DOC'S DESK

     Well, it's been out for several months.  Have your young daughters been vaccinated yet?  Have you suggested it to your adult daughters?  Have you considered it?  I have not been impressed with the enthusiasm to get this vaccine.  I have a significant number of inquiries about it weekly, but have not seen the numbers I thought would be coming in to actually get the vaccination.  I believe the clinical trials done on the vaccine prove the effectiveness and safety in preventing infections with HPV subtypes 6,11,16,and 18.  I have told patients that I do believe we will have more different vaccines coming out.  Maybe, that is the reason for the hesitancy to get vaccinated with Gardasil.  The cost of it and whether the insurance will cover it are other possible reasons.  I do not believe the vaccine should be mandated to any age group.  I do believe at this present time, it should be recommended to parents of minors.  The parents should have the final decision on the vaccine if their daughters are minors.  Gardasil is probably just the beginning of the vaccines to come.  I believe in the near future there will be a more multivalent vaccine more inclusive of the other High Risk HPV subtypes besides 16 and 18.  Gardasil is a good start though when you consider that subtypes 16 and 18 are responsible for 70% of cervical cancers in this country.  Parents of young minors should discuss the vaccine with the pediatrician and parents of teenage daughters should consider talking with a gynecologist for further advice.  I hope this has been helpful.  For more information on Gardasil visit there website at Gardasil.com.  Doc