How a nurse made the Gardasil decision for her daughter

How a nurse made the Gardasil decision for her daughter

Parenting teens

How a nurse made the Gardasil decision for her daughter

This image made available by Merck in October 2016 shows a vial and package for their GARDASIL 9 human papilloma virus vaccine. Credit: AP | Merck.

I’m sitting at the crossroads that makes every American mother cringe: To Gardasil or not to Gardasil. I find just stomaching the commercial to be difficult. A message linking my 10-year-old to death from a sexual escapade is unappetizing at best. She’s not even old enough for lip gloss! The anti-vaccination messages aren’t helpful whatsoever; they are filled with anecdotal stories without links to peer-reviewed studies.

As a registered nurse and former neuroscience researcher, I began a fact-finding mission to decide what was right for my daughter. So far, I’ve spoken with four doctors, read recommendations from the Centers for Disease Control, American Academy of Pediatrics, the product insert and website, Wikipedia, the prescriber document, along with information from three additional professional associations. Then, I called Merck, the manufacturer.

Credit: Merck

Nurses love a medical puzzle

The HPV vaccine choice is so difficult and personal, I’m left with the presumption every mother must make her own decision. It would make things easier if Merck would get their messaging straight, and would stop airing commercials about sexually transmitted diseases and 10-year-olds. “We’re all going to die!” is already the cataclysmic call for the doomsday preppers, the car seat manufacturers, the vegans and friends trying to sell me body wraps and eye creams.

The good news: Gardasil is highly effective at stopping nine HPV viruses that can lead to cervical, vaginal, vulvar and anal cancers, along with genital warts. It has the expected side effects commonly seen with most vaccines.

One dose of the vaccine Gardasil, developed by Merck & Co. Credit: AP file

However, some of the other side effects are troubling: Seizures, blood clots and autoimmune disorders. Seizure-like activity can happen when the shot is given, but it does not reoccur. After 170,000 million doses, there is no scientific link between either autoimmune disorders or blood clots and the vaccine. Even with a silver lining, reviewing the data made me want to re-enroll my kids in kindergarten. Remember when lunchboxes were our biggest decision?

I spent so many hours taking notes, my daughters rebelled by creating a hamster run in the house (may my crystal bowls rest in peace).

I am still struggling

I still don’t quite understand when this vaccine should be given. The doctors with whom I spoke prefer age 13, while the literature supports ages 9 to 11. It’s probably promoted to coincide with a child’s normal vaccine schedule, but I’m a fan of spreading out non-mandatory shots to lower the vaccine load. The “duration of effect” has not yet been established for Gardasil (we know it’s somewhere greater than five years and probably much longer), so my plan to dose it to last through the “frat party” years had to be ditched, because it holds no scientific water.

The HPV vaccine is administered as a series of three shots. Credit: Getty Images.

For me, even the dosing schedule is problematic.

Children between ages 9 and 14 might receive two or three doses, depending on which version of the vaccine they receive. Not even the maker could give me a direct answer, but luckily, all of the prescribing physicians could. Their prudent advice saved me from the assumption that all girls should get a third dose. In reality, it’s a complicated decision that should only be made by your doctor.

The moment of truth

As I sat tapping my pencil, whispering, “Decide, decide. Trusting in herd immunity is not a choice…” a thought came to me: If cancers prevented by this vaccine do plummet, when my children are grown, there won’t be new treatments or specialized oncologists. If they contract one of these cancers, they will be in big trouble.

My decision scale tipped; I will schedule my daughter’s HPV vaccination series at age 13, with the version and dose recommended by our pediatrician.

Wisdom does not come easily or without sweat equity — wisdom comes suddenly.

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