Last week, at the CNN Tea Party Express debate, Texas Gov. Rick Perry came under fire for his mandate as governor that required all girls and young women in Texas to be vaccinated against HPV, with Rep. Michele Bachmann (R–Minn.) exclaiming that “to have innocent little 12-year-old girls be forced to have a government injection through an executive order is just flat-out wrong.”
Ignoring Bachmann’s ill-informed tirade about side-effects of the vaccine and Perry’s connections with drug companies, the debate about the HPV vaccine that followed has raised an important question: Should governments be mandating the HPV vaccine? When considering the effects of HPV, how it has spread in the population, and the opt-out system proposed by Perry, the unequivocal answer to that question is yes – the government not only has the right to require that young women take the vaccine, it has a responsibility to do so as well.
In order to contextualize the debate, it is first necessary to understand how prevalent HPV is and why it is worth being vaccinated against.
HPV is widespread. According to the CDC, about 20 million Americans have HPV and another 6 million people will be newly infected each year, which, according to estimates means that about 50% of sexually active adults will be infected at some point in their lives. However, what’s problematic is not only that HPV is prevalent, but also that it causes an incredible 70% of all cervical cancer in the United States.
If HPV is indisputably bad, then why is there uproar against Perry’s plan to vaccinate young women?
One argument against the mandatory HPV vaccine follows the chain of reasoning that since HPV is a sexually transmitted infection, a mandatory vaccination against it would encourage young girls — the 12-year-olds that Perry’s plan would include — to be sexually active. While it is difficult to prove whether this claim would be true, it is reasonable to suggest that the possibility of contracting HPV in the future is not usually a factor that determines whether young people choose to be sexually active.
Further, and perhaps more importantly, the argument for mandatory vaccinations extends beyond the individual — the greater the proportion of the population that’s vaccinated, the lower the incidence of the infection. Therefore, mandatory vaccinations are a matter of public health, of reducing the number of people who carry and pass on the infection.
A second criticism of the mandatory vaccines from Bachmann and her supporters has been that the law infringes on parental rights, since the government is making the decision to vaccinate minors without parental consent.
However, in this particular case, parents did have a choice to opt-out of vaccinating their children. The benefit of the opt-out system is that while it enables parents to make a decision should they not want their children vaccinated, it also ensures that a majority of girls and young women are vaccinated; hence tackling the widespread incidence of the infection without denying parents their rights.
The question of mandating HPV vaccinations, then, is not one of parental rights or morality but one of public health. And Perry’s mandate was clearly in the interest of public health.
Photo Credit: stevendepolo
The Discussion
In general, I support public health mandates - particularly the immunizations required for children to enter public schools.
What worries me in this case (and I speak as someone who got the HPV shots) is that it is a fairly new and untested vaccine. Do I think it's likely to have side effects down the road - No. Do I think it's possible? - sure, as with many new medications, long term effects are difficult to determine. Given the uncertainty, I understand the reluctance of parents to immunize their kids, even if the vaccine has measurable benefits. That said, the opt-out clause makes me far more supportive of the measures - parents have the responsibility to make sure they know what's going on with their kids in school.
Health prevention should be taken to avoid unmitigated spread of contagious diseases.
Something must be done
However, the current vaccination regime lacks transparency and accountability.
I would propose something like nutritional labels and guidance so that parents, children and other members of society are aware of
(1) Objectives
(2) Reasoning
(3) Cost benefit analysis
(4) Side-effects
(5) Pros and cons of taking this vaccine
Health prevention should be taken to avoid unmitigated spread of contagious diseases.
Something must be done
However, the current vaccination regime lacks transparency and accountability.
I would propose something like nutritional labels and guidance so that parents, children and other members of society are aware of
(1) Objectives
(2) Reasoning
(3) Cost benefit analysis
(4) Side-effects
(5) Pros and cons of taking this vaccine
You are exactly right. But I am living in an area where we are threatened if we give our children anti polio drops. That threat is from Pakistani spy agencies created extremists and terrorists. So how will we vaccine our children??
By allowing parental withdrawal in this mandate, the only valid argument you had is eliminated.
In order to make a wise decision, an individual must be appraised of the consequences of their decision. Often decisions are made without conscious knowledge of the individual. These decisions are seldom wise. With a mandate like this in place, at least the individual knows there is a decision to be made.
I've heard free market worshipers argue about "opportunity costs" prior to reading this article. What is the opportunity cost of a single case of cervical cancer? Because it is immeasurable, and likely non-existent, opportunity cost is the "straw man" argument that I've also heard followers of the unseen hand complain about.
I wonder if anyone has done a study as to the percent of parents who would refuse to allow their children to be vaccinated? There are quite good computer simulations that could then be used to get an idea of the effect of that number on the spread of the disease being vaccinated against. If the effect were quite small I would opt for giving parents the option.
Also, specifically for HPV, has anyone studied what the effect would be if some girls waited until they were 18, say?
I support vaccinating everyone, of all gender identities. A recent studied showed that about half of men have HPV.
I appreciate that you take on the "parents' rights" arguments and address them in a way that acknowledges that parents should maintain some decision-making ability without endangering the health of their children.
We vaccinate against polio and tuberculosis as public health actions - nobody but the Amish object to that, for heavens' sakes. If we can prevent cancer on a similar scale and effectively stop a devastating disease before it ever takes hold in our population, I do not understand why we wouldn't include it with our childhood series of vaccinations any way.
Absolutely spot on. You need an opt-out, not everyone wants vaccines (for whatever reason, health or otherwise), but given the huge infection rate, and the ever higher rate of cervical cancer afterwards, it makes sense. You protect women's health against an (at best) unpleasant virus and the money you lose from buying vaccine, is recovered in reduced cervical cancer cases.
Having read both sides I haven't found a reason why not!