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Q: My daughter is 12. She has had two of the three shots of Gardasil. Her third shot was due July 2008, but we became concerned about stories of dangerous side effects and didn't get the third shot. Will she have health issues or trouble getting pregnant when she grows up if I don't get her the third shot? I would prefer to wait until further testing of the drug is performed. Please help.
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Henry H. Bernstein, D.O. Henry H. Bernstein, D.O., is a senior lecturer in Pediatrics at Harvard Medical School. In addition, he is chief of General Academic Pediatrics at Children's Hospital at Dartmouth and professor of pediatrics at Dartmouth Medical School. He is the former associate chief of General Pediatrics and director of Primary Care at Children's Hospital Boston.
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June 15, 2009
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A:

Gardasil is the brand name for the human papillomavirus (HPV) vaccine. There is a reason that three doses of the vaccine are given -- to insure that girls like your daughter are fully protected against the types of HPV that most commonly cause cervical cancer and genital warts.

Skipping a recommended dose of vaccine will put her at risk for a preventable disease. For this reason, I would recommend that your daughter get her third dose, assuming she had no problems after her first two doses.

The vaccine is safe. HPV vaccine was (and continues to be) studied in thousands of females around the world. No serious side effects have been found that would change current recommendations. The most common side effect is soreness of the arm, which can happen after any shot. There also have been reports of some teens fainting after getting a shot. If this is a concern, your daughter should simply be observed in the doctor's office for 15 minutes after getting the vaccine.

This vaccine is licensed for girls and women aged 9 to 26 years. It is given earlier in life, hopefully before someone gets exposed to HPV. This is because HPV is the most common sexually transmitted disease in the United States. More than three-quarters of all sexually active people will become infected with HPV at some point in their lifetime.

The primary way someone gets HPV is through sexual activity. It can be spread from one person to another even with only one encounter. Many HPV infections have no symptoms and the person's immune system takes care of the infection. However, adolescents and young adults sometimes can develop genital warts. Other times, women can develop abnormal cells on their pap smear and pre-cancerous lesions that then can go on to become invasive cervical cancer.

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