Too much information? Birds, bees and HPV

updated 12:06 p.m. ET Sept. 6, 2006

GRIFFITH, Ind. - What they thought would be a routine physical for her volleyball team found 14-year-old Amanda Zaborowski and her mom facing a big question: Did they want Amanda to get a new vaccine that would protect her against the common and serious sexually transmitted disease HPV, or human papillomavirus?

The vaccine, Amanda’s doctor told them, could prevent potentially deadly cervical cancer. He also explained that the three-dose inoculation would work best if she had it well before becoming sexually active.

This was a doctor that her mom, Linda Zaborowski, had trusted since Amanda was a child. She thought the vaccine sounded like a good idea. But she ultimately wanted her daughter to make the decision.

“If you think this is right for me, you know what’s best,” the high school freshman told her mom and doctor. “I’ll do it.”

HPV is a weighty topic that more parents are addressing with their daughters, since the Food and Drug Administration recently approved the vaccine for girls as young as age 9. Some parents, particularly those with preteen girls, are wondering just how much information to share.

Do they simply say it’s a vaccine against cancer and leave it at that? Or should they also explain that HPV is a sexually transmitted disease that, among other symptoms, causes genital warts?

Linda Zaborowski says it was clear that she needed to give Amanda, her eldest daughter, more information than less.

“When I was young, my mom said, 'Here’s a book.’ That’s how we learned about sex,” says Zaborowski, who is a cafeteria bookkeeper and recess aide at her children’s schools in Griffith, Ind., a suburban town near Chicago. “But it’s not like that now.”

She started to realize that when she sat in on Amanda’s fourth-grade lesson on reproductive anatomy a few years ago and discovered that some girls were already menstruating.

Government surveys also have found that about 7 percent of children have had sexual intercourse before age 13, while about a quarter have done so by age 15. And while teen pregnancy rates have steadily dropped since the early 1990s, millions of teens and young adults are contracting sexually transmitted diseases — HPV among the most common.

6 million new infections
Researchers at the federal Centers for Disease Control estimate that more than 6 million Americans — many of them teens and young adults — get a new infection of HPV each year.

Theresa Rohr-Kirchgraber, an adolescent and internal medicine specialist at the Emory University School of Medicine in Atlanta, says parents need to take those statistics seriously when deciding how to address the HPV vaccine.

“Cervical cancer is real. Sex is real — and even though we believe our kid is different and will never have sex until they are married, it is not reality,” Rohr-Kirchgraber says.

During medical visits with girls and their parents, she discusses HPV along with routine vaccines for meningitis, as well as the DTaP shot for diphtheria, tetanus and pertussis (also known as whooping cough).

“When you just put it on the list and make it one of the many they need, it becomes less of an obstacle,” she says.

Dr. Kenneth Alexander, an associate professor of pediatrics and an infectious diseases expert at the University of Chicago’s Comer Children’s Hospital, also is a proponent of fully explaining the HPV vaccine to teens.

“Parents only want to talk about cancer prevention. When they talk about STDs, they get pretty uptight,” he says. “Teenagers are often more savvy. They’re willing to talk about the two issues together.”

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