You Mothers Get Down with the Sickness

Yesterday I read an article about the controversy brewing over the vaccine for Human Papilloma Virus. HPV causes as many as 70% of the cases of cervical cancer. World-wide, cervical cancer kills over 200,000 women each year. In this country, however, thanks to routine HPV screening, the death toll is far lower. But even so, immunizing women against a virus so strongly linked to a potentially deadly cancer is a no-brainer. Right?

Wrong. It seems that at least twenty states are considering making the vaccine mandatory. WTF? Already? Gardasil just came out! I haven't even finished discussing with my wife whether our daughter should get the vaccine. It turns out that Merck, the drug's manufacturer, is among those behind the push for mandatory immunization for pre-teen and teenage girls. This creepy synergy between corporate interests and paternalistic legislators makes me uneasy.

Generally speaking, I am strongly in favor of fighting diseases and protecting public health through immunizations and other measures. But it's hard to know whether the public is served by mandatory HPV vaccinations. Let's face it: HPV is not like chicken pox or measles. It is spread by bumpin' uglies. So though many people are eventually exposed to the virus, it's not as if one can catch it by sharing a coke in the lunchroom.

Forcing a brand new medicine of unknown long-term efficacy for a disease not easily spread among pre-teens strikes me as overzealous. And GlaxoSmithKline, Merck's competitor, is scrambling to bring their own HPV vaccine to market. So maybe there is more going on to this push for compulsory immunization than just good preventative health care and good public policy.

The pressure to legislate HPV immunization has given common cause to strange bedfellows. Advocates for civil liberties and conservative Christians find themselves working side-by-side: one group is concerned about corporate power in medicine and intrusion of privacy, the other with stamping out promiscuity and premarital sex. Sheesh, get a room you two!

Lost in the controversy is that although HPV affects both women and men, the call is to vaccinate only girls. Why is that? Is that cashing in on fear? Is it sexism for the 21st century? I mean, a dick gets the genital warts just as much as a puss. But gunk on your junk that could kill your female sex partner apparently doesn't warrant consideration: since only girl parts actually get the cancer, only the girls gotta deal with it. Limp.

So here we are: the profit-driven pharmaceutical industry that has a drug that could really help women on the one hand, and the anti-sex zealots who have a very good argument about freedom of choice on the other. It's left me wondering: what is good science, what is good medicine, what is good for the public, what is good for my daughter?

I need a drink.

Update 2/21/2007: The New York Times reported yesterday that Merck is dropping their support of legislation to mandate this immunization. Apparently they fear some kind of backlash. While discussing the topic this morning, a friend said bluntly that drug companies and the medical industry have got us by the balls. Too true. To which I would add, the public doesn't like to be shown that fact. I think Merck realized that.