Sunday, May 15, 2011

Sex and Immunizations...HUH?

I read a lot about immunizations. As the mother of two (now mostly grown) children, I didn't really give them much thought back in the day. As a nurse, I was well aware that immunizations had risks. My children's doctors, back in the day, always made sure I was aware of that immunizations they were given, risks, and side effects. Outside of some after-shot crankiness and fevers, my children had no issues with any of their immunizations.

Hepatitis B was not a recommended vaccine when my children were born. I knew it was out there, and, at the time, it was given only to those infants at risk (mothers with positive tests, persons from areas where Hep B is common as exposure could be an issue). As a nurse, I knew it was not just "sexually transmitted", and the issue of a "biter" in daycare was as important as blood or body fluid transmission. But, it wasn't offered, so they did not get it then. I DID see a young child with Hep B in the hospital where I worked. But it wasn't common so at that time I put it out of my mind.

When it was recommended, I did make sure they got the Heb B doses. And yes, to be honest, I delayed (only a few years; it was not recommended until they were nearly school age for those who did not get it at birth) until they were middle-school age so they would be protected during the highest at-risk years sexually. (At that time, it was felt the immunization was only effective for 10 years, so I wanted to give them that 10 years when they would need it most.) Later reviews have shown that once someone has developed antibodies from the vaccine, they may be protected for life.

Gardasil. The vaccine that protects against that other sexually transmitted disease HPV. Only sexually promiscuous girls would get HPV, right? Wrong. One of the problems with HPV is that your system can clear it, or you get it, or, in rare cases, it becomes dormant. I had a patient who, after 30 years of monogamous marriage (on her part, per her report and on his part per HIS report), developed an HPV infection. Both firmly denied extramarital activity. Upon probing, the husband recalled that many years prior to marriage, he'd had 'warts' on his penis that went away and never came back. Guess where the wife got HPV from? Loving husband. Their marriage survived, but she had several issues with abnormal pap smears leading to additional treatment. If you asked her, she would have gotten the HPV vaccine in a second.

In the back of my head I always see the young teenage girl who was brought to the gyn clinic I worked at. Her mother was concerned because her daughter always cried when urinating. When I went in to examine her, I was horrified...I could not see anything because this girl was one huge mass of warts from pelvic bone to anus. If you touched them, they bled. Every time she uninated, the warm urine over the bleeding warts hurt her immensely. We called in the physician to manage this case. The upshot was many, many weeks of care to burn off the warts and be able to see this girl's urethra and vagina. This girl had had sex once. If you had asked her, she certainly would have preferred a vaccine over the care she required.

When the vaccine became available, I asked my children if they wanted to get it. I got the literature from the doctor's office, verified with my insurance as to whether or not it was covered, and let them make the decision. Both opted for the vaccine, and got the series of 3 with nothing more serious as a side effect than a brief dizzy spell (younger hates shots and needles and hyperventilates).

So, yes. I am pro "STD" vaccines. I am pro all vaccines, because the risks of the disease outweigh the risks of the vaccine. As a child who got a vaccine that is no longer given - smallpox scars in the US designate a certain demographic. I have one, my brother has one. Our younger sister does not have one because, lucky girl, she was born after it was eradicated in the US. My children did not have to have it because they were born after it was eradicated world-wide. Maybe, in the future, my grandchildren or great-grandchildren will not need vaccines against other diseases that have only human vectors, like measles. Wouldn't that be wonderful?

1 comment:

  1. I was reading some religious women debating vaccinations and they all agreed they would NOT get Hep B or Guardasil. Their little angels were going to stay chaste and pure until marriage, because in their "perfect" world, sexual activity only begins with two monogamous virgins on their wedding night.

    Apparently their daughters are not only immune to premarital sex, but to abrasions, accidents, blood transfusions, rape, and picking a husband who may have had a wart before marriage (like your lovely story).

    Hope their daughters can avoid any exposure to both diseases, I guess.