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Why the HPV vaccine has stalled
March/April 2009
by Jenny Blair '97, '04MD
Doctors had hoped that the twin scourges of cervical
cancer and genital warts would end after the 2006 introduction of Gardasil, a
safe and effective vaccine against human papilloma virus (HPV), which causes
both diseases. But so far, fewer than 25 percent of eligible women and girls
have received even one dose, and proposals to require vaccinations of preteens
have met with fierce resistance.
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A majority of parents and students thought vaccination would lead to promiscuity.
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To understand why, epidemiologist Alison Galvani, an
assistant professor at the School of Public Health, and her colleagues surveyed
326 parents of eligible preteens and 286 college students about their
perceptions of Gardasil’s risks and benefits. While both groups felt the
vaccine could prevent many instances of genital warts—and the more than 10,000
cases of cervical cancer a year in the United States alone—a majority of
parents and students also thought vaccination would lead to increased
promiscuity. Indeed, the students thought vaccinated women would go on to have
1.8 times as many sexual partners as unvaccinated ones. Gardasil’s cost also
emerged as prohibitive. Even with health insurance, the average cost of the
three required vaccinations is $181. (Side effects were a minor concern.)
Galvani and her team developed a mathematical model
for evaluating ways to boost vaccination rates. (The results appear in the
December 2 Proceedings of the National Academy of Sciences.) Because there is no evidence that
changes in sexual behavior will occur as a result of vaccination, they argue, a
targeted public health education campaign would likely counter fears of
increased promiscuity. And a little financial aid wouldn’t hurt. 
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