Should all 11 and 12 year old girls be vaccinated against sexually transmitted human papillomavirus (HPV)?

Michigan appears poised to be the first state to enact this requirement for all girls entering middle school (though parents could opt out for religious or medical reasons). Many other states are likely to follow suit quickly.

Cervical cancer is second only to breast cancer in the number of diagnoses made each year in women; about a third of the cases are fatal.

The HPV vaccine, approved by the FDA in June 2006 for girls as young as age 9, appears to be virtually 100% effective at preventing the two strains of HPV that account for about 70% of all cervical cancers. It looks like this vaccine could prevent many needless cancer deaths in women every year.

As a pediatrician whose wife has had breast cancer, I am moved by the suffering that might be prevented in my daughter and others in the next generation.

The main argument being raised against making this a standard middle school vaccine is the concern that it might encourage promiscuity among teens.

It seems to me that there are many, many factors that are more likely to promote sex than this shot – and that many of them do not offer such huge potential benefit. It also seems to me that the teenage years may be the most important time to provide this protection. Of course, each family should be allowed to reject the vaccine easily, if they choose. But how wonderful if the shadow of cervical cancer is shifted away from the majority of girls!

When my wife and I were born, American teenage girls, aged 12 to 17, weighed an average of 118 pounds. Some weighed more and some weighed less. Today, the average has swollen to 130 pounds. And teenage boys have packed on even more weight, going from a healthy 125 pound average up to 141 in such a short span of time.

Meanwhile, school-aged kids between 6 and 11 have swollen by an even higher proportion, up more than 13 percent, from 65 up to 74 pounds. What does this mean? These government statistics, released October 27, 2004, are the latest to come from the National Health and Nutritional Examination Survey, which tracked Americans from 1960 through 2002. The story making the headline news is that the average adult today is 25 pounds heavier than adults were in 1960 while only a bit taller. It’s an important story. But the children’s numbers are even more chilling.

That 25-pound adult increase occurred to a generation that was slim on average when they were kids and teens. But obesity can build like compound interest. The girth (and the diabetes, high blood pressure, heart disease, cancer, arthritis, etc.) awaiting this generation of overweight children when they grow up is frightening – unless we take action now. Today about 31 percent of American kids are at weights that put them at health risk. This isn’t an individual problem; it’s a cultural problem.

Today’s sedentary kids are bombarded with enticing messages to eat super-sizes of artificial, high-sugar, high fat, highly processed nutritional trash. We need to create a culture organized around healthy, fun physical activity and around healthy amounts of healthy, delicious natural foods. This means changes in our schools, our homes, our restaurants, our airwaves, and in our thinking. I hope we heed this wake up call and learn what it takes to start raising the healthiest, not the fattest, generation of kids in history.

I’ve often heard parents comment, when watching their toddlers or school-aged kids jet giddily around the home (or restaurant), “I wish we could bottle their energy and sell it!” I wish we could, too.

I wish we could sell activity to teens. We need to do it.

A study published in the September 5, 2002 issue of the New England Journal of Medicine chronicles an alarming decrease in physical activity in teenage girls who were followed from the age of 9 or 10 years until the age of 18 or 19. In some groups the level of physical activity dropped by more than 2/3 by age 16 – and the decline continued to accelerate from there!

We must find fun ways to keep teens moving and active if we want to keep them healthy now, and in the future. Think how much easier it was to move and get in shape when you were a teen than it is now. Active fun. Everyday.

Data collected by the Centers for Disease Control and Prevention (CDC) points to a growing problem: an estimated 35 million teens, in the United States alone, are missing one or more doses of childhood vaccines. This leaves these teens vulnerable to catching preventable infections as adults, when the diseases are often more serious and have greater complications.

Here are the vaccines most likely to be missing: one or more of the 2 doses of the MMR vaccine, the 3 doses of the Hepatitis B vaccine, the varicella vaccine, and/or the tetanus-diphtheria booster shot. All of these should have been received by age 12. Most teenagers are at increased risk because of missed doses.

Exercise during the teenage years may be one of the most important ways to prevent osteoporosis. The July 2000 issue of Pediatrics reported results from the ongoing Penn State Young Women’s Health Study that show an association between adult hip bone density and sports-exercise patterns from ages 12 to 18. Exercise increases bone density, and the difference between being sedentary and active during peak bone growth can have lifelong impact.

Obesity among teens has become a major epidemic. More teens are overweight now than at any time in history. A January 2000 report to the Centers for Disease Control and Prevention (CDC) identified the single most powerful change teens can make to bring their weight under control.

“Of all the ways of tackling this problem, TV reduction appears to be the most effective measure in reducing weight gain in this population,” Dr. William Dietz, Director of the Division of Nutrition and Physical Activity, told the CDC Advisory Board. Bike, dance, play ball – have fun being active!