Tuesday, February 20, 2007

More thoughts on the HPV vaccine debacle

Here's an account of an attempt to put a human face on this saga from the Fort Bend Herald:

Every three months, Amanda Vail will relive her rape as she undergoes another pap smear to check for cervical cancer.The man who attacked her in December gave her a virulent strain of the human papillomavirus, or HPV. Vail's doctor told her she has up to a 70 percent chance of developing cancer.

At a Monday night hearing, she urged lawmakers to spare other young women from the same fate and kill a bill that would override Gov. Rick Perry's anti-cancer vaccine mandate.‘‘I would not have to be repeatedly violated had I been vaccinated,'' said Vail, a 29-year-old graduate student from Houston. ‘‘That option wasn't available to me, and it is now available to these young women.''

This is sort of what I have been trying to get at on this issue. Not all sex is voluntary (to put it in highly inappropriately casual terms), and not even all consensual sex occurs with all facts out on the table. Even seemingly monogamous married couples have the risk of bringing HPV in from earlier in life. But that is not really the argument opponents seem to be making. I will leave the argument related to the vaccine's expense alone, because that actually has some validity (it also requires balancing the vaccine's approximate $360/dose cost against the cost to taxpayers of caring for cancer and STD patients, which requires more arithmetic than I care to do at the moment and will inevitably lead me into a rant against pharmaceutical companies.) My beef is with the argument about parents' rights et al--the argument that mandating a vaccine compromises parents' rights to raise children as they see fit. Never mind that any parent may opt out of having their child vaccinated; all children must be denied the vaccine to protect the rights of some parents to withhold information about the birds and bees from their children (presumably until their wedding nights).

Conservatives oppose the vaccine requirement because they believe it contradicts Texas' abstinence-only sex education policies and strays too far into families' lives. Others have balked at the $360 cost for the three-shot series and questioned the vaccine's efficacy and safety.
There have been good arguments made pointing to doubts about the vaccine's safety/efficacy, to be sure. The "family's rights" argument is always the one trotted out first, though, as near as I can tell, and it just doesn't make any sense to me. Do conservatives oppose checking children for scoliosis in schools because it impacts parents' control over their children's spines? Okay, that is a silly hypothetical, but think about the principle--parents are asserting a right to raise their children as they see fit (fine) and to guide the moral development of their children (also fine) in ways that affect public health (maybe not so okay). This vaccine guards against one STD, so it is hardly a license to throw caution to the wind. I suspect that this quote may more accurately reflect a major objection (and I do sincerely hope there is context lacking here):
Robert Morrow, a small government activist from Austin, said he's offended that Perry would want to spend taxpayer money to interfere with parents' rights. ‘‘I do not think the state of Texas should be in the business of preventative health care for teenage sluts,'' Morrow said.

Wait, who is the slut in his assessment? I do not want to go where his statement inevitably leads, but someone has to--is he calling rape victims sluts? Or people who engage in sexual activity without access to all of the facts because their parents and state government decided that simply telling kids not to have sex would be enough? I don't know. I do know that framing an argument against the vaccine as an argument against "sluttiness" is just disappointing. Pop quiz: How many times do you have to have sex to get HPV or any other STD? Answer: Once.

Is someone who has sex once automatically a slut? Honestly?

You want to argue about the cost? That is fair.

Are you concerned about the adequacy of testing prior to bringing the vaccine to market? Good point.

Do you have libertarian objections to government-mandated vaccinations in general? No problem.

Do you have problems with the way the drug is being marketed? I'm inclined to agree with you there.

Is there evidence of some sort of crony link between Rick Perry and the drug's manufacturer? Let's see it.

These are valid arguments, and most likely valid objections, but they do not appear to be the main objection. This debate is not about cost, nor is it about libertarian principles of small government. HPV is a very effective scare tactic to promote abstinence, and now there is a danger that the scare tactic is not as scary as we thought. Given the general tendency to oppose sex education in nearly any form, it would be a pretty important loss.

This is a fight to protect rhetoric, that's all.

1 comment:

Charles Hueter said...

Dear Dr. (Mr.? Mrs.?) Cryptic,

Thanks for linking to my website regarding libertarian objections to state-mandated vaccinations. I write in regards to the "$360/dose cost" link you have in your post. Unfortunately, it appears to be busted. You may want to recode that so it works.