" precancerous cervical lesions every year, which translates to a lot of biopsies and other unpleasant procedures and considerable expense.

http://www.aafp.org/afp/20070101/editorials.html

Gardasil will prevent relatively more deaths in poor countries, because cervical cancer is easily diagnosed and responds well to early treatment, which is seldom available in poor countries. So it will prevent relatively fewer deaths but prevent more hysterectomies here.

There's a serious downside to delaying vaccination. The vaccine is most effective if given before a girl is sexually active. The safety concerns about Gardasil are theoretical. The dangers of HPV infection are well documented.

I haven't had Gardasil, because I'm above the recommended age range. I have had the HPV DNA test.

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I've had various types of procedures done, and of them, the biopsies and exploratory procedures were the most invasive. I have been DNA typed--I'm not one of the ones covered by Gardasil, but I still have had precancerous cells of various grades many, many times. If I'd not been so proactive about getting the lesions removed, I'd have had cancer by now. I'm always suprised that I still have a cervix after all the snipping they've done :) owie ... anyway, it's still a personal decision about getting the vaccine, but as I said a while ago, vaccines are generally far less harmful than the diseases they protect against.

Nina

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Just to expand on what Nina said, someone I know and care for dearly also got HPV without ever having sex with the person she got it from. Sorry to be blunt here, but the guy was touching himself and then touching her and that was all it took. I also grew up with a guy who married young, had affairs and brought HPV home to his wife. She died of cervical cancer when she was 25. She left behind three beautiful kids who are now in foster care.

Everyone has to make their own decision regarding this vaccine, but if I had a daughter she would definitely be getting vaccinated.

Michelle

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What tragic stories!

I think that a lot of people are freaked out about giving a vaccine against a sexually transmitted disease to girls who are really too young to be having sex. But that's exactly the point. It's best to give the vaccine to the girls when they are really too young to be having sex. It's more effective that way.

I don't recall anyone giving me a full-disclosure type of discussion about diphtheria before I got a diphtheria booster when I was a kid, so I don't think that it's realistic to expect that too many people will really need to go into a detailed discussion about sexuality when the girl gets her HPV shots.

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just my own thoughts on the topic.. but i know that gardasil is anew vaccine.. but im kind of glad that there is one now available.. b/c i mean look at "some" of todays younger people.. they are becoming sexually active so very young its mind blowing...and with some many partners..

I know for myself i have really thought about getting the vaccine.. only b/c full blown cervical cancer and the cancer cells runs in my moms side of the family.. all of my moms sisters and grandma i have either had cancer or cancer pre cancer cells at one.. some at young ages.. I dont know if there's is caused by Hpv.. but who knows..that is like my reasoning for the vaccine.. not so much based on sexual activity...b/c i was was getting screened for cervical cancer LONG before i ever became sexually active..

so chrissy i agree should look at the risk involved and talk openly with her mom and doctor and do the research.. and make and educated and informed discion...that really only she can make and follow thru on..

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Michelle,

That story broke my heart...

I'm sorry if I sounded too political...I agree with many of you about younger girls and the need to educated and vaccinate...I was trying to stay off of the political but looks like I didn't succeed!

I think I was just focused on Chrissy, as a 21 year old, making her own decision with the help of a gynecologist.

Emily

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Wow,

Thanks to everyone for your advice/opinions. Chrissy and I are very close, probably due to POTS, but I'm not complaning! She is not sexually active, which is why Dr. Grubb thinks it's the perfect time for her to get the vaccine. Her gyn is also supportive of her receiving it now. She just had her sinus surgery on Tues., (which so far has gone extremely well) so once she's recouperated from this I think she'll make the right decision.

Thanks again,

Patti

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Thanks Michelle! Stupid stuff stresses me out sometimes I guess! I worked so hard on that post and listening to the podcast, then felt terribly if I had sounded too headstrong (not the word I'm looking for, but the best I can do right now!)....

Interestingly, Merck has now withdrawn its ads and its campaigns to try to get states to mandate the vaccines, b/c it is so new and we really don't know the effects of the vaccine on young girls yet. This just happened as we were having this thread. I guess they, as the pharmaceutical company, were really the ones pushing the vaccine, not medical professionals (to get it mandated).....

Patti--So glad that you and Chrissy are so close and she was able to make an informed decision that you all feel good about. I'm really close to my mom too...and was even before I got sick. It's great to be so close as mother-daughter! B)

Emily

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