As parents, we are charged with doing everything within our power to ensure our children grow up healthy. Fortunately, we live in a country where seatbelts are mandatory and pollutants are measured down to parts per billion, taking a lot of the guesswork and personal responsibility out of the equation. Every so often though, an issue comes along that divides our sensibilities between our values and our fears. The HPV vaccine is the latest development in disease prevention that asks us to find where we stand in the gray area between values and safety. What should be an easy decision, whether or not to vaccinate our daughters against a disease that kills 4,000 women a year in the United States, is complicated by the fact that the cancer itself is caused by a sexually transmitted disease.

As the parent of a fifteen year old girl, I’m very aware of the fact that my daughter is growing up. My wife and I have had many conversations with her about sex and sexuality, about abstinence and prophylactics, about the value of chastity and how we would prefer she not have sex until her first wedding anniversary. I’d like to think that were we being graded on “talking with your teen about sex,” we would be in the 95th percentile. Unfortunately, all that talk was just that- talk. We were happily dealing in theory and semantics then. Now this vaccine has forced us into reality- and that can be a scary place.

In order to properly deal with this, I had to splash myself in the face with a cold glass full of facts and statistics- the more disturbing the better. I wanted to shock myself into action through fear, basically manufacturing my own consent. As a bonus, all this information allowed me to have a conversation with my daughter that was centered on statistics instead of sex. Here are the ones I found most motivating (courtesy of the CDC):
Human papillomavirus, or HPV, is the name of a group of viruses that includes more than 100 different strains or types. OVER ONE HUNDRED! The vaccine only covers the four nastiest types, but those four are accountable for 70% of cervical cancers.
80% of women will have some form of HPV by age 50. That’s pretty much everyone but spinsters, nuns and Nanci Pelosi.
The virus usually causes no symptoms, and there is no cure. How horrible is that? Not only might you not know you have the virus, but even if you do have symptoms, there’s nothing you can do about it.
Most cases clear up on their own, but some persist and can cause cancer decades later. Yeah, you know that one time you had sex thirty years ago? That’s what’s killing you. And don’t think condoms are going to guarantee your safety either. With an effectiveness against HPV of only 70%, they’re in the C-/D+ range on this assignment. (That’s because HPV can be transmitted by genital skin contact alone, unlike some other STDs which are only transmitted through shared bodily fluids.)

Having learned all this, I realized that in order to take the necessary steps to protect our daughters, we must have what is quite possibly our first concrete admission that they will one day have sex.

A friend of mine-also the parent of a teenage daughter-found these facts somewhat less compelling. She was worried that vaccination would send the message that sex would be safer, and thus more tempting. This is a problem a lot of people have with the vaccine, and depending on where you look, you can find research that either verifies or denies it. I personally think it has a lot to do with how you approach it. If you tell someone you’re giving them a STD vaccine and don’t elaborate, maybe they’ll think it was for all STDs and that they’re completely bulletproof. I suppose that might make some girls more likely to go wild. On the other hand, if you tell them that the shot can only inoculate them against four of the hundred-plus types of HPV, you would send a message that even with this measure of protection, they’re still woefully susceptible to more diseases than they even knew existed. Honestly, it’s a pretty easy sell. What’s not so easy is actually getting vaccinated.

Limited supplies, combined with the $360 price tag, have kept many from getting the series of three shots. There is hope that the federal government will make HPV a mandatory inoculation, so it could be provided at low- to no-cost. However, that plan is running into some problems with social conservatives who have moral objections to requiring girls as young as nine to take part in STD preventatives. I have two problems with this. First, in order for the vaccine to work, it has to be administered before exposure to the viruses. To ensure that, it must be given before their first sexual contact. In practical terms, that means that bureaucrats who want to debate this issue for months-running-on-into-years do so at the risk of a whole generation of young women. Second, every state in the union has a law in place to protect people from having their religious/moral beliefs trampled by the government, which allows them to exempt themselves from any and all required vaccines.

For now, the buck stops with you. Since the government’s not telling you what to do, you’re forced to make your own decision. Statistically speaking, every woman in America has a one in 38,000 chance of dying from this disease, which makes it pretty rare. At the same time, I’m going to do everything in my power to make sure that one woman is not my daughter.

Jason Adair resides in Auburn, California, where he writes, performs and parents.

Editor's Note: In early February, Texas governor Rick Perry sidestepped voting procedures in the state's House of Representatives by signing an executive order which made Texas the first U.S. state to require the vaccine for school admission, effective beginning in 2008. Perry's action, which would make the vaccine (the most expensive in pharmaceutical history) affordable and accessible to families of all income levels and those without health insurance, was hailed by public health officials and many in the scientific community, even as it drew scornful criticism from religious conservatives, certain parents' rights groups and many of the lawmakers whose authority he side-stepped. Among his critics are those who point out Perry's financial and political ties to Merck & Co., makers of the vaccine, brand-named Gardasil.
As of late February, those Texas lawmakers are pushing a bill through committee that would rescind Perry's mandate. Cosigned by 90 of 150 members of the state House of Representatives, it is expected to pass.
In California, a bill that would require school girls to get the shots has not been assigned to a committee. Assemblyman Ed Hernandez (D-Baldwin Park), lead author of the bill, said the controversy in Texas had not lessened his support for making the vaccinations mandatory, telling the L.A. Times, "We plan on moving forward with our bill because I believe mandating this vaccination is the right thing to do," he said. "The cervical cancer vaccine provides us the ability to significantly diminish a disease that needlessly kills and permanently maims thousands of women every year."