Our overreaction to the HPV vaccine, and Richardson's mistake
by Christie Chisholm, Weekly Alibi, April 12, 2007
It almost isn't surprising. Almost.
At this moment in the history of our country, we should no longer be shocked by puritanical ideals sneaking into our politics, by our culture's simultaneous loathing and worship of sex, by some of our leaders'—and some of our citizens'—heartbreaking disdain for science. Yet, somehow, the jaws of disbelief still manage to unhinge and swallow us whole. Or maybe it's just me.
This year's State Legislative Session ushered in a series of momentous accomplishments: Our representatives banned cockfighting, legalized medical marijuana, increased our minimum wage and put restrictions on payday lenders. All initiatives will work to increase the quality of life of those in New Mexico. But there was another bill passed by our House and Senate that would have likely saved lives. Sadly, last week Gov. Bill Richardson vetoed that bill, in one of the more myopic and cowardly gestures he's made in recent memory.
Senate Bill 1174 would have mandated all sixth-grade girls in the state receive the Gardasil vaccine, which protects against the majority of cancer-causing strains of HPV, the human papillomavirus. More than 99 percent of all cervical cancer cases are caused by HPV, and 70 percent of them are attributed to two strains of the virus: types 16 and 18. Gardasil protects against both strains and therefore has the potential to eliminate nearly three-quarters of all cervical cancer cases. The vaccine also protects against 90 percent of all genital warts (which come from HPV 6 and 11).
As a matter of pride, I feel it’s important to point out that a pivotal role in developing the vaccine was played by UNM’s Dr. Cosette Wheeler and the Hope Clinic.
I shouldn't need to stress the importance of this medical breakthrough, but the bill suffered a rash of protest from parents in the state that clung onto one of the key characteristics of HPV: It is spread through sex and sexual contact.
The nature of the virus has stigmatized the medicine. How could we give 11-year-old girls a vaccine that protects them against an STD? Whether parents are frightened by the fiction that giving their daughters the vaccine is tantamount to condoning sex or simply offended that the medical community would suggest their children may be nearing the loss of their virginities, they've made their voice clear: They want their kids to have nothing to do with the vaccine. And the governor heard their call. Never mind that the legislation allowed parents to sign a waiver, excusing their daughters from the requirement. They just don't like the idea.
Such thinking operates under a parsimonious morality, where the fear of sanctioning premarital sex outweighs the risk of losing lives. The Centers for Disease Control and Prevention estimate that 20 million people are infected with a genital HPV strain and that more than half of sexually active men and women will contract one at some point in their lives. It's predicted that by age 50, 80 percent of all women will have HPV. It is so common that abstaining from sex until marriage is no longer a safeguard. Last year, around 9,700 women in the U.S. were diagnosed with cervical cancer, and an estimated 3,700 died from the disease.
Richardson copped-out by claiming his veto had to do with "insufficient time to educate parents, schools and health care providers" on the new requirements. But what would his reaction have been—and would parents still be protesting—if the vaccine wasn't for HPV, but for HIV? Would he have found the time to educate the public, postponing the effective date of the legislation if necessary, instead of requiring legislators to gather again to debate the bill another year, in another session, with countless hours that could be used to discuss a measure they haven't already approved?
Consider the public concern over a vaccine that prevented lung cancer or breast cancer. Or what if, instead of a disease that primarily effects women, HPV more often affected men? The reality of HPV is that it rarely causes penile cancer—although it does happen. But if 9,700 men a year had to have their scrotums peeled and cut to save their lives—and if 3,700 of them died anyway—would we be so anxious to dismiss the vaccine? Anal cancer among men and women is on the rise—due in part to the growth of HPV—but that's not something we hear much about. "Those" forms of sex and the people who engage in them obviously aren't considered “proper” topics for conversation in our society.
Yet what it all seems to come back to is age. Parents, understandably, don't enjoy the idea of their children having sex, and they don't want to start thinking about it any earlier than necessary. Unfortunately, we live in a time when we no longer have that luxury. According to The Kinsey Institute, 25 percent of young men today have had sex by the age of 15; the number is 26 percent among young women. The statistic leaps to 40 percent for women by age 16, 70 percent by age 18 and 92 percent between the ages of 22 and 24. The majority of our children have sex before marriage, even before the legal age of adulthood, and the best way to protect them from HPV is to vaccinate them before they take the plunge. It is for this reason that the medical community, including the Federal Advisory Committee on Immunization Practices, recommends vaccinating girls aged 11 to 12, and as early as age 9, against HPV.
Our Legislature voted to take that recommendation, but we have been betrayed by a governor who cares more about his own image than our interests. I wish it were more surprising.
Fortunately, two victories for the HPV vaccine occurred this year in the Legislature. The governor signed Senate Bill 407, which mandates insurance companies cover the cost of the vaccination, and the approved state budget this year includes $965,000 to provide the vaccine to school-based clinics for fifth-grade girls—it’s enough for all fifth-grade girls in New Mexico to receive a vaccine.
If you’re interested in having your child vaccinated, talk to your doctor and your child’s school.