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Ignoring A Vaccine

If you want to prevent flu, you get a flu shot; if you don't want sunburn and skin cancer, you slather on sunscreen or stay out of the sun.

But what if you want to prevent cervical cancer, which kills upwards of 4,000 women in the U.S. each year? If you're under 25, you're likely to ignore a vaccine that can save your life.

Human papillomavirus (HPV) is the country's most common sexually transmitted disease and the prime cause of cervical cancer, plus several different types of cancers in both men and women. Since 2007, there have been at least two vaccines on the market capable of blocking up to 90 percent of these cancers.

And yet, people are avoiding the shots in droves. Why? Medical researchers are struggling to come up with a good answer.

First of all, the shots aren't cheap. HPV vaccines are generally comprised of three shots at $120 each, which can stretch the budget of the average college student, and often are not covered by insurance. Also, the vaccines are still fairly new, and there are still lots of misconceptions and unanswered questions.

"We don't even know how long they work," says Mary Gerend , who has studied college students' beliefs and motivations about Gardasil, the first HPV vaccine to appear (in 2006). Gardasil is sold by Merck Pharmaceutical (the other HPV-fighter, Cervarix, made by GlaxoSmithKline, debuted in 2007). "So we're seeing some reluctance, and that's understandable."

Gerend, an associate professor of medical humanities at FSU, says she has always been interested in how people respond to public-health messages and make prevention decisions.

When Gardasil came out four years ago, it was offered to girls as young as 9 to inoculate them before they become sexually active. Gerend's current work focuses on college-age men and women, for whom the HPV vaccine wasn't available at younger ages.

Gerend notes that most women, parents and health-care providers are extremely interested in a vaccine that can prevent cancer. Her research shows that awareness of HPV is relatively high and many college-age men and women say that they understand the benefits of vaccination.

But they're still not exactly lining up for the shots. Based on 2007 data, the Atlanta-based Centers for Disease Control estimates that only about a third of adolescent females intend to get vaccinated for HPV; among 18-to-26 year-old women the number drops to only one in 10.

"One thing we found is that most young women don't really think they are at risk for HPV infection, so they don't see themselves as needing the vaccine," Gerend says.

She's at work now on a National Cancer Institute project to identify those public health messages that most motivate young women to get vaccinated. Initial results indicate that focusing on the negative slightly outweighs focusing on the positive. Women's ears perk up when they learn about the risks they'll avoid by getting the vaccine than when they learn about the preventative benefits of getting vaccinated.

Gerend's work sparked worldwide interest last year, when she published a paper in the journal Sexually Transmitted Diseases that studied young men's motivation to get the vaccine. Though HPV-related cancers are rare in men, the vaccine can protect their future sexual partners from infection and attendant cancers. Did knowing that cause more men to want to get vaccinated? It did not.

"I think they got the message," Gerend says. "But it might not have been strong enough." -K.M.