The Republic of T.

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Circle Circle, Dot Dot: An HPV Vaccine Round-Up

I know everyone else is talking about the Snickers commercial during the Superbowl and, being a good gay blogger, I should probably say something about it too. So, there. I just did. You don't need me to say more, do you? Good, because I've had something else on my mind for the last couple of days.

I stuck a toe into the water earlier, and now I hesitate to jump back into the debate about the HPV vaccine, after learning just how controversial vaccines are in general. (And, no, I didn't know about this video before writing this post.) But after posting that Maryland's proposed HIV vaccine bill was pulled, I kept reading about the issue and came across some interesting developments and issues. And a couple of surprises, like Texas becoming first state to require the HPV vaccine for girls entering the sixth grade.

Texas on Friday became the first state to require all 11- and 12-year-old girls entering the sixth grade to be vaccinated against a sexually transmitted virus that causes cervical cancer.

Averting a potentially divisive debate in the Legislature, Gov. Rick Perry, a Republican, signed an executive order mandating shots of the Merck vaccine Gardasil as protection against the human papillomavirus, or HPV, starting in September 2008.

Mr. Perry’s action, praised by health advocates, caught many by surprise in a largely conservative state where sexual politics is often a battleground.

“I had no idea; I was absolutely caught off guard,” said Representative Jessica Farrar, Democrat of Houston, who sponsored a bill to require the vaccinations starting this September. “Normally, the governor does not take things like this upon himself, although I’m glad he did.”

Under the order, girls and women from 9 to 21 eligible for public assistance could get free shots immediately. The governor’s office said parents could opt out of the school program “for reasons of conscience, including religious beliefs.”

Not just that, but Virginia passed similar bill, after including an opt-out for parents.

A bill to require all girls entering the sixth grade to receive a vaccine for the sexually transmitted virus that causes cervical cancer passed the House on an 80-17 vote after it was changed over the weekend. The bill was amended to give parents the right to review information about the vaccine and exempt their daughters if they wish. Exemptions already exist for parents who object for religious or medical reasons.

The Senate unanimously passed a similar bill on Friday without the parental opt-out provision.

Now, it's been pointed out that HPV isn't easily communicable among school children like other illnesses targeted with vaccines; like measles or mumps. But it's worth keeping in mind that it is sexually transmitted, and whether we like it or not, kids are sexually active. Not only does abstinence-only education fail to reduce STD or pregnancy rates, but some of them abstinence-only programs actually mislead students. But as far as the opposition is concerned, as I've pointed out before, it doesn't matter that it doesn't work.

But at least parents in Texas Virginia can opt not to protect their children (not just their daughters, but I'll get to that later) from the possibility of cancer due to HVP. So, they can continue to raise their kids according to their values. Great. But Amanda makes an excellent point about just what kind of values those are.

it’s true that the opt-out policy does mean that it’s going to be a lot harder for vindictive, misogynist parents to refuse to protect their daughters from cervical cancer. It’s the difference between neglect and active abuse, really. Without mandatory vaccinations, denying your daughter preventative treatment was easy, since you simply had to neglect providing it.

Under the opt-out policy, however, if you want to keep your daughter in danger of getting cervical cancer, you have to get an opt-out form, fill it out, sign it, and make your daughter take it back to school and then the school officials will know that you’re the kind of creep that would rather have your daughter be dead from cancer than to face up to the fact that she is going to grow up and have sex one day. On top of that, you run the risk of having your daughter get cancer or even just genital warts one day and remembering that you took action to deny her treatment that would spare her this pain. I don’t know about you, but if I found out my parents had a chance to spare me from a disease but they went out of their way to make sure that I wasn’t spared, I’d be furious. I may even refuse to speak to them again. I’d blame them for my cancer. And I’d be right to do so.

And Mike, whose post led me to Amanda's, makes an excellent point as well.

For the last several decades, the theological right have not had to deal with the specific consequences of their actions–particularly since those driving the theological right are mostly men. It's easy to 'moralize away' horrible outcomes when it's someone else's body and life. But it's much harder when you might be called to account for your decisions. In this case, if your daughter dies from cervical cancer, it's your fault: not the gummint's fault, not the Evul Libruls' fault, not Michael Moore's fault.

Yours and yours alone.

Well, actually, according to the "theological right" (an excellent term that I may adopt from Mike), if your daughter contracts cervical cancer it may be her fault, and just what she deserves for her lack of virtue according to this World Net Daily columnist I found via TAPPED.

There is only one good reason a virtuous young woman should consider getting the HPV vaccination. That is if the man she plans to marry has had sex with other women, meaning he could be infected with HPV or an array of other STDs. I don't know why a virtuous young woman would want to marry such a man, but there you go.

And remember the abstinence-only expert I quoted earlier.

Later in the same talk, she explained further why what “works” isn’t what’s important—and gave some insight into what she means by “truth.” “Let me tell you something, people of God, that is radical, and I can only say it here,” she said. “AIDS is not the enemy. HPV and a hysterectomy at twenty is not the enemy. An unplanned pregnancy is not the enemy. My child believing that they can shake their fist in the face of a holy God and sin without consequence, and my child spending eternity separated from God, is the enemy. I will not teach my child that they can sin safely.”

Which leads to some legitimate questions asked by a columnist in The Nation, again via TAPPED.

What is it with these right-wing Christians? Faced with a choice between sex and death, they choose death every time. No sex ed or contraception for teens, no sex for the unwed, no condoms for gays, no abortion for anyone …"

What's with them goes pretty far back to the beginnings of Christianity, when the church took a position condemning any and all non-procreative sex. That is, sex for pleasure or any purpose other than reproduction. That was a theme running through several books I've read lately; including Born to Be Gay: A History of Homosexuality, What is Marriage For?: The Strange Social History of Our Most Intimate Institution, and Marriage, a History: How Love Conquered Marriage. (Andrew Sullivan did a pretty good write-up on the Christian tradition against sex for pleasure, back in 2003.) In the bigger picture of human history, it turns out that most cultures embraced sex for procreation and for pleasure, or at least accepted the latter without applying negative judgments or inflicting penalties. Against that contiuum, the conservative Christian insistence on punishing non-reproductive sex is actually abnormal. (Thus those contemporary Christian swingers, and evangelists preaching the virtues of hot, non-procreative sex for married heterosexuals are actually abnormal within the history and traditions of their own faith.)

But, interestingly enough, the opposition to the HPV vaccine isn't entirely Christian or conservative, as this post over at Women of Color Blog underscores. Some parents, concerned about the possible side-effects of the vaccine, might opt out of their daughters getting it, for reasons that have nothing to do with religion. Nothing I've seen, however, suggests any negative health effects from the vaccine. And the overwhelming opposition from the theocratic right isn't about the potential negative health effects. Instead, they're concerned that it might actually work when it comes to preventing disease. And that, in their eyes, would be the worst possible outcome.

One of the comments at the Women of Color Blog links to a post that makes an interesting point about vaccinating everyone. Boys and girls, that is.

Maia is also right that if we're going to try for herd immunity against the strains of HPV against which Gardasil protects, the most effective way to do it would be to vaccinate everyone – but there's also the consideration of cost, too. You can see my post I wrote about it earlier for details, but last month there was a study released that looked at the costs versus benefits of different vaccination strategies with Gardasil, and it was in fact vaccinating only girls that had the best cost-to-benefit ratio. It wasn't perfect, but they did predict a 78% reduction in HPV transmission, at a fraction of the cost of vaccinating people of all genders.

So, to increase reduction we might consider vaccinating boys too. Now, I don't know the biological … um … ins-and-outs of how HPV is transmitted, and whether guys can carry it with no ill effects while passing it on to women. But there's another reason for parents to consider vaccinating their sons. If their sons turn out to be gay, there a possibility that the HPV vaccine may save boys from cancer too.

The vaccine for the human papillomavirus could help prevent not only cervical cancer, but also anal cancer, the New York Times reported. Both cancers are caused by the same strains of HPV.

Anal cancer is most common in men who have histories of receptive anal intercourse; however, it can affect anyone. There is an annual rate of about 35 cases per 100,000, but that figure nearly doubles in people living with HIV.

"The cervix is similar biologically to the anus, so there's plenty of hope that it will work there also," Dr. Joel Palefsky, a professor of medicine at the University of California San Francisco, told the Times.

But before wingnuts decent on the anal cancer issue and indulge in their habit of playing fast and loose with statistics (remember the misleading information in those abstinence-only programs), the article seems to contradict or at least omit some significant statistics. The National Cancer Institute puts the number of estimated cases for 2007 at 4,650 and the number of deaths at 690. The American Cancer Society says it affects more often than men.

The disease affects women somewhat more often than men. Of the 4,650 new cases, 2,750 will occur in women and 1,900 in men. Women are more likely to have cancers in the inner part of the anus (the anal canal), while anal tumors in men tend to develop on the outside of the anus.

Perhaps the thats because of heterosexuals increasingly plowing the backfield.

When I saw the item about the HPV vaccine possibly benefiting gay men, I said to myself "Well, that ought to seal the deal with anyone who's opposed to the vaccine for 'moral' reasons." If blocking the vaccine knocks off the "sluts" and the "faggots," they'd hardly pass up a chance to kill two birds with one stone, and lay it all at the door of said birds' "immoral" behavior or lack of "virtue."

But which is more immoral? Engaging activity that, however risky, is an inherent part of being human? Or actively working to increase the risks of others who engage in that activity, by withholding information or actual medicines that might prevent or significantly reduce the risk of undesirable consequences like STDs or unwanted pregnancies? How moral is increasing the risk for everyone by doing the above, because almost nobody is abstaining; including even Baptist newlyweds?

How about doing so precisely to increase the likelihood of those consequences for others, because "AIDS is not the enemy. HPV and a hysterectomy at twenty is not the enemy. An unplanned pregnancy is not the enemy?"

Where's the "virtue" in that?


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  2. the “theological right” (an excellent term that I may adopt from Mike). Please do! Seriously, your point about the sexually repressive nature of the theological right is critical in understanding them. I wouldn’t want to be a member of a religion that categorically says all non-procreative sex is bad. Crazy.

  3. You missed a reason to oppose the vaccination. The former chief of staff for Gov. Perry in Texas is now a lobbyist for Merck. So obviously, the mandatory vaccine is just the good old boys network at work, and has nothing to do with the health of girls / women. There is population of folks out there that believe that if Merck is making money on this, then it must be bad somehow.

    I have an 11 year old daughter. My wife’s doctor told her if he had pre-teen daughter he wouldn’t hesitate. We may not do it this year – but pending a dissenting opinion from our rather conservative pediatrician, I expect we’ll get her vaccinated in the next year or so.