Ask Dr. Marla: Should I Get My 13-Year-Old Daughter the Gardasil Vaccine?

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Should I get my 13-year-old daughter the Gardasil vaccine to protect her from getting the human papilloma virus (HPV)? What are the pros and cons?

The current recommendations by our National Advisory Committee on Immunization known as NACI, is HPV Vaccine use for girls aged nine through 26. The effi cacy of the vaccine is greatest in girls prior to their fi rst sexual intercourse and before being exposed to the HPV types.
About 30 types of HPV can affect the genital area. There are high risk types such as HPV Types 16 and 18 that can cause cervical cancer or abnormal cells in the lining of the cervix that can sometimes turn into cancer. There are other types such as Types 6 and 11 that can cause genital warts and noncancerous changes in the cervix. Many other types of HPV can cause abnormal Pap tests as well.
HPV affects both women and men. Anyone who has any kind of sexual activity involving genital contact with an infected person can get HPV. Intercourse isn’t necessary. Many people with HPV do not show any signs or symptoms. Many people get HPV within their first two to three years of becoming sexually active. By age 50, eight out of 10 women have been exposed to HPV although many will have the ability to clear the virus on their own.
Each year in Canada we see 36,000 new cases of genital warts, 177,000 new cases of low-grade cervical dysplasia (abnormal cells on Pap), 52,000 new cases of high-grade cervical dysplasia (more worrisome cell findings that can be a precursor to cervical cancer), and 1,100 new cases of cervical cancer, and 450 deaths.
The vaccine you are asking about is called quadrivalent as it protects against four HPV types – Types 6, 11, 16 and 18; the first two cause 90 percent of genital warts, the last two cause 70 percent of cervical cancer cases. There is also good evidence that there is something called cross protection – meaning protection against strains that are not in the vaccine.
The most frequent side effects reported with the vaccine include fainting, dizziness, nausea, headache and local reactions at the site of the injection.
This vaccine, while very effective, does not eradicate all forms of cervical cancer. It is important to teach our children about safe sex and stress the importance of regular Pap screenings when they become appropriate. For more information visit the Public Health Agency of Canada’s website at

Published March 2010

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