HPV Vaccine Debate

Sen. Connie Lawson (R-Danville) has one of the best legislative proposals this year. Lawson's SB 327 proposes to require vaccination of all girls entering the 6th grade against human papillomavirus (HPV), a sexually transmitted disease most commonly referred to as genital warts. HPV is perhaps the most commonly-transmitted STD. Until recently, it was thought the discomforting genital warts were the only thing an infected woman had to fear from HPV. We now know that it causes deadly cervical cancer in women. It is estimated about 6.2 million people become infected with the virus each year.

The Senate Health and Provider Services Committee, which is chaired by Sen. Pat Miller (R-Indianapolis) approved Lawson's bill unanimously, but not without watering it down considerably to assuage opponents. So who could possibly oppose Lawson's bill? Of course, the Christian right. Why? Because it will encourage young girls to be promiscuous if they don't have to fear getting the dreaded disease. And who are the legislators hearing from? Micah Clark of the AFA, of course. Clark offers this opinion on Lawson's bill as he discusses what he calls "a behaviorally spread disease":

The fact that HPV, unlike polio or measles, is a behaviorally spread disease makes this a hot-button issue among some parents. Unfortunately, as I mentioned last week following an interview I did, the opposition has been simplistically portrayed as a concern that the vaccine promotes sexual activity among teens. Again, that was not my concern. My contention is over a false message of safety. Condoms do not protect against HPV. The vaccine is only 70% effective, and the length of its effectiveness is not fully known. Therefore, without an accompanying abstinence message, and adequate information about the limitations of the vaccine, SB 327 is incomplete.

Putting that aside, there is still another problem. I believe that SB 327 is written incorrectly. SB 327 has a good objective - protecting women from a horrible disease - but it goes about achieving that goal in the wrong way. Rather than linking attendance language to the bill and requiring schools to track how many sixth grade girls have obtained the HPV vaccine, SB 327 should have schools simply provide accurate, written, information about the vaccine and its availability to all parents. The parents can then make the decision about vaccination, and when they believe it is appropriate for such discussions of an STD with their daughter. Another option would be for SB 327 to require doctors, instead of schools, to provide information about the vaccine to all parents. This approach recognizes the rights of parents, their values, and their responsibilities. It also removes the appearance of the heavy hand of government, as it seems to appear in SB 327’s introduced form. If SB 327 were modified in this manner, I believe it would sail through the Senate without much controversy.

To assuage the wing nuts like Clark, the Senate watered down Lawson's bill so that the vaccination is offered but not required of 6th grade girls as a condition of enrollment, even though a number of other vaccinations are already mandated, including diphtheria, pertussis (whooping cough), tetanus, measles, rubella, poliomyelitis, mumps, hepatitis B and chicken pox. Some of the opponents used the excuse that the vaccine hadn't been tested long enough, although 10 years of testing has found no adverse side effects according to medical experts. Many young girls who could be safely protected from the deadly disease will become infected, but as Clark puts it "the appearance of the heavy hand of government" is removed.

Contrast the religious right's reaction to news that HPV causes cervical cancer among women to its reaction to the discovery of HIV/AIDS in the 1980s. Because those at greatest risk of HIV/AIDS were gay men, a disfavored group by these folks, we enacted laws requiring health care providers to report the names of persons who tested positive for the disease, and we enacted laws to put people in jail who knowingly spread the disease to another person. Some of the zealots actually tried unsuccessfully to have people infected with the disease quarantined. For a short time, some states like Illinois, wouldn't issue you a marriage license unless you were tested for HIV/AIDS. There are about 45,000 new cases of HIV/AIDS reported in the U.S. each year compared to the more than 6 million who are infected with HPV. Each year, there are 16,000 cases of cervical cancer diagnosed, causing death to 5,000 women. Worldwide, nearly a half million women die each year from cervical cancer.

You will never see a legislative effort to crack down on people who are spreading HPV like you saw with the HIV/AIDS disease. Why? Because it involves such a significant portion of the heterosexual population, perhaps as many as one in four, you'll never see the legislature adopt the measures it enacted for HIV/AIDS for HPV. On the one hand, they don't want to punish heterosexuals for promiscuity, but at the same time they don't want to protect the population from the disease out of fear it will promote sexual promiscuity. Makes a lot of sense, doesn't it?

I think many people in the GLBT community are frustrated by the fact that the medical community was able to quickly develop a vaccine for HPV, but scientists are no closer to developing a vaccine for HIV/AIDS than they were 20 years ago. If such a vaccine were available, you can bet people would be racing to the doctor to get vaccinated. The idea that some parents would choose not to protect their daughters from HPV is difficult to understand knowing the potential health consequences. But then every thing about the debate with the religious right on this issue is difficult to understand.

UPDATE: Texas Gov. Rick Perry (R) has bypassed the legislature and signed an executive order requiring all Texas schoolgirls to be administered the vaccination against HPV, making Texas the first state in the country to require the vaccine. As with Indiana, opposition in the Texas legislature came from the religious right who claimed it amounted to tacit approval of sexual activity among young girls. "If there are diseases in our society that are going to cost us large amounts of money, it just makes good economic sense, not to mention the health and well being of these individuals to have those vaccines available," Gov. Perry said. The order does contain an opt-out provision, which allows parents to sign an affidavit saying they object to the vaccine on religious or philosophical grounds.