Politics Standing in the Way of a Cancer Vaccine

By Mark Yarchoan

In May of this year, an FDA panel unanimously approved a vaccine called Gardasil that
is highly effective at preventing cervical cancer. The vaccine, which is manufactured by Merck
& Co., works by preventing infection of several strains of the human papilomavirus (HPV), a
sexually transmitted virus. The strains of the virus blocked by the vaccine are responsible for 70
percent of cervical cancer cases and 90 percent of genital warts cases. (A note to women on this
campus: this vaccine is most effective if administered before the first time one has sexual
intercourse, and should be available from the health center).
Groups working to reduce the incidence of cancer in this country have long hailed this
vaccine as a giant leap in public health, and they hope to have the vaccine added to the regimen
of mandatory vaccines that school children must receive in order to attend public school.
Fearing a conflict over the vaccine, many liberals in Congress and elsewhere warned the Bush
administration and Christian conservative groups to avoid fighting the vaccine’s approval or use.
Many conservative groups such as the Family Research Council, Focus on the Family, and
Concerned Women for America, responded to these warnings by offering open praise of the
vaccine. Peter Sprigg, vice president for policy at the Family Research Council, wrote in a letter
to the editor of the New York Times that, “after extensive study, we and other pro-family groups
have concluded that the clear benefits of developing an HPV vaccine outweigh any potential
costs.” On the surface it appeared as though these groups were highly supportive of widespread
use of the vaccine toward virtual elimination of HPV.
But the Family Research Council and other conservative groups have taken a subtler, yet
very destructive stance against the HPV vaccine. They feel that public school boards should not
make the vaccine mandatory, but families should instead be given “choice.” Research Council
feels that parents “have an inherent right to be the primary educator and decision maker
regarding their children's health.” Their concern seems to hinge on the concern that the vaccine
is an invitation for premarital sex, and people can safely avoid the virus through abstinence.
By positing this issue as a choice between the vaccine and abstinence, these groups are
both misleading and damaging. There is no obligation to engage in sexual activity after
receiving this vaccine, and the argument for abstinence should be unaffected by the vaccine.
Furthermore, if the vaccine is mandatory such that all children are vaccinated, no stigma would
be attached to the vaccine and it would not suggest parental approval of premarital sex.
Although it is true that many people will remain abstinent after receiving a mandatory HPV
vaccine, and in a sense this vaccine will be wasted on them, statistics show that many people
whose parents advocate abstinence instead choose to engage in sexual activities. If unvaccinated
for HPV, these people put not only themselves at risk, but they risk spreading the virus to others.
There is an overriding public health issue at stake in this case. In the U.S. alone, there
are 10,400 new cases and 3,700 deaths from cervical cancer a year. We know that vaccine
campaigns are most effective at controlling diseases when they are aggressively distributed. It
was through widespread distribution of small pox and polio vaccines, for example, that these
diseases were essentially eliminated from the population. We now have a safe and effective
vaccine against several strains of HPV, providing us with a unique opportunity to essentially
eliminate yet another deadly virus from the population. In fighting this virus, time continues to
be of the essence, and the faster this political conflict is resolved and the vaccine is aggressively
distributed, the more people can avoid getting deadly cervical cancer.