By Tim Robertson
In its 2007 immunization guidelines, the Centers for Disease Control and Prevention recommended that all young women between the ages of 11 and 18, be vaccinated for the human papillomavirus (HPV), a widespread sexually transmitted disease that causes many cases of cervical cancer.
However, decisions about vaccination programs are made by the state. A lively debate ensued, pitting advocates of a mandatory program against organizations and individuals who feel the vaccine should be voluntary. Unfortunately the arguments against mandatory vaccinations address only narrow aspects of the discussion and ignore the larger implications of the program.
While preventing a disease seems to be a straightforward proposal, questions emerge about ethics, economics and necessity of the preventative treatment.
Among the groups asking questions is the Christian advocacy organization “Focus on the Family.” “The HPV vaccine does not, in any circumstance, negate or substitute God’s plan for sexuality, which is sexual abstinence until marriage and sexual faithfulness within marriage,” stated the group. Given such beliefs, they feel that the immunization should not be mandatory, as abstinence is a safer alternative.
What Focus on the Family misses, is that almost all women continue to be susceptible to HPV well into adulthood when abstinence or safe sex practices are abandoned in marriage. “By age 50, as many as 8 out of 10 women who have ever had sexual intercourse have the virus,” according to the Kentucky Cancer Program.
A three-dose vaccination taken between ages 11-12 continues to protect women indefinitely.
Others argue that pap smears, the yearly examinations given to women in order to detect cervical cancer, have been successful in greatly reducing the incidence of the disease. However, the vaccine along with a recently developed genetic screening for HPV, are expected to reduce the cost of prevention and detection, while continuing to decrease occurrences.
Gynecologists working for health maintenance organization Kaiser Permanente, whose payment does not depend on patient volume, administer a pap test and a genetic screening. If both tests are negative, neither are required again for three years rather than yearly, saving the organization and the patient money.
Professor of pathology at Columbia University Medical Center, Dr. Thomas C. Wright, said, “We can potentially change the entire cervical screening paradigm.”
This economic aspect is important, as many consider the current $360 price-tag for the three-dose vaccination unfeasible for universal disbursement. Fortunately, in June of 2006, a federal vaccine advisory panel voted to recommend the inoculation for young women ages 11-26, effectively committing around $2 billion dollars to distribute the vaccine to the uninsured.
Additionally, most insurance plans cover the procedure, acknowledging that even at $360 it is a good investment in preventing future complications.
These developments, along with falling prices due to increasing supplies and competition, make the expense of the safeguard manageable.
Of all the so-called reasons presented against the mandatory vaccination of young women for the HPV virus, none of them are compelling arguments. There may be others out there that hold more water, but until they are brought to light, I simply ask why not?
Cancer of all kinds continues to be the second most deadly disease afflicting Americans, and anyone who has known and watched someone with terminal cancer understands the pain involved.
The cure for cancer is regarded as one of the most significant scientific achievements on the horizon, but for at least a few types of cervical cancer, we have a cure today.
It’s difficult to imagine how any parent who opted against a “voluntary” HPV vaccination, based on any of the above reasons, could deal with their daughter being forced to have a hysterectomy, or worse die. There are so many problems in this world we can’t fix, it’s hard to believe anyone could be against fixing the ones we can.
Tim Robertson is a graduate student in the department of political science. E-mail him at robertson@louisvillecardinal.com.
