In the year 2000, about 18 million new cases of sexually transmitted infections (STIs) were reported in the United States. About half of those infections were among 15-25 year olds.
At present, vaccines for the prevention of several STIs, including gonorrhea, chlamydia , genital herpes , human papillomavirus (HPV), and human immunodeficiency virus (HIV), are in development. These vaccines would be most effective if targeted towards young teenagers, before they become sexually active.
Adolescents have the right to confidential reproductive health services in many states, but it remains unclear to what extent states will require parental permission for newly approved STI vaccines. It is unlikely that most teens will seek out the vaccine without the encouragement of their parents or doctors. Pediatricians, however, have expressed some hesitation in recommending STI vaccines for their patients, perhaps in part because they anticipate negative reactions from parents.
But very little is known about parental attitudes towards STI vaccines. In light of the widespread, yet largely unsubstantiated, concern about the promoting effects of condom availability on teenage sexual behavior, some parents may be equally concerned about a similar effect from STI vaccines.
In a study published in the February 2005 Archives of Pediatric and Adolescent Medicine , researchers report that parents are just as willing to vaccinate their children against sexually transmitted infections as they are to vaccinate their children against other types of infection.
Researchers interviewed 278 parents or guardians who accompanied their children (aged 12-17 years) to medical appointments.
The parents were asked to rate, on a scale of 0 to100, their willingness to vaccinate their children based on four factors:
Mode of transmission (is the infection sexually transmitted or not).
Severity of infection (is the infection curable, chronic and incurable, or usually fatal).
Effectiveness of vaccine (50%, 70%, or 90% effective).
Availability of behavioral methods of prevention, such as hand washing or condom use (available or not available).
The parents and guardians interviewed for this study were 92.8% female, with an average age of 40.9 years. Their children were 69.1% female, with an average age of 14.4 years.
The researchers found that parents were just as willing to vaccinate their children against STIs as they were to vaccinate their children against non-sexually transmitted infections (81.3 versus 80.0 on this study’s rating scale).
The study also showed that parents had a strong preference for vaccines that prevented potentially fatal infections, compared to those that prevented chronic or curable infections. They also had a relatively strong preference for vaccines with 90% efficacy compared to vaccines with 70% or 50% efficacy. Finally, parents expressed limited preference for vaccines that protected against infections that could not be prevented behaviorally.
This study is limited by the fact that all of the participants were from a Midwestern city with limited racial and ethnic diversity. As a result, the study findings cannot be generalized to all parents.
This study demonstrated that parents would be as willing to have their children vaccinated against STIs as they would be to vaccinate their children against any other type of infection. There was no evidence that they construed the availability of these vaccines as an inducement to increased sexual activity on the part of their children.
Once available, STI vaccines could go a long way towards protecting adolescents against sexually transmitted infections. However, these vaccines will only protect against a limited number of STIs, and should not be viewed as a replacement for barrier methods of contraception such as condoms. There is a theoretical danger that many vaccinated teens will assume they are no longer at risk for any STI’s and act accordingly. Physicians and parents must emphasize that STI vaccines should be seen as an extra form of prevention, as something to be used in addition to—not in place of—safe sex.
RESOURCES:
Centers for Disease Control and Prevention
US Department of Health and Human Services
www.cdc.gov
National Institute of Allergy and Infectious Diseases
National Institutes of Health
www.niaid.nih.gov
Sources:
Rosenthal SL et al. Parental acceptability of vaccines for sexually transmitted infections. [Editorial.] Arch Pediatr Adolesc Med . 2005; 159:190-192.
Zimet GD et al. Parental attitudes about sexually transmitted infection vaccination for their adolescent children. Arch Pediatr Adolesc Med . 2005; 159:132-137.
Last reviewed Feb 11, 2005 by Richard Glickman-Simon, MD
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