Autumn: The HPV Vaccine and a Rousing Game of Political Football

I went to see “Contagion” last weekend, a film about a fast-moving airborne virus that kills within days and voraciously chews at the edges of the social fabric. After the movie the prevailing comment in my group was that it was “simple”. It didn’t follow, in other words, the formula of some of the other pandemic disaster flicks we’ve seen – no zombies, no aliens, no ridiculous plot premises. Indeed, in an interview with Movies Online, director Steven Soderberg discussed that it was “the right time for an ultra-realistic movie about this subject.” Much of the film examines the role of the government in managing such a crisis. Against a contemporary backdrop of the anti-government Tea Party movement in the U.S., Soderberg considers the problems of the Federal bureaucracy: 50 different state health policies, cronyism, social media pressures, quarantines, curfews, law enforcement and the inevitable main character in all epidemic films – the vaccine.

Vaccines are a controversial subject in this country. We love ‘em and we hate ‘em. Certainly in a crisis like the one in “Contagion” all eyes would be on the government to develop a vaccine to stop the virus. But outside of an emergency situation we have the luxury of time in which to examine the implications of vaccines. Their profit potential, safety and effectiveness, effect on the immune system, adverse side effects and civil rights implications are all subjects that give us pause when asked to roll up our sleeves. And so they should. Vaccines are a matter of life and death, big money and political influence. They should not be taken lightly. So when Michele Bachmann, GOP candidate for the presidency, alleged that human papillomavirus (HPV) vaccine causes mental retardation in children, the pot of fear and loathing that is the vaccine controversy in America got a great, big stir.

HPV is the most common sexually transmitted disease in the U.S. The CDC says 50% of all sexually active men and women will get it at some point and that 20 million already have it. Most HPV infections go away on their own but some result in cervical cancer, the second-leading cause of cancer deaths in women worldwide. The American Cancer Society says that of the 12,000 cases of cervical cancer this year, the majority will be HPV-related. The virus is also increasingly implicated in vaginal, vulvar, penile, anal and head and neck cancers, an estimated 24,000 cases per year. A national debate exists about whether to head off the effects of the virus by requiring girls to be vaccinated before they become sexually active to allow the vaccine to work to its fullest potential. In 2007 the governor of Texas, Rick Perry, signed an executive order requiring all
sixth-grade girls in his state to receive the vaccine. The order had an opt-out option for parents who didn’t want their daughters vaccinated but still the order was not popular; the state legislature overrode it in 2008. In the recent GOP debate Perry took a lot of heat for signing the order. Minnesota Representative Michele Bachmann has been particularly vocal about the issue, calling Perry’s mandate “flat-out wrong” and saying she felt “offended for all the little girls and the parents that didn’t have a choice” in the matter. After the debate Bachmann told NBC’s “The Today Show”: “I had a mother last night come up to me in Tampa after the debate. She told me that her little daughter took that vaccine, that injection, and she suffered from mental retardation thereafter. It can have very dangerous side effects.” Really? Michele Bachmann has decided that the vaccine is dangerous, then scared parents half to death with allegations that it causes mental retardation based on the anecdotal evidence of one person?

There are two vaccines that have been approved to protect against the cancer-causing strains of HPV, Gardasil and Cervarix. Each is given in three doses over a six month period. The vaccines can prevent most cases of cervical cancer if a woman has the vaccinations before she has been exposed to the virus. Therefore, the CDC recommends routine vaccination for girls who are 11-12 years of age. Even so, the CDC says that less than half of girls have gotten one dose and less than one-third have gotten all three doses. About two-thirds of teens receive their shots for meningitis, tetanus, diphtheria and whooping cough. Not only is mandating the vaccine unpopular, it would seem the vaccine itself is disliked. Maybe the cost has something to with it – the vaccine costs about $400 (It’s usually covered by insurance) and there is the matter of having to get three doses of the stuff. But more than likely, concerns about sex are the biggest factor. Eyebrows may rise because the vaccine works best before a girl is sexually active and these days that means 11 or 12 years old. Parents may worry that promoting the vaccine at such a tender age will cause their daughters to become sexually curious before they’re ready. Perhaps, as is true with sex education and birth control, people fear the vaccine will make kids think that sleeping around just got a little safer. The message about the vaccines may truly be about protection, not promiscuity, but for some parents the word “promiscuity” rings much louder. As for requiring the vaccinations, the American Academy of Pediatrics (AAP), the CDC, and the American Academy of Family Physicians all recommend that girls receive HPV vaccine around age 11 or 12, yet some individual members of the organizations are philosophically opposed to mandating it. But other vaccinations ARE required. Should the HPV vaccine be treated as a special case because it protects against a sexually transmitted disease instead of an airborne one? The recommendations for use of the vaccine, based on scientific data, including safety studies, indicate that the benefits of HPV vaccines far outweigh any of the known risks. The safety record of these vaccines is excellent. After five years and more than 35 million doses of HPV vaccines given, all of the available scientific evidence shows that HPV vaccines are safe and effective, and provide the best opportunity to prevent HPV infection and its consequences.

There will continue to be controversies and questions in this country about vaccines of all kinds, to be sure. They center on the health and well-being of our kids and as such they are hot-button issues, often viewed with suspicion and emotion. This being obvious, public figures need to be careful what they say about them instead of using them to score political points. In the future it would be nice if the Michele Bachmann’s of the world would verify the existence of flames and smoke before yelling “Fire!” in a crowded theatre.