A few months ago, my local moms’ group on Facebook broke into a debate over whether or not to get their children the HPV vaccine—aka the vaccine to protect against human papillomavirus, the most common sexually transmitted infection in the U.S. There are more than 100 different strains of HPV, and while most are nothing serious, some high-risk strains can cause cancer. It was a tense conversation; some parents—even those who had been all for vaccination when it came to measles and polio—were dead set against the HPV vaccine, familiar with the vaccines they grew up with but fearing the new inoculation on the block. (The HPV vaccine was approved by the FDA in 2006.)
Despite the risk—wading into a parenting debate, especially one about vaccines, on social media is like walking into a lion’s den—I wanted to jump in. Not to tell them how to make decisions about their kids, but to tell them my story. To tell them, the consequences of not getting the vaccine. Consequences I knew all too well.
The CDC recommends children be vaccinated at 11 to provide protection hopefully long before they’re exposed to HPV. But by the time the HPV vaccine was approved, I was already out of college—and I’d already gotten my first abnormal pap smear. I already had HPV.
HPV is wildly common: almost every sexually active person will get HPV at some point in their life, with 14 million people becoming newly infected each year. The good news? Most cases are no biggie, the vast majority of people with HPV don’t experience any symptoms at all. But that doesn’t mean you can just write it off; HPV causes genital warts in around 350,000 people—ultimately not dangerous, but definitely unpleasant. Then there are the strains of HPV, at least 14 of them, that cause cancer: 12,000 women will be diagnosed with cervical cancer each year and 4,000 of those women will die from it, even with screening and treatment.
If you are fortunate enough never to have had an abnormal pap smear because of an HPV diagnosis, let me assure you, the follow-up is not pleasant. First, there’s the emotional turmoil that tags along with this kind of test result: What does this mean? Do I have cancer? Have I passed HPV onto my husband without knowing it? A million questions swirled through my mind, each one more terrifying than the last.
But even that paled in comparison to the physical aftermath. To understand which strain of HPV I had contracted, my gynecologist ordered a colposcopy—an exam similar to a pap smear in which a doctor uses a scope to take a closer look at your cervix to spot abnormal cells. Then came the cervical biopsy.
In medical terms, a cervical biopsy sounds sterile and unassuming: a doctor takes a tissue sample from your cervix to test for cancerous cells. Every website out there told me this is a virtually pain-free experience, like a quick stinging sensation. In reality, it was significantly worse. Every woman’s experience with pain is different but for me it felt like a terrible pinching sensation—like if you got the skin of your finger caught in a pair of scissors—deep inside me. (Underestimating the amount of pain a patient feels is relatively common in the medical world, especially with women and gynecological health issues.) If you are like me and unlucky enough to have more than one spot on your cervix that needs to be biopsied, you’ll have to hold still through multiple painful biopsies in a single exam.
I had to go through this entire process three times. The second time my pap test came back abnormal two years later, I was pregnant. That meant leaving the abnormal cells to sit for months—you can’t perform a biopsy on someone whose cervix is busy keeping a baby safely contained on the other side of it. The third time, my annual pap smear came back abnormal, the samples taken at the gynecologist were processed at the lab during a three-day gap in my insurance as I switched from one job to another. With that biopsy, I ultimately I paid $900 out of pocket for the privilege of finding out whether or not I had cancer.
This is what I wanted to tell the moms on Facebook: I paid heavily in both flesh and stress for something that could have been prevented with a vaccine.
Fortunately, my HPV never did turn into cancer and 10 years after my first abnormal pap test, the disease seems to have cleared my system. (Most people who have HPV find that the disease eventually goes away on its own.) But even though I’ve had five perfectly normal pap results now, the possibility that it might return still hasn’t cleared my mind; every year when I see my ob-gyn, as is recommended for women with a history of abnormal results, dread lingers in the pit of my stomach until my test results come back.
I am so thrilled that the next generation doesn’t have to suffer through this process the same way I did. The HPV vaccine, which protects against the strains of HPV most likely to cause cancer, has made a massive impact. In the first four years after the vaccine was introduced in the U.S., rates of cancer-causing HPV fell over 50 percent in teen girls and studies show cervical cancer rates in the U.S. are still falling. Other countries have seen similar victories in the fight against cervical cancer. In Scotland, precancerous cells on pap smears have been nearly eradicated—there’s been a 90 percent reduction in the rates of these abnormal paps thanks to the vaccine, according to BBC News.
So, why the debate over the vaccine? The internet is full of misconceptions about deaths and serious reactions, but the vaccine is well-studied and perfectly safe. “The side effects are similar for all other vaccines,” says Sarah Leite, M.D., a board-certified ob-gyn in Connecticut. Think: pain around the injection site, headache, and nausea. (The scariest documented side effect, a disorder called Guillan-Barre syndrome which can cause paralysis, is extremely rare: only four cases have been confirmed in 29 million doses of the vaccine.) The benefits far outweigh the risks, Dr. Liete says. “From a gynecological perspective, the vaccine has not only reduced cervical cancer, but additional testing, examination, procedures and cervical excisions.”
I wanted to tell the moms on Facebook all of this and that it’s not too late for them to get the vaccine themselves—it’s recently been given the green light for everyone through the age of 45. More importantly, I’ll be making sure my daughter gets it as soon as she’s old enough. I wish I had been protected from the trauma of an abnormal pap smear—that’s an experience I never want her to face.
Rachael Brennan is a writer in Connecticut covering insurance and women’s issues. Follow her on Twitter at @rachaelbwriter.