The controversy over HPV vaccine
Janet Smith, Ph.D.
Published July 27, 2007
The human papillomavirus, spread by sexual contact, is the leading cause of cervical cancer and also causes genital warts. The widespread practice of getting Pap smears, permitting early detection and treatment of conditions for cervical cancer, has cut in half the incidence of and fatalities from cervical cancer in recent years. Many states, including Michigan, are considering mandating that girls around the age of 11 be given the new HPV vaccine. While virtually everyone hails the production of this vaccine, many have objections to the mandatory vaccination of young girls.
The vaccinations are expensive. Three shots given over a several month period are required, each costing about $150; it will cost billions to inoculate the targeted group year after year. Since it is a new drug, the manufacturers do not know the duration of its effectiveness. Thus, some argue that it is foolish to vaccinate girls at such a young age before most are sexually active. Booster shots may be needed after about five years. It is even possible the protective power of the vaccine will wear off.
While the new vaccine protects against 70 percent of the strains of this sexually transmitted disease, that means that women remain vulnerable to 30 percent of the strains. So perhaps it doesn't protect so well after all. On the other hand, perhaps such expensive universal protection is not so necessary: Of the women studied, only 3.4 percent had strains of the virus that would be combated by the new vaccine.
Many believe that mandatory vaccination is a violation of parental rights. Some parents believe that the drug has not been sufficiently tested, that governmental provision of it is one further indication of societal toleration of premarital sex, and that girls who are not likely to be sexually active should not be forced to receive the vaccine. These parents do not necessarily oppose the provision of the vaccine to others but believe that rather than an "opt-out" policy to allow rejection of the vaccine, there should be an "opt-in" policy for parents to give permission for their daughters to have the vaccine.
The enthusiasm for the vaccine has waned somewhat recently. Jon Abramson, M.D., chairman of the Centers for Disease Control and Prevention's advisory committee on immunization practices, announced that he and several other committee members oppose mandatory vaccination, since HPV spread by elective behavior and is not an infectious disease such as measles. He also deplores the expense. In fact, Merck, the manufacturer of the vaccine, has dropped its lobbying campaign in favor of mandatory vaccination.
The National Catholic Bioethics Center and the Catholic Medical Association while maintaining there is nothing morally wrong with parents having their daughters receive the vaccine, also conclude that it would be a violation of parental rights and an unnecessary public health measure to mandate that all girls receive the HPV vaccine.
Finally, there is a serious social justice question involved in the question of federally funded vaccines. Many people in our society are without basic medical care. If we have billions of dollars to make available for medical care, perhaps it should go to those who are without financial resources. Many who need the HPV vaccine can afford to pay for it or their health care plans should pay for it. Spending millions of dollars vaccinating prepubescent girls rather than those who need it, would deprive others of needed health care.
Janet Smith, Ph.D., holds the Fr. Michael J. McGivney Chair of Life Ethics at Sacred Heart Major Seminary.
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