dotCommonweal

A blog by the magazine's editors and contributors

.

More on HPV

The new Texas law requiring girls to be immunized against viruses that cause cervical cancer reminded me of parents' orientation day at my son's Catholic school, when a large number of moms asked for forms allowing them to waive their children's vaccinations "for pro-life reasons."

This was news to me, but Right to Life of Michigan's Web site claims that some vaccines were developed with cell lines that originated with aborted babies. RTL's site notes that Church leaders declared receiving the vaccines morally permissible.

RTL also offers a list of non-fetal vaccines available, and I'll take that list with me to see if those are offered by our doctor when my son is up for his next round of boosters. I'll ask him to consider using those vaccines if they're not. But either way, I'll have my son vaccinated. Not to do so strikes me as endangering his health and that of other kids.

Which leads us to the Texas law that requires vaccination.

Tony Perkins and his ilk (see Cathleen Kaveny's post below) are all too predictably ranting about the vaccine's potential to lure kids into premarital sex. The "logic" of their argument is that having the vaccine could confuse kids into thinking they're protected against all STDs. All of which completely ignores the fact that parents have an obligation to provide clear moral guidelnes and health information to their children. Opposing the Texas law on the basis that it might encourage a teen to have sex implies to me that some parents are copping out on this obligation.

Moreover, the vaccine may protect girls and women against viruses that might be passed on by a sexual assailant or a philandering husband (or wife if the vaccination proves effective for boys, too).

Nonetheless, I think there are reasons a prudent parent might want to proceed with caution, but those reasons are not at the forefront of this debate--or at least the coverage of it.

I want to know, for example, how the vaccine was developed. RTL doesn't have info on its Web site yet.

I also want to know what the short- and long-term side effects of the HPV might be. Since my son was diagnosed with allergic asthma and ADD, two medications he has taken have been slapped with warnings, Advair and allergy meds containing phenylpropanolamine. We also use old-fashioned, low-dose Ritalin for ADD because the newer ADD drugs simply haven't been on the market long enough for long-term side-effects to have been assessed.

I'm also concerned, though this is unrelated to the efficacy of HPV, that the Texas law was, at least in part, rammed through with help from the vaccine manufacturer. This represents a new level in direct-to-consumer marketing that drug companies have found so effective; instead of creating a need for the drug through TV ads, let's just mandate it. Never mind that the vaccine isn't cheap for parents without health care--the HPV series of three, $120 shots could pose a hardship.

To allow fundamentalists like Perkins to co-opt the discussion over HPV does a disservice to parents trying to make wise decisions for their kids.

Comments

Commenting Guidelines

Jean, I do know that this vaccine was developed by researchers at the University of Louisville.

See Arthur Allen bookhttp://www.vaccinecontroversy.com/mt/for good background on anti-vaccine story. In autismland fear of vaccinations has become huge distraction: a bit of historical perspective comes in handy when folks are prone to view their situations as wholly unique (I wonder how many of those Michigan moms are using the religious exemption as way around fears linked to autism-vaccination causation theory though these kids are presumably well past age of onset).

Allen's own website offers some thoughtful commentary on vaccination.http://www.vaccinecontroversy.com/mt/2006/12/how_to_think_ab.html

I don't think this vaccine should be mandatory so quickly, however, it is important to note that vaccine politics, if that's what you want to call them, often are really about "rewarding" drug companies for being willing to develop vaccines. This is one reason the CDC errs on the side of recommending universal vaccination -- in order to ensure that drug companies see vaccination as an economically feasible enterprise. Now that blockbuster drugs of other kinds are getting harder to find, perhaps companies don't need such dramatic incentives, but over the last decade, vaccine research has clearly declined.And while we're at it, we should always evaluate universal vaccination with the understanding that the people who benefit the most from vaccination are those who are least well-served by our health care system: those who lack access or means to obtain yearly pap smears (because they are uninsured or just can't take off work to get them) -- and more than likely they can't afford the vaccine unless it is subsidized by the state, which the state is unlikely to do unless the vaccine is mandatory. Just thought you might like to understand how, yet again, our inegalitarian health care system screws up our public health priorities.

There certainly are a lot of different issues attached to the HPV vaccine. A vaccine that prevents cancer should be cause for great celebration and yet that's hardly the case. The information offered by the media about the HPV vaccine has been sketchy and at times misleading. It is very easy to watch the Gardasil commercials and get the impression that now there is a vaccine that will prevent cervical cancer. But while there is truth to that, it's not the whole truth. The CDC Web site, on the other hand, is very informative about the vaccine, both pro and con. http://www.cdc.gov/std/hpv/STDFact-HPV-vaccine.htmA very big pro is that the HPV vaccine immunizes against 4 HPVs which are responsible for 70% of cases of cervical cancer that are undetectable by a pap screen. But that doesn't mean pap screens are now obsolete, a pap screen is still necessary for the other types of HPVs that account for the remaining 30% of cases of cervical cancer. One of several cons is the relatively small age window of viable candidates for the HPV vaccine. It is FDA approved for females ages 9 to 26, and it's most effective if administered to individuals who have never been sexually active, because it is sexual activity that introduces the HPVs into the system. (Research as to whether women after the age of 26 can be effectively immunized is in the planning stages.) Also, it's unknown whether booster shots will be required, meaning the creators of the vaccine don't really know how long it will be effective; and there is insufficient data on whether there are any long-term side effects that have yet to be detected. These are big cons indeed and need to be addressed before the vaccine is released into mandated use.The reality is that of the 10,000 women who are diagnosed with cervical cancer annually in the United States 4,000 die. Most women who are diagnosed haven't had a pap screen for 5 or more years, and poor women are the majority of those who die from cervical cancer largely because they are less like to receive annual pap screen, or have the necessary treatment in the event of testing positive. A vaccine to immunize against cancer is surely preferable to an annual screen to determine whether one already has cancer. I hope the HPV vaccine will become as common and predictable and effective as the measles vaccine. And based on what I'm reading, I feel cautiously optimistic that it will happen. Eventually. But not yet, because there are still many questions that must be answered so that when the vaccine is administered, it is done safely and to the good of the recipients as opposed to the good of big Pharmaceutical, who just might have its own profit-making agenda.

But the lack of data on vaccine durability is true for any newly introduced vaccine. We simply can't know how long it will last until it has been used for several decades or more. However, the flipside to the issue of continued vaccine effectiveness is that it matters less when immunization is universal because a lot fewer people will ever be exposed over their lifetime.