Sex and Vaccination
Zavrel, Erik, Herreid, Clyde Freeman, Journal of College Science Teaching
Part I: A Texas tempest
Texas Republican governor Rick Perry initiated a whirlwind of controversy on February 2, 2007, when he issued an executive order mandating that all girls entering into the state's public school system be vaccinated against the human papillomavirus (HPV) prior to entering the sixth grade. This virus is strongly implicated as the causative agent of cervical uterine cancer. "The HPV vaccine provides us with an incredible opportunity to effectively target and prevent cervical cancer," said Perry. "Requiring young girls to get vaccinated before they come into contact with HPV is responsible health and fiscal policy that has the potential to significantly reduce cases of cervical cancer and mitigate future medical costs" (Office of the Governor 2007). Governor Perry believed it was his obligation to safeguard the public health and safety, while many parents in this deeply conservative state were outraged by what they perceived as a governmental intrusion into a private family matter.
The human papillomavirus (HPV) is the collective name for a group of over 100 viruses, 30 of which are sexually transmitted. HPV is spread during sexual activity by skin-to-skin contact and not by the exchange of bodily fluids. HPV is responsible for genital warts, and most HPV infections occur without any symptoms and go away without any treatment. But a strong link has recently been established between HPV and cervical cancer. The American Cancer Society estimates that in 2007, over 11,000 women in the United States will have been diagnosed with cervical cancer, and more than 3,600 will die from this malignancy (ACS 2006). Hispanic women develop cervical cancer twice as often as Caucasians, and African American women about 50% more often than non-Hispanic, white women (ACS 2006). The Centers for Disease Control and Prevention (CDC) estimates at least 50% of sexually active men and women will contract HPV during their lifetime (ACS 2006). In the United States each year, 6.2 million people are newly infected with HPV, and as many as half of them are aged 15-24 years (CDC 2004).
The pharmaceutical giant Merck recently developed a vaccine for HPV. The new vaccine, Gardasil, was approved by the Food and Drug Administration on June 8, 2006, for girls and women aged 9 to 26. It protects against two HPV strains believed responsible for about 70% of cervical cancer cases, and two other strains that cause 90% of genital wart cases. The vaccine is given by intramuscular injection in three doses over a six-month period and costs about $360 for the full series (CDC 2006). The HPV vaccine is recommended for 11-12-year-old girls, but can be given to girls as young as nine. There is no U.S. federal law requiring HPV immunization. State laws regulate immunizations for school and childcare facilities (CDC 2006). In October 2007, the British government announced all girls 12 years of age and older would be vaccinated free of charge (U.K. Department of Health 2007). Similar programs are planned for several Canadian Provinces (O'Brien 2007).
1. If you were a state representative in Texas, would you favor mandating the vaccination against sexually transmitted diseases (STDs) like HPV if vaccines were available?
2. Should the prevention and treatment of STDs factor into the safeguarding of public health? Why might some parents object to having their daughters vaccinated against HPV?
3. Would you consider getting the vaccine yourself or recommending it to a family member? Why or why not? What are the questions that you would like to have answered before you decide?
Part II: The Governor's case
In the public debate that followed, a number of important arguments in favor of the vaccination order were made. Most statements below are derived from the CDC (2006).
* Though the recommended age for girls to be vaccinated may seem young, it is due to the fact that it is best for girls to be vaccinated before becoming sexually active. …