"I adore my daughter more than anything in the world," she said, "and I can't predict what she's going to do as a teenager, what risks she's going to be exposed to. To me, this is just extra protection."
Such pro-vaccine parents are sure to be the majority, said Jessica Kahn, of Cincinnati Children's Hospital Medical Center, who has researched the expected attitudes.
A national survey of 513 pediatricians published in March, found that about three-quarters of pediatricians would recommend the vaccine, 40 percent thought parents would be reluctant to have their children vaccinated against a sexually transmitted disease, and 70 percent expected parents to worry about the safety of a new vaccine. In a separate paper published earlier this month in the journal Pediatrics, a survey mailed to 1,600 parents found that 65 percent would lean toward permitting their preteen child to get the vaccine.
"Most parents will be eager to have their daughters vaccinated against HPV as long as they know they're sending the right preventive messages: that they still need to practice safe sexual behaviors, postpone sexual initiation as long as possible," and the like, Kahn said.
The logistics may pose even more problems than parental attitudes, several doctors said.
Initially, the vaccine will likely not be covered by insurance or paid for by the state, and it could cost as much as US$500. "That's a dealbreaker right there," said Victoria McEvoy, medical director and chief of pediatrics of the Massachusetts General West Medical Group.
Massachusetts has not made a decision yet on whether to fund the vaccine.
"We are several months away from making a decision," said Donna Rheaume, spokeswoman for the state Department of Public Health.
The three-visit regime that the vaccine will require is also a "huge problem," McEvoy said. Without getting the full three-dose regimen, teens won't get the full benefit of the vaccine.
"Adolescents, unless they're dragged by their parents, don't come in unless they think they're pregnant, they have acne, or they need a note for soccer or work."
Nonwhites and those with poor access to healthcare stand to benefit the most from the vaccine because they are the least likely to get annual Pap smears and follow-up care after a problematic test, said Elizabeth Garner, a gynecological oncologist at Brigham and Women's Hospital.Yet they are precisely the people who will have the hardest time getting access to the vaccine and getting the full dosage, she said.
McEvoy said she'll likely wait a year or so before offering the vaccine in her own practice, waiting for it to "sort itself out a little bit," get covered by insurance, and paid for by the state. She'll also be watching for reports of unexpected side effects; after 28 years of practice, she likes medical innovations to accum-ulate some history of safety before she recommends them.
In contrast, Hagan of Vermont plans to offer the vaccine to his patients as soon as it's available, confident that the state Health Department will subsidize it.
"If we have a safe and effective way to prevent a particularly prevalent form of cancer, then why wouldn't we do that?"
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