Untangling the HPV Vaccine Debate

Untangling the HPV Vaccine Debate

Rick Perry got something right, Michele Bachmann is all wrong, but we all need to think harder about whether the HPV vaccine should be mandatory.


Should schoolchildren be required to receive the three-course vaccination against HPV, the sexually transmitted infection that causes 12,000 cases of cervical cancer each year? Michele Bachmann has made the issue a major line of attack against Texas Governor Rick Perry, who signed a 2007 executive order requiring female public school students to receive the vaccine before they enter the sixth grade. (Texas parents have the right to opt their child out of the vaccine.) “I’m a mom of three children. And to have innocent little 12-year-old girls be forced to have a government injection through an executive order is just flat-out wrong,” Bachmann said at Monday night’s GOP debate. “That should never be done…. Little girls who have a negative reaction to this potentially dangerous drug don’t get a mulligan. They don’t get a do- over.”

In the wake of the debate, Bachmann has given several TV interviews in which she makes the claim—totally contrary to medical evidence—that the HPV vaccine causes mental retardation.

This type of misinformation is dangerous. Cervical cancer is known as a “silent killer” because in its early stages, it is typically symptomless. That’s why women are advised to undergo regular gynecological exams and pap smears to screen for HPV: If they do not get regular check-ups, the cancer may be discovered at too late of a stage to treat it effectively. For this reason, the disease is closely associated with poverty and lack of health insurance. What’s more, treatment of HPV and cervical cancer, which can include scraping of the vaginal walls and hysterectomy, can be very painful.

So Rick Perry was absolutely right on Monday when he said, “What was driving me was, obviously, making a difference about young people’s lives. Cervical cancer is a horrible way to die.”

It’s important to point out, however, that as uninformed as Bachmann’s critique of Perry has been, there is no broad consensus on whether HPV vaccination should be mandatory. In 2007, for example, the New York chapter of the American College of Obstreticians and Gynocologists (ACOG) came out in support of a state vaccination requirement for school enrollment. But in August 2008, after the Bush administration required the vaccine for young immigrant women seeking green cards, a coalition of health care, feminist, and immigrants’ rights organizations—including the national ACOG, the National Latina Institute for Reproductive Health, and the National Asian Pacific American Women’s Forum—opposed the move. “Prospective immigrant women should have the same opportunity as American women to make an informed decision about whether or not to be vaccinated against HPV,” ACOG stated. In November 2009, the CDC and Department of Health and Human Services, then under the control of the Obama administration, reversed the policy.

Last year, the national ACOG recommended the HPV vaccination for all girls and young women between the ages of 9 and 26. About twenty states now require vaccination for school enrollment, although in legislatures, the topic continues to be a contentious one. On both the left and the right, there is concern over the profit-motives of Merck, the company that manufactures Gardasil, the most common HPV vaccine. Vaccination conspiracy theories are unfortunately quite popular across the political spectrum, in part because of celebrities who have embraced the debunked claims that childhood vaccinations cause autism. And social conservatives argue that innoculating young girls against a sexually transmitted infection somehow condones sexual activity and promiscuity, and that school enrollment requirements, even with an opt-out, violate “parental rights.”

A reality check: more than 95 percent of Americans have premarital sex, and more than 50 percent of sexually active Americans contract HPV at some point in thier lives. The disease can cause genital warts in men, and a small percentage of affected women will develop cervical cancer.

The HPV vaccine is also FDA-approved for boys and men, and I happen to believe that the best way to fight cervical cancer would be to encourage both girls and boys to undergo vaccination; after all, innoculation is most effective when it occurs throughout the population. That said, schools and medical professionals need to do a better job of providing parents with accessible, accurate information about vaccination. In the absense of such public outreach efforts, we let Michele Bachmann frame the debate, and conspiracy theories fester.

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