Iwrote a column recently advocating the vaccination of our daughters against human papilloma virus, a sexually transmitted disease that can cause genital warts and, years later, cause cervical cancer.
The response to the column was passionate, as you might imagine. Readers objected to everything from the unknown long-term effects of the drug to the unseemly role of Merck, the company that makes the vaccine, in urging it on the public.
Readers recalled the record of pharmaceutical companies with drugs such as hormone replacement therapy, Vioxx and Fen-Phen, which were thought to be helpful when introduced but were found, over time, to be harmful.
And several readers reached further back in time and recalled DES and thalidomide, drugs administered to pregnant women to prevent early labor or morning sickness and subsequently found to have devastating effects on their children.
"You can let your daughter start forming the line to receive her HPV vaccine," wrote one reader. "Then in 20 years when she's infertile or has some rogue, unexplainable neurological issues, you can wonder how all of this happened."
What makes the HPV vaccine safer than these other drugs, according to Dr. Neal Halsey, a pediatrician and head of the Johns Hopkins Institute for Vaccine Safety, is that nothing remains in the body to create mischief later.
"There is no residual chemical in the body," Halsey said. "All that is left is the immune response."
In many vaccines, patients are given a small amount of the live virus to create the immune response that will protect them if they are exposed later.
This vaccine is different. It is an artificial copy of HPV, Halsey explained. "It doesn't have any genetic material from the virus. But it produces the immune response we need."
Halsey said it was "not a logical approach" to wait 20 years to see what happens to the women who are vaccinated.
"In the meantime, we will have thousands of women dying of cervical cancer every year.
"The truth is that this vaccine protects women against cervical cancer. It is highly effective, nearly 100 percent, against about 70 percent of the cancers. It is really a very good vaccine and a very safe vaccine."
Halsey urged parents to sit down and look at the information about the enormous increases in HPV among young women.
"Within just a few years, more than half of them will be affected. And that's just the data from Maryland."
Halsey's daughters are much older than the recommended age for vaccination -- which is up to the age of 26.
"But I would have been among the first in line. I would have given both of them the vaccine."
Meanwhile, Dr. Peter Lurie, deputy director of the watchdog organization Public Citizen's Health Research Group, said he, too, has heard from consumers who think the HPV vaccine is a drug company money-making ploy.
"It is a drug company conspiracy in the sense that this company has really overmarketed their product. They pushed very hard for legislation to be passed to make the vaccine mandatory.
"The company overplayed its hand," said Lurie. "That doesn't mean that the vaccination is dangerous and it doesn't mean that it shouldn't be mandatory. I think it should be."
Lurie considers HPV to be a public health issue with a public health answer.
"There is a general argument about the making of any vaccine mandatory," he said. But there is nothing, according to Lurie, that distinguishes HPV from polio, DPT, chicken pox or measles in any important way.
Except, perhaps, that you contract it by having sex.
"An argument can be made that infectious diseases should be treated the same regardless of what behavior caused them," he said. "Public health should not be judgmental."
There are no guarantees in life, Lurie said.
"The risks of this vaccine haven't been qualified with absolute certainty, that's true.
"But the benefits have been qualified with remarkable certainty."
In the previous column on the HPV vaccine, I misspoke. The drug is administered in three shots over six months, not eight months.