Don’t Let Politics Interfere in the Fight against Cervical Cancer
The announcement that scientists at Merck & Co. and GlaxoSmithKline have developed vaccines that drastically reduce or eliminate a major cause of cervical cancer is welcome news. These vaccines, among the most important public health victories since the polio vaccine, appear to be both safe and effective in preventing the most dangerous strains of the cancer-causing and highly infectious skin-to-skin contact disease known as human papilloma virus (HPV). Instead of wholeheartedly applauding this scientific breakthrough, however, some social conservatives have expressed concern that, because the disease is generally spread by sexual activity, widespread administration of the vaccines to teens could be seen as encouraging teenage sexual activity and promiscuity. Rather than admit that some young adults will have sex and seek practical solutions to the associated risks, social conservatives have chosen to hide from the facts, and women pay the ultimate price.
Merck’s new vaccine, Gardasil, is a promising solution to a very serious health threat; cervical cancer affects over 10,000 women in the United States each year, killing more than 3,700 annually. The Centers for Disease Control and Prevention (CDC) estimates that over 20,000,000 men and women are carriers of HPV, the primary cause of cervical cancer in the United States, although most people experience no serious side effects and do not even know they are infected. Preliminary lab tests show that both Gardasil and GlaxoSmithKline’s vaccine Cervarix are 100 percent effective in preventing cervical pre-cancers and noninvasive cervical cancers caused by HPV 16 and 18, two strains of the disease that are responsible for 70 percent of all cases of cervical cancer.
Research has shown that to be most effective, the vaccines should be administered to individuals before they become sexually active. The vaccine causes a stronger immune reaction – making it more effective – among adolescents between 10 and 15 years of age, as opposed to young adults between 16 and 23 years of age. To ensure people are vaccinated at the appropriate time, the Advisory Committee on Immunization Practices at the CDC should recommend that public schools add the HPV vaccines to the list of required vaccinations, which already includes vaccines for diseases like diphtheria, measles, rubella and polio. Of course, it is not always easy to make medical benefits available to all. Therefore the Institute of Medicine (IOM) should undertake a study and recommend the best measures for disseminating the vaccine, including the option of adding it to the mandatory vaccination.schedule for school attendance. Having students vaccinated for HPV before becoming sexually active would greatly reduce the prevalence of HPV and cervical cancer.
Some conservatives have objected to adding an HPV vaccine to the list of required school vaccinations. They argue that mandating the vaccine for students will encourage young people to be more sexually promiscuous. As Bridget Maher of the Family Research Council said, “Giving the HPV vaccine to young women could be potentially harmful, because they may see it as a license to engage in premarital sex.” Conservatives also claim that mandating the vaccine infringes on parents’ right to teach their children as they see fit – particularly for parents who favor abstinence-only education. Worries of increased sexual activity among youth are entirely unfounded; there is overwhelming scientific evidence that comprehensive sex education does not increase youth sexual activity, but does decrease the transmission of sexually transmitted infections (STIs). Conservatives have once again raised the fear that advocating for anything other than abstinence will increase sexual activity, a ploy previously used to restrict comprehensive sex education in schools and access to over-the-counter emergency contraception.
Arguments that a mandatory HPV vaccine would infringe on parental rights are unpersuasive. Mandatory public school vaccinations are nothing new; every state has some form of vaccination requirement in order to protect public health. A disease as prevalent and unlikely to be detected as HPV, and with such dire consequences, represents a serious public health risk. Administering the vaccine to all youth will not prevent parents from teaching their children the value of practicing abstinence, but it will protect the next generation of sexually active people from contracting and spreading HPV.
The real problem social conservatives have with an HPV vaccine, emergency contraception, and comprehensive sex education is that these issues force them to acknowledge that some young adults engage in sexual activities, and that abstinence-only education is not the solution. According to a study by researchers at Columbia and Yale, students pledging abstinence have only slightly lower rates of pre-marital sexual activity than those who do not. However, they have the same rates of contracting STIs and having unintended pregnancies as those who do not pledge, because they do not practice safe sex. Rather than rely on a single, largely ineffective strategy, we must acknowledge that half of all high school students, as well as the majority of Americans, will engage in pre-marital sexual activity and act accordingly. Although we should encourage youth to wait to have sex, we should also ensure that those who do engage in sexual activity do so in a safe, mature, and responsible manner.
The conservative strategy of willful ignorance can no longer be tolerated; the costs are too great to be ignored. To pretend that teenage sexual behavior does not occur is to abrogate our responsibilities as adults to address and solve real problems. Vaccinating students against HPV is a positive step toward minimizing the health risks of sex, and it will not be the last. Scientists are continually developing new advances that will reduce the spread of STIs and improve public health; even now scientists are researching the use of microbicides – agents that kill or deactivate the microbes that cause diseases – to stop the spread of HIV/AIDS. Unfortunately, this is not a debate that will end with an HPV vaccine, just as it did not end with emergency contraception, condoms, or other measures to reduce sexual health risks. We must take a stand now that narrow ideology cannot be put before people’s health and lives.
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