How should I word this letter?

[Thistledew]

My cousin has been debating whether to have her daughter vaccinated against the HVP virus. I want to write her a message to encourage her to do so, as I have had to have a series of investigations for indications of pre-cancerous cells that have shown up when I have had smear tests (and I know I am very lucky that it has not been worse). I do feel strongly that my cousin should take all possible steps to protect her daughter from this, as I do not want anyone to go through what I have or worse.

Some of the message I want to send to my cousin includes links to medical research to correct some misapprehensions she has about the risk of contracting the virus- for example, that she is under the impression that it is the volume of sexual partners that causes the increased risk of contracting the virus, so it is impossible to catch it from just one partner; whereas actually the amount of sexual partners only increases the risk of sleeping with someone who carries the virus, and it is perfectly possible to catch it from just one sexual partner.

My cousin's reluctance to arrange for her daughter to have the vaccination comes from the fact that she is strongly religious, so would discourage her daughter from having sexual relationships outside marriage, and the fact that she and her family follow a lifestyle designed to promote health and well-being.

My dilemma is that I am also tempted to remind her that no matter how well she has brought her daughter up, teenagers are inclined to make mistakes and poor decisions. Although her daughter at the moment also follows her mother's beliefs and view of life, she may not always do so.

Do you think this last bit is necessary? Or a bit too preachy? Does it detract from the rest of what I want to say?

I think it depends on whether your cousin has invited your opinion or not (and I do mean invited rather than just let off steam to you about the vaccine). I'm one of the anti vaccine brigade and would not take kindly to such an email, no matter how well meaning.

I'm not sure it's a great idea at all, but if you do send a letter then don't put the last bit!
Write it as though you assume her dd will marry and only ever have one partner just as her mother believes she will but show the evidence that proved her dd is still at risk even so.
The last bit will def cause her to ignore the whole message!

I am in the same camp as your sis,I think.

We will encourage our DD to abstain from sex before marriage, though educate her about protection from STIs/pregnancy - giving her all the facts. I have no qualms about discussing these things openly with her already and she is only 10

BUT if ANYONE dared to question MY parenting decisions about not getting her vaccinated,i would be livid.

We're dealing with a 21 year old who has just had a 2.5cm malignant tumour plus her cervix plus the top of her vagina removed. It's called a radical tracelectomy. As teenagers go, I'd say she stayed in a lot more than most, she got drunk a lot less than most and as far as I know, she had only two boyfriends in the last three years.

So now we wait - for the next five years. That's literally true. If your cousin wants to avoid ever facing this exctrutiating process, I suggest the vacination is a very good idea.

Or perhaps just ask her if she wants to be a grandmother.

Why are you writing a letter rather than talking face to face?

Although I personally agree that girls should be vaccinated, I don't think it's your place to say.

I speak as someone who has had cervical cancer and know the trauma involved, but I still believe you have to respect other peoples choices and not interfere.

but its down to parental choice, and we assess risks & make choices all the time for our DCs, and they are often of vital importance - do we allow them out on their own/home alone/to ride a bike with no helmet/to do dangerous sports/ride with no seatbelt/ride funfair rides, go swimming in the sea etc etc

i cannot understand some parents decisions, but its their decision to make, and mine to make for my DD

actually - when the time comes and she is old enough, i think I will let her decide for herself.

Or you could point out that your niece could save herself for marriage, sleep with her husband on her wedding night and catch HPV then. Her wedding ring won't save her from cervical cancer.

If I was your cousin I would be highly unimpressed at receiving such a letter. And I type that as someone who has had LLETZ 3 times for CIN 3. No, scrap unimpressed; I would be furious with you for questioning MY parenting decisions.

presumably the parents also hope their DD will marry an inexperienced man, or at least someone who has been tested for STIs?

Kathy, I am sorry, you seem to speak from bitter experience. But we still all have to make our own decisions.

personally i think ANYONE who still smokes, or who drinks heavily, or does either of these while pg is mad - but they have freedom of choice

Yes PABH, every individual has freedom of choice, except the niece who must rely on the good sense or not of her parents.

I've watched a frightened girl being told that she might be very lucky and not need a hysterectomy. It's not something I ever want to do again. Parents have the chance to prevent it.

But I do think a letter is inappropriate. Surely this is a topic for face-to-face.

My cousin was a week off her 21st birthday and a virgin when she was diagnosed with cervical cancer and had to have surgery. I'd advise anyone to protect themselves as much as possible but again, think that it is better done face to face.

Preaching abstinence is a dreamer's folly.

The virus knows nothing about morals or religion, it just wants to live. Any girl who has sex once with any boy who has had sex once with any girl..... who has the virus, can develop cervical cancer. A woman who has not had sex before marriage (and I have never met one who claims this) is almost certainly marrying a man who has done it. Get your heads out of the sand and face facts.

You moralists need to take a good hard look at yourselves and make a realistic decision about a vaccination that might just save your daughter's lives.

Thanks for the replies.

My cousin posted on facebook that she was in dilemma and had not made up her mind, so I don't think that giving her my opinion is out of order. Also, I have made it clear that it is of course her deciscion to make as to what she decides for her daughter and I will not question her choice once she has made it.

I am sending her a letter - or rather email- as she lives abroad and that is our most common way of communicating.

I decided in the end to leave the last bit out- as she is equally vulnerable whether she has one or 50 partners so moral choices are really irrelevant.

Does the daughter want the vaccine? I think this is different across the country but when I had the HPV vaccine (catchup program) both the 16/17 year olds and the year 8s could over ride the parents wishes. I know several girls at my old school whose parents didn't consent for religious reasons but the daughters wanted the vaccine and were still allowed to have it done. Not that I'd recommend trying to get her to go behind her mothers back of course but if she actually wants it done I think she could get it.

If you want to try to convince your cousin I would do it face to face if possible rather than in a letter but tread carefully. i.e say you would want to get this done and why but if at any time your cousin tells you to butt out then do so. Its not worth a big argument over.

Write to your cousin's daughter. Our PCT has made it clear that it will take Gillick/Axon competence if a child wants it without their parents' consent, and I think this is a national position.

It's the daughter's body, not her mother's, and it's odd that people who believe that parents should be able to control their daughters' contraceptive choices are usually dismissed (there's a thread on this todayh), while those that deny their children other medical decisions are given more slack.

It's not enough for a woman to have only one sexual partner. That partner needs to in turn only have had one partner. It happens, but to punish your daughter with cancer having the temerity to marry a man who had had a one-night stand ten years earlier seems harsh.

I think you should ask her to identify exactly what she sees as the downside to having the vaccination.

I genuinely do not understand this allegedly religious opposition to a vaccination. having a vaccination is not having extra-marital sex. it's a vaccination. it bears no cost. it's not a sin. it could protect someone from a life-threatening disease. even if I thought extra-marital sex would send my daughter to hell and even if (perhaps especially if) I was, for some strange reason, utterly convinced she would remain of the same view, I would still consent to her having this vaccination.

obviously don;t rant like that! but perhaps ask her to think hard about what exactly it is that she sees as the downside to something that could save her daughter's life.

"I genuinely do not understand this allegedly religious opposition to a vaccination"

Religious nutcases think that women who have sex outside marriage are whores whose painful and premature death is to be welcomed. HPV reduces the risk of a painful and premature death. The nutcase mothers think that the painful death of their own daughters would be a fitting punishment for sex, and don't like anything that would stop it.

People who don't give their children HPV on risk grounds are probably wrong, but at least their position is rational - they do not want their daughters to die a painful death, rather than think the vaccine on offer has more risks than benefits. They no more want their children to die of cervical cancer than people who have strong views on other vaccinations want their children to die of infectious diseases: their argument is about relative risk. As I say, I think they're probably wrong, but they cannot be accused of wishing their children harm.

Religious nutcases, however, actively wish harm on their own children. They think a very nasty disease with fairly bad outcomes if not caught early is the sort of thing a loving God would do, and don't like the thought that there might not be enough cancer to go around if their daughter is sexually active.

I know that my cousin would not for one minute see cancer as a 'punishment' for her daughter having sex outside marriage. It is more that she believes that living healthily by eating a good diet, keeping fit, and avoiding over medicating where boosting the body's natural defences is an option. She sees guiding her daughter towards having sex only within marriage as an extension of protecting her mental, physical and spiritual well-being.

I have sent the email, but the decision is hers alone.

Unfortunately the body's natural defences aren't great at fighting cancer (or a multitude of other diseases). I hope your cousin makes the best (informed)decision for her daughter.

Unless you have been specifically asjked for your opinion, you have to stay out of it.

maybe here are some who think that stuff about punishment but I suspect they are a very small minority, even among thse who make religiously-based arguments against the vaccination, and that was not the kind of argument I was talking about.

anyway, Thistledew, I hope your cousin receives and reads your letter as being in the caring spirit it's intended, that she makes (what I, and you too obviously, believe to be) the right decision, and that everyone is happy! (but, remember, your cousin's daughter can, of course, chose to have the vaccine - perhaps when she's bit older). also - well done for putting your cousin's daughter's welfare above all the other considerations - like not offending your cousin, like your cousin's "right" to parent how she choses etc.