Whitney Sienko McInnis December 6, 2007 “HPV Vaccine Controversy” The recent news of a vaccine that could prevent a large percent of cancer deaths in the United States alone would generally be considered a reason to celebrate. However, the current attempts of many states, including the governor of Texas, Rick Perry, to pass an ordinance making it mandatory for preteen girls to have the Gardasil vaccine to protect them from some of the forms of cervical cancer caused by HPV has met a great deal of opposition.
The objections to this legislation getting passed are primarily voiced by concerned parents who believe that the vaccination is too new to the market and that the long term effects are still too unknown.. This essay will discuss what genital HPV is and how it causes cancer in women, will describe the Gardasil shot and the attempts to make it a mandatory vaccine inoculation for schools in the United States and will detail both sides of the controversy surrounding it.
Though the benefits of this vaccine could greatly outweigh the risks, the governor attempting to force a mandate requiring the vaccine to be given to all sixth grade girls could be considered an imposition on parents’ right to choose what is best for their children. Genital HPV is a sexually transmitted disease that is caused by the human papillomavirus (“Genital HPV Infection“), a group of viruses that contains more than 100 strains, 30 of which are sexually transmitted.
This disease is spread by genital contact, and the carrier generally has no signs or symptoms of the infection. The only way to fully protect oneself from contracting HPV is to have no genital contact with another person. That is why it is no surprise that more than 20 million people currently have this infection and that 50 percent of sexually active persons will contract it at some point in their life. There is no cure for HPV, but it is possible for the infection to go away on its own.
Though it is usually an asymptomatic infection, it occasionally causes genital warts and mild discomfort, but the greatest danger of this infection is in the ten identified strains that have been linked to cervical cancer in women. Most of the deaths caused by cervical cancer are in women who did not undergo routine pap smears to check for abnormalities. Since persons infected with HPV rarely show any signs or symptoms of an infection, it is often detected too late if at all.
It is estimated by the American Cancer Society that in 2007, approximately 11,150 cases of invasive cervical cancer will be diagnosed in the United States, and, though the death rate is declining every year because of an increase in pap smear testing, cervical cancer will still kill about 3,670 women this year (“What is cervical cancer? ”). Development of a vaccine to protect against HPV began in 1993, and the trials for the Gardasil vaccine itself began in 1997.
After only nine years of testing, Merck submitted an application to the FDA for fast-track approval (CQ Researcher 419). It took only four clinical trials before the FDA approved Gardasil (Mendenhall), and the drug was approved by the FDA for only eight months before it was first mandated. Gardasil is used to prevent HPV and the cervical cancers that are caused by certain strains of the virus, such as types 16 and 18 which are responsible for about 70 percent of all cervical cancers diagnosed in the United States (McClain).
It also protects against two of the strains that are known to cause genital warts. Gardasil was licensed in June 2006, and within a month states such as Michigan were already proposing to mandate the vaccine for girls as young as eleven. In February 2007, Texas governor Rick Perry ordered the vaccine for sixth-grade girls (“Texas Plans for Mandatory HPV Vaccine Fuel Controversy” ), only to have more than two-thirds of the Texas House of Representatives vote to rescind the executive order (Lang).
In response to the twenty two states that were proposing to mandate this vaccine, Representative Paul Gingrey from Georgia reintroduced the Parental Right to Decide Protection Act (CQ Researcher 419). There are many reasons that this vaccine could be beneficial, not only to our society, but to many of the underdeveloped nations of the world in which HPV and cervical cancer are still considered to be an epidemic (MacDonald). It could save the young women who get the vaccine from the future trouble of ealing with a highly invasive cancer, as well as protect them from the embarrassment that comes with contracting a venereal disease. However, the controversy of this topic is not in whether the vaccine is a benefit to women’s health, which many, including the FDA and the Centers for Disease Control, believe that it is; but in the debate over whether it is the parents’ right, not the states’, to choose what is best for their child. The question of mandatory vaccination raises medical, moral and legal issues that are not easily reconcilable (Lovinger).
Many parents are opposed to the mandating of this vaccine for three reasons. First, HPV is not spread by casual contact, as are the other diseases that children are vaccinated against for the safety of the classrooms. Second, the vaccine has only been approved for a short while, thus not all of the side effects and long term effects are known. Last, parents are afraid that by getting their child vaccinated against a sexually transmitted disease they will be encouraging promiscuity.
Gardasil would become the first vaccine mandated for school-aged children that targets a microbe spread primarily through sex. (Wallis) Many have questioned whether an STD vaccine should be required for school attendance, since genital HPV is sexually transmitted as opposed to being spread by casual contact. Whooping cough, polio, Hepatitis and measles are just a few of the vaccines that children must already have in order to attend many public schools, and all of these infections are easily spread either by being in contact or close proximity of someone who is infected (CQ Researcher 415).
These infections are all rapidly spread and have the possibility of becoming an epidemic at a school, which is the reason that it is necessary for children to have them. You cannot get genital HPV by shaking hands or sitting next to another child in class, so there is insufficient reason for the vaccine to be mandatory for school attendance (CQ Researcher 416). If parents’ would like to willingly give their daughter the shot, then it is a family choice. Also, there is still much uncertainty about the inoculation’s long-term safety and the possibility of dangerous side effects.
While the most common complaint by girls that have received the shot is pain at the site of injection, a national watchdog group using the Freedom of Information Act has uncovered more than 1,600 reports to the FDA of “adverse events” linked to Gardasil, with 371 of those events being ranked as “serious”. These “effects” included three deaths from blood clots and heart problems, which Merck was quick to explain away by blaming birth control pills and pre-existing conditions. Other reactions included paralysis, seizures and fainting (McClain). There has also been some debate on the means in which the trials to test the drug were conducted.
The clinical studies done only included 1,200 girls under the age of 16. Barbara Loe Fisher, co-founder and president of the National Vaccine Information Center is concerned about these studies as well and she stated, “That is just not enough information. What is the scientific evidence that it is safe and effective to use in the age group for which it is recommended? If you look at it on balance, it has not been proven. ” Diane Harper, director of the Gynecological Cancer Prevention Researcher Group at Dartmouth Medical School called the inoculations “a great big public health experiment. Many parents are upset at the thought of their children becoming the “guinea pigs” for this vaccine and are concerned about the many stories that they have heard or read in the news about the possible long-term effects and the side effects that may not be mentioned on the pamphlets at the doctor’s offices (Gulli, George and Intini). Finally, many parents are concerned that they will be sending the wrong message to their children by giving them a shot to protect against an STD.
Some people have raised the issue that we could be sending teenagers the message that we expect them to be sexually active. A study done by the University of North Carolina showed that one in ten parents was concerned that the vaccination would encourage their children to have more sex (“Will Teenage Girls Have More Sex? ”). Though the abstinence based teaching of sexual education in our country falls many times on the deaf ears of the hormone-run youth of society, forcing every student, even those who may not be at risk, to have the Gardasil shot is somewhat extreme.
Overall, this is a decision that needs to be made in the home, not in the courtroom. In conclusion, the controversy surrounding this topic is more a battle of family right to choose verses the state government’s level of involvement in the health of our children. Once the vaccine’s long term effects have been more studied and the vaccine has earned a more respected reputation, I believe that people will grow to accept that it is simply another way to protect those that we love from a devastating disease.
However, it should be the decision of the parents in cooperation with their child’s physician of when and how to protect our children from such obstacles in life. Though the Gardasil vaccine is a victory in protecting the lives and bodies of women all around the world, forcing nine year old girls to have the Gardasil shot as an obligation to school attendance is overstepping the boundaries between a family’s choice and the will of an unacceptably paternalistic government. Word Count: 1678 Sienko
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