In 2006 the FDA approved Gardasil, the first vaccine against the sexually transmitted human papilloma virus (HPV). HPV is responsible for most cases of cervical cancer. The hope was that most girls would be vaccinated against HPV at about age 11, before they began sexual activity.

At first, Gardasil seemed destined for widespread acceptance (see this blog, Oct. 14, 2010). But more extensive data show that the rate of vaccination has remained lower than expected. According to the most recent data from the Centers for Disease Control and Prevention (CDC), only 35% of all girls 13 to 17 years of age have received all three of the required shots. And an article in Pediatrics this month reports that the number of parent planning to have their girls vaccinated is declining, rather than increasing.

The new findings are of concern to health officials. No one knows why vaccination rates are still so low. Possibilities include the uneasiness of parents to address the issue of sexual activity in girls as young as 11; concerns about vaccine safety; the need for three shots rather than just one; the fact that Gardasil is not administered at the same time as all other childhood vaccinations; even the cost ($400-$500).

Health officials are struggling with how to encourage parents to have their pre-adolescent girls vaccinated. Ideas include providing more education about the value of the vaccine in preventing cancer; lowering the cost of the vaccine; making vaccinations more convenient by requiring only the first dose to be delivered in a health care setting (the others could be given in schools or at pharmacies). Only time will tell which if any of these strategies will work. But it’s a shame that we now have a vaccine that would prevent about 4,000 deaths per year from cervical cancer, and a lot of girls just aren’t taking advantage of it.

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