The HPV vaccine story has gotten all tangled up.
As recently as June 8, 2006, public health advocates, progressives and many parents were celebrating a huge victory: The Food and Drug Administration had approved Merck’s new vaccine Gardasil, a shot series that would help protect girls from cervical cancer and genital warts. To their continuing delight, the Centers for Disease Control’s immunization committee recommended less than a month later that the shots immediately be given to all females between the ages of 9 and 26. The committee acted on persuasive data indicating that the vaccine, which prevents the sexually transmitted human papillomavirus (HPV), works best before girls are sexually active.
Human papillomavirus is the most common sexually transmitted infection in the world, and most women have had it– 80 percent of US women, by the CDC’s estimates. Often it goes away on its own, without its carrier’s awareness. But each year hundreds of thousands of women and girls in the United States develop persistent infections from it, more than 10,000 get cervical cancer and 3,700 die from the cancer.
Gardasil, given in a series of three shots, protects against four strains of HPV. Two of those strains cause 70 percent of the nation’s cervical cancer cases, and two of them cause 90 percent of genital warts. This new vaccine, widely given, has the potential to make cervical cancer almost obsolete here.
All good news, right?
Today, as thirty-one state legislatures consider mandating the vaccine for middle school girls, skepticism about the wisdom of embarking on this swift and widespread inoculation program has bubbled up from critics who span the political spectrum. These strange bedfellows include Christian conservatives and their abstinence-only ilk, who have long argued that safe sex encourages profligate sex; a slew of Big Pharma critics, who see how Merck (which stands to make $4 billion a year on the vaccine by most estimates) is angling to corner this huge new vaccine market; the growing antivaccine movement, which objects to all such school-entry requirements; the parental-rights folks with a libertarian strain, who bridle at any mandates regarding their children’s health; and a smattering of women’s health advocates, who worry that the pace of the vaccine’s introduction is jeopardizing its ultimate success.
What’s all the noise about?
Some of it is predictable and comes from the usual quarters. Cultural conservatives and abstinence-only hardliners have been trotting out familiar arguments: Safe sex leads to more sex, they insist. Conservative California State Senator George Runner told the Los Angeles Times recently that he objected to this immunization because the disease was a result of lifestyle decisions, as opposed to contagion. He wondered: “Is there a more productive way for us to spend the money that may help someone who’s in a health situation that has nothing to do with their personal choices? Where do you want to focus your resources?” Conveniently avoiding any logical extension of his argument to lifestyle decisions like, say, smoking, Runner and his allies insist Americans have to distinguish between the deserving and the undeserving ill.