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Monday, August 28, 2006

How to explain HPV vaccination's purpose to teens?

Among the many questions regarding the implementation of Gardasil on a large scale is how the purpose of the vaccine should be explained to children as young as 9 years old (but mostly 11-12) receiving it...
  • What level of detail regarding HPV, its sexual transmission, and cervical cancer is appropriate?
  • Should the physician handle these discussions alone, should they be left to parents to deliver, or should a team effort be employed?
  • Should parents be permitted to instruct the doctor to give an 'abridged' version of the vaccine's purpose and function vs. the 'full' version they might otherwise deliver?
  • In general, it's obvious that a discussion of Gardasil with a nine or ten year old would be dramatically different than one with a 13 or 14-year old (with added individual differences even within a specific age group). However, there's no clear guide to help physicians (or the other health care providers who will administer HPV vaccinations) tailor their discussions of the vaccine to children of varying ages, particularly in cases where there isn't an established physician/patient relationship to provide guidance as to a child's maturity, etc.
  • What if a parent and child/patient have different opinions regarding whether to vaccinate? Is there a place for child assent to vaccination in these circumstances (particularly among older teenagers)?
With all that in mind, an AP story posted this weekend considers some of these questions. Titled "HPV vaccine creates parental challenge," the story follows a 14-year old girl and her mother as they learn about HPV vaccination from the girl's doctor. It's a useful way to begin thinking about these issues less on the national policy level and more from the perspective of individual patients and families. (Thanks to Dom Sisti for the heads-up.)

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