The HPV Vaccine Controversy | Shobha S Krishnan, MD

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Reviews: (Excerpts)

Shobha Krishnan's The HPV Vaccine Controversy is a welcome and much-needed book authored at a critical time….Krishnan's book does a masterful job of organizing the complex and expansive HPV literature into well-organized chapters discussing different aspects of the HPV field…. The HPV Vaccine Controversy is a superb book for any person who wants to be introduced to this fascinating field as well as for the more experienced clinician or health educator who wants to get a fresh and renewed perspective. This book is a much-needed reference source for parents who want more written information and explanations before making the decision as to whether to give the vaccine to their children as well as for concerned patients who have pressing questions and want full and detailed answers. This book is a terrific contribution, and individuals involved in the HPV field should be grateful for its publication.

                                                                                            The Journal of the American Medical Association

                                                                     JAMA, June, 2009; 301 (23):2504-2505.


One of the great strengths of the book is the author’s use of pedagogical techniques, such as “Myths and Facts” and “Key Facts” sections in each chapter…..The subtitle includes A Guide for Parents, Women, Men, and Teenagers. However, this book is also an excellent resource for health professionals; it is a fact-based and balanced approach to the HPV vaccine controversy and achieves her aim of having “the reader become well-informed and educated with the disease manifestations of HPV and the roles of the new vaccines.”

                                                                          Canadian Medical Association Journal, Oct 26th 2009



Planned Parenthood Review:

Shobha Krishnan…brings a fact-based, learned and level-headed approach to the many complexities surrounding HPV…Krishnan has the gift of making science accessible without dumbing it down, and of delivering factual medical information with a dose of compassion and humanity. (She takes time, for example, to devote an entire chapter to the psychological impact of an HPV diagnosis.) Most important and no doubt of most interest to readers, Krishnan carefully and diplomatically parses the current debate around the vaccine, addressing questions about whether or not it should be mandated and tackling the fears that it will “promote promiscuity.” This myth-busting, common-sense guide is suitable for everyone – from parents to young adults and even health-care providers.

Planned Parenthood review:



One may ask why there is a controversy about a vaccine that has the potential to reduce the incidence of the second most common cause of cancer death in women worldwide (cervical cancer). Dr Krishnan addresses this question from the standpoint of the knowledge of the safety and efficacy of this vaccine and the public's acceptance of the vaccine in 2008, 2 years after its approval by the US Food and Drug Administration (FDA)…Dr Krishnan does an outstanding job of explaining the HPV vaccine. Furthermore, she provides a superb discussion on counseling patients with HPV infections…This discussion can be a useful guide for the clinician who deals with patients with any STD…In summary, The HPV Vaccine Controversy is a useful guide for the clinician and for the lay public 4 years after FDA approval of the quadrivalent HPV vaccine


Nursing Ethics:

…much of Krishnan’s success in spreading the word about HPV lies in her method of delivery. Rather than projecting her own personal views on the reader, she objectively and sensitively presents the facts and allows her readers to formulate their own stance. Readers come away from The HPV vaccine controversy feeling passionately about what they can do to combat HPV, empowered to make informed health care decisions, and better equipped to advocate for patients...  Nursing Ethics, 17(3) 410–415, 2010


British Journal of Cancer:

Dr Krishnan provides a well-balanced view of the strengths and weaknesses of the currently available prophylactic HPV vaccines, including the need to continue screening efforts, and to avoid feelings of fear and guilt on the part of a woman when a HPV infection is detected during cervical cancer screening…British Journal of Cancer (2010) 102, 1312–1312.


This book by Shobha Krishnan comes at a time when everyone, medical professionals and laymen alike, need to be educated on all aspects of HPV infection so that they have a better understanding of the disease process….The book begins with the Controversy surrounding the HPV vaccine and the author discusses the various hurdles this medical breakthrough has witnessed, including resistance by the public on religious and moral grounds, and obstacles in the way of its implementation. The chapter on FAQs on HPV and the vaccines dwells on the lack of understanding of HPV and the vaccine amongst college students and emphasizes the need to raise public awareness. It also stresses that even if one gets vaccinated, it is crucial to take precautions, such as practicing safe sex, making healthy lifestyle choices and getting oneself screened. Finally, the chapter on Vaccines on the global front discusses the burden of cervical cancer worldwide. It argues that for the vaccine to be introduced in the developing world, cooperation will be required between various governmental and non-governmental agencies. The author states that focusing on women alone does not fully address the issue of HPV-related disease; men should be equal players in reducing the viral load in society. The book makes for good reading, and is thoroughly researched, handy and lucid in style. It will be useful to all those involved in the field of HPV, including those who make healthcare policies, as well as to parents, students and religious leaders. We congratulate Dr Krishnan for this constructive and valuable contribution to the medical literature.

                                                                          THE NATIONAL MEDICAL JOURNAL OF INDIA VOL. 22, NO. 5, 2009

American Journal of Nursing: The HPV Vaccine Controversy: Sex, Cancer, God, and Politics

By Shobha S. Krishnan. Westport, CT, Praeger Publishers.

This reasoned, in-depth discussion examines all sides of the human papillomavirus (HPV) vaccine controversy. Readers get the information they need to make an informed decision about vaccination. The book contains comprehensive information about HPV and the vaccine, including the risks and physical and emotional aspects, and a discussion from the parents’ perspective. This timely book uses information to defuse a volatile, emotional topic.

•Comprehensive, clear information

•Considers all aspects of the topic, adding a reasoned voice to the debate

• Invaluable for parents trying to make sense of conflicting information and reach an informed decision.


Although this book is billed for lay people I am sure adolescent health physicians and nurses will also find it very useful. It is an excellent, precise summary of the Human Papilloma Virus (HPV) and its role in cancer formation in the genital tract…The author handles the advice on the role of sexual behaviour, infection and prevention in a very well balanced way…even the men are included…I thoroughly recommend this book to everyone interested in sexual health especially as it relates to HPV. All clinics that see young people should have a copy of this brilliant book…

Dr Sue Bagshaw, Immediate Past President,

International Association of Adolescent Health

Krishnan, Shobha S.  The HPV vaccine controversy: sex, cancer, God, and politics: a guide for parents, women, men, and teenagers.  Praeger, 2008.  230p bibl index afp; ISBN 9780313350115, $39.95. Reviewed in 2009mar - Krishnan (Columbia Univ./Barnard) offers a well-written, easy-to-understand book that does a superb job of providing timely, relevant information regarding human papilloma virus (HPV). Chapters treat transmission, effects on the human body, prevention, and how the virus causes cancer. The author, both a gynecologist and family practice physician, does an outstanding job of explaining the controversy surrounding the vaccine, and has brought to light a rarely discussed issue: why males/boys are not mentioned in the vaccination plans, when according to the data cited HPV causes almost as many cancers in men as in women. The book also offers frank discussion of the HPV-related disease risks of homosexual behavior....this volume will be a very valuable acquisition for public, two-year community college, four-year university/college, and consumer health libraries. Summing Up: Highly recommended. Lower-level undergraduates and general readers. –

                                                                     CHOICE- American Library Association


The HPV Vaccine Controversy: Sex, Cancer, God and Politics by Shobha Krishnan, MD is a guide for parents, women, men and teenagers, but is also an excellent reference for clinicians and researchers… The frequently asked questions chapter …this excellent inclusion to the book provides readers with straight answers to common questions about HPV infection and the vaccine. It may provide clinicians with answers to some of the toughest questions fielded in the office… In the following chapter, Dr. Krishnan proposes her argument as a mother and clinician for why she believes young women should receive the HPV vaccine. This open thought process incorporates the facts previously presented in the book and weighs opposing arguments to come to this final conclusion…The final chapter considers HPV vaccine a necessary chapter…Each chapter ends with key facts; bulleted, important points from the chapter, helping readers retain the subject matter, while also allowing for a quick skim of the book for clinicians. The glossary, index, and chapter categorized reference sections are excellent….excellent and timely book …well organized and written….should become a valuable reference for those interested in HPV.

                                                    Journal of Lower Genital Tract Disease- A journal of the American Society for Colposcopy and Cervical Pathology- 14(1):68-69, January 2010.


Recommended for academic/medical libraries and comprehensive collections at public libraries....Gynecologist Krishnan (Barnard Coll. Heath Svcs., Columbia Univ.) provides admirable and balanced coverage of the controversy and science involved. She discusses her own decision to have her daughter vaccinated and whether or not she believes it promotes promiscuity.

                                                                     Library Journal Xpress Sept. 9, 2008


This book offers a thorough discussion about a single topic - the Human Papilloma Virus (HPV) vaccine. In the author's note, Dr. Krishnan acknowledges the ethical dilemmas inherent in the recommendation for HPV vaccine. She applies various ethical doctrines in a discussion specific to the HPV vaccine controversy. Her stated goal in writing the book is not to generate a recommendation, but to introduce all sides of the story. Here, a teenage girl and her parent could find the answers to nearly every conceivable concern they might have about the vaccine. For providers of primary care who advise about and administer the HPV vaccine, there is a wealth of information to share and discuss with patients and their families. Patient education is essential in addressing HPV and all other sexually transmitted infections (STI). Dr. Krishnan's book provides for health care professionals an education in depth and a caring, measured approach regarding the art of communication about HPV vaccination, in particular, and about sexual activity in teenagers, in general. Well written and extensively referenced, this book would be a valuable addition to the library of any provider of general pediatrics or adolescent medicine, or those working in the field of public health.

                         International Journal of Adolescent Medicine and Health: 2009; 21(4):00-00

Shobha Krishnan, MD, author of The HPV Vaccine Controversy, has a great background for tackling a subject as complex as human papillomavirus (HPV), The vaccine controversy portion of the title is well covered in several chapters of the book; the author is empathetic to the parents and patients; dilemmas surrounding these difficult decisions, presents adequate details on both sides of an issue,..Health educators purchasing this book will probably dog-ear the chapter on Frequently Asked Questions on HPV and the Vaccines; Many college health practitioners will also find useful the patient questionnaire that gauges a person's emotional impact after being diagnosed with HPV disease. It is a great resource for college health professionals facing these types of questions on a regular basis. The final chapter presents an outstanding global view of the issues associated with diagnosing and preventing cervical cancer in parts of the world with socioeconomic inequalities. In summary, this is a great book for anyone dealing with sexuality issues, as well as who wants to know more detailed information about HPV and its vaccine.

                                                                     Journal of American College Health

                                                                     Vol 57, No. 5 / March - April 2009


The goal of this book is to better answer questions and concerns of parents, providers, and patients (both young and the more mature)… inform readers on the disease manifestations of HPV and the role of vaccine therapy. The author also wishes to address issues that have been raised in an attempt to empower women. The book is impressive in the vast area covered, the questions answered, and the controversies raised. The author provides an unbiased view and is honest about what we don't know. The key facts at the end of each chapter help identify the take-home points, and the glossary and figures help emphasize pertinent information….
 It attempts to provide a complete source of information without directing patients and parents to multiple sources and sites. It covers just about everything patients and parents want to know


                                                                     Doody Reviews, July 3rd, 2009


A gynecologist, family physician and mother, Dr. Krishnan delves into the pros, cons, misconceptions and legislative controversy surrounding the HPV vaccine in her new book. This up-to-date guide provides a wealth of information for readers who are unsure about the vaccine

                                                                        2008 Women's Cancer Handbook


This book is packed full of information. It should be a tool for parents and for health classes in high school, as to teach all teenagers the dangers of sexually transmitted diseases / infections and to also encourage both parents and teenagers to be open and honest in regards to their sexual activity. This book contains so much needed information, from the cause to the treatment, and also the vaccine itself…This book also delves into the vaccine aspects for both males and females. This book contains much needed information and also gives references and Internet resources. This book is easy for the layman to understand, and also contains a glossary.

                                                                     qualitybookreviews.wordpress, Sept. 2008


If you care about your health, you must read this book. The HPV Vaccine Controversy: Sex, Cancer, God, and Politics. Shobha S. Krishnan, M.D. gives you practical, jargon-free information about one of the most widely spread sexually transmitted diseases--Human Papilloma Virus (HPV)….But rather than frighten the reader with facts and statistics, Krishnan uses a conversational tone that provides information to make decisions about having an annual gynecological exam, gives parents assistance in deciding whether or not to have their daughters immunized, and leaves the reader feeling confidently informed of the nature of this virus and how she can protect herself from its effects…. Men also need to read this book…. this book includes information on topics including sex, cancer, religious beliefs, politics, the emotional impact of the HPV diagnosis….



Dr. Krishnan provides the reader with a frank and honest presentation of the facts about HPV, the consequences and the choices for preventative health care. Good health care is about making informed decisions. Before taking a side on the HPV Vaccine issue, get the facts; read The HPV Vaccine Controversy. It is an excellent, informative resource for laymen and health care professionals.

                                                                     Public Healthcare Issues, Sept. 30, 2008. 


Finally, there is a book that covers the often contentious debate surrounding HPV vaccinations for teenagers in a thorough and objective way. Leaving no stone unturned, The HPV Vaccine Controversy…makes a compelling case for why preteens and teens should be vaccinated ...Krishnan writes in an understanding way that addresses the concerns of reluctant parents and even politicians alike. Kudos for a job well done

-Toni Weschler, MPA, Author of Taking Charge of your Fertility and Cycle Savvy: The Smart Teen's Guide to the Mysteries of Her Body

 A very thorough, insightful and informative book on the subject of HPV and cancer, while taking into account the questions and fears of parents … Charts are used to further breakdown the subject into bite-sized bits that don't overwhelm. There is a question and answer section taken from a clinic she held for college students….To date, THE HPV VACCINE CONTROVERSY is the most comprehensive guide that I have seen on the subject. Krishnan addresses all the controversies, making this book one of those valuable tools that could help in understanding the overwhelming tug-of-war concerning the vaccine. Krishnan's method of filtering out the vast amount of information can help young women and their parents learn about the HPV virus, and hopefully make informed decisions.                                                                    



S. Krishnan, author of The HPV Vaccine Controversy: Sex, Cancer, God, and Politics speaks to the subject of this exciting and groundbreaking work ...She took it upon herself to compile an accurate and intensive report of all the research we have so far. She includes tables on the current legislation in each state, information on the progression of vaccines in other countries, and extensive FAQs. It is currently the only book available on the subject, but Dr. Krishnan pulls more than enough weight for an entire library. Her expertise is invaluable on the weighty subject of HPV vaccines, and she holds nothing back in her work.


Dr. Shobha S. Krishnan's speaks to us more than as a gynecologist and family physician; she is the mother of a young daughter. She wants to educate and inform us and hopefully prepare us for the next round of discussion when we are faced with vaccines for other sexually transmitted diseases. Will The HPV Vaccine Controversy give you enough information to make an informed decision? That is entirely up to you and would say this is one book that shouldn't be passed up. I would say read it and learn all you can to make a better informed decision one way or the other on whether or not to vaccinate your daughter for HPV.



Excerpt-A comprehensive new book, The HPV Vaccine Controversy, by Shobha S. Krishnan, M.D., provides a well-documented, readable guidebook to HPV that covers everything from sex to science to politics and religion. One particularly compelling section details the author's own deliberations as mother to a young daughter, reviewing factors that any parent should consider before vaccinating a daughter-By Edward C. Geehr, M.D., LifeScript Chief Medical Officer

 Excellent reading with much needed information for parents to navigate and make up their own minds. The book covers crucial areas that typically confuse parents- it was quite clear to me that the vaccine would do more good than bad after reading the book. The author maintains an objective stance throughout the book while dissecting the issues very well.


An interesting book that I specifically read to help me decide whether or not this vaccine is something that I should consider for my 12 year old daughter.  After reading the various pro's and con's, which is portrayed in this well written book, I now feel like I have enough of an understanding to be able to talk with my daughter's primary care physician and not get lost in the doctor-speak that I might not have understood prior to reading Dr. Shobha's book. I seriously recommend this book for all parents considering whether or not your child may benefit from this relatively 'new' immunization. ~ VW



Book Review: Krishnan, Shobha S. The HPV Vaccine Controversy: Sex, Cancer, God, and Politics: A Guide for Parents, Women, Men, and Teenagers. Westport, 2008. Greenwood eBooks.
In The HPV Vaccine Controversy, Shobha Krishnan covers quite a bit of ground. At the very beginning, she reminds the reader that this book is a reference guide for Parents, Doctors and Teenagers… is well-researched, well-presented and well-covered. The book covers three main areas: What HPV is, who it's for and what should be done about it…The book is a good resource and recommended for those parents and caregivers of young girls (and boys) who are concerned about HPV.

                                                                     Brick O Neal

I HIGHLY suggest reading this book if you have daughters in your household. And I STRONGLY suggest reading it if you have sons. The book focuses not only on the vaccine itself but also spends a great deal of time discussing what HPV is, it's many manifestations, and how it affects both women AND men.

  Nine out of ten people will want to pick up a book that has the words 'Sex', 'Cancer', 'God', 'Politics' and 'Controversy' on its front wrapper. But these aren't terms of enticement for this 230-page hardcover. Dr. Shobha S.Krishnan's book is about the Human Papillomavirus (HPV) vaccine and the questions surrounding it. To every Indian engaging in sex (hey, we're a nation of one billion!) the book is necessary education…. Dr. Shobha's book brings us those "simple, essential things" that we don't know and will never ask — prevention, symptoms and treatment. …In a rapidly changing society with nil public debate on new vaccines, an independent, up-to-date, non-pharma evaluation of a vaccine is a fortunate happening. If parents and paediatricians make a medical choice, shouldn't they be sure it is an informed one? Dr. Shobha's reader-friendly book, with its wide index, could be the first important step towards it.

                                                                      The Hindu -India




Upcoming reviews:

Journal of Pediatric and Adolescent Gynecology       

International Journal of STD and AIDS

Journal of The American Academy of Dermatology

American Journal of Sexuality Education

International Journal of Nursing Ethics

Indian Journal of Medical Ethics