evolution

Last November I told you about a potential vaccine against HPV (human papillomavirus), the leading cause of cervical cancer, which kills about four thousand women a year.

It seems to be ready to go; Merck and GlaxoSmithKline have independently developed vaccines, and Merck’s vaccine has been shown to be effective against those strains of HPV that cause cervical cancer, causing little or no side effects. Merck has already submitted its vaccine for approval by the FDA.

We can effectively wipe out a deadly form of cancer with an HPV vaccine. Furthermore, a Dartmouth Medical School preliminary study (press release) appears to link HPV with squamous-cell carcinoma, the second-most common form of skin cancer, affecting 200,000 Americans a year. Although the researchers cautioned in the press release that it’s too early to establish a causal relationship between HPV and squamous-cell carcinoma, it’s easy to see that if such a relationship were found, the risk for such cancers could be slashed dramatically.

So, that’s good news, right? All we have to do is simply vaccinate everyone against HPV at the age of 14 when we all are supposed to have our tetanus boosters, and these cancers become topics for medical textbooks. Right?

No, says the Family Research Council. (These are the Focus on the Family people, the Dobsonites.) They don’t think making the vaccine mandatory is a good idea (New Republic, reg. req’d):

Religious conservatives are posing the debate as a choice between abstinence and safe sex. “We feel people should have the choice of abstinence as a means to avoid HPV,” a spokeswoman for Christian Medical & Dental Associations told me. “Our concern is this vaccine will be marketed to a segment of the population that should be getting a message about abstinence,” says the Family Research Council. And in theory, that’s fine. But, like communism, certain ideas have a hard time succeeding in the real world. Studies show that not only do abstinence programs have little to no effect on rates of sexual activity, they also tend to mislead or withhold information about practicing safe sex. That’s why people who pledge abstinence are less likely to have safe sex and avoid STDs when they do find partners. So while, in theory, the choice of abstinence over Merck’s vaccine would be fine, in reality, it too often would mean a choice to expose oneself to HPV–and the risk of cervical cancer.

And because HPV is so widespread–absent a vaccine, 80 percent of Americans will contract it at some point in their lives–the stakes in this discussion are high. It’s true that most of the hundred or so strains of HPV are innocuous, so the fact that over 20 million Americans have it at any given point is not necessarily cause for alarm. It’s also true that the annual number of cervical cancer cases is relatively small–10,400, a third of which are fatal. But each year, 4.7 million American women require one or more follow-up appointments for an abnormal pap result, and at least 3 million of these cases result from having HPV. The cost of these appointments to the individual (and to our already overburdened health care system) quickly adds up. A 2003 Stanford study suggested that the cost of inoculating people against the disease would be far smaller than the current cost to the health care system associated with HPV.

Since the disease is so common, many fail to bring it up with their partners. Those who refrain from intercourse can still get HPV from other sexual activities. And even those who remain fully abstinent until marriage could contract it from their spouses. In short, HPV is a significant public health threat. It therefore isn’t enough to back the vaccine’s “availability”; one has to support the strongest possible steps to inoculate the entire population.

In fact, a little Googling dug up a Stanford press release about the study mentioned above. The researched assumed the existence and use of a vaccine that is actually less effective than those made by GSK and Merck, and they were still able to show that, long-term, vaccination was still cost-effective versus the standard treatment today — preventing, as the New Republic piece indicates, millions of costly doctor’s visits, extra tests; not to mention costly cancer treatments.

Conservative opposition to an HPV vaccine on the grounds that it is a license for teenage sex makes utterly no sense. “Teaching abstinence” to the exclusion of other methods for birth control and disease prevention as social policy in schools is counter-productive in this society. People simply aren’t buying it; a simple scan of teenage pregnancy rates and what’s produced by the culture should tell you that. It’s fine as a personal creed (however misguided I may think that is); something to teach one’s own family. I’m not arguing here that you shouldn’t do that.

Frankly, I agree with fellow Raging RINO commentators over at Restless Mania that conservative opposition to an HPV vaccine for any reason makes no sense: it highlights the success of “big business” that “progressives” insist wants to destroy the very universe so that their CEOs can dive, like Scrooge McDuck, into massive piles of gold coins while saying “MINE! MINE!”, and sending their fascist shock troops to beat poor people and minorities into submission with oversized King James Bibles. People like the FRC put ammunition in their guns.

No bad comes of this vaccine, especially from a conservative standpoint. Two corporations developed vaccines and a wealthy citizen donated money to the project in its early stages. Health care costs go down, which means that government subsidies of health care go down. Insurance costs go down, which means that subsidies of health insurance go down. Here’s an opportunity to put money back in Americans’ wallets, and to have some more Americans alive to enjoy it, for very little risk. Why not take it?

As a conservative (who is not a Republican), opposition to this makes no sense to me.

UPDATE: I posted this piece, with minor changes, to my Newsvine column; and it was rated so highly that it got me a temporary spot as one of Newsvine’s “featured writers”. Part of the rating is, no doubt, the mileage one seems to get there from criticizing conservatives, but I hope at least some of it is because the piece is good.

You have to register to comment there, so you may not want to (unless you want one of the 18 invites I have left), but you can read the discussion and bring your favorite points back here if you want.

It also needs to be noted that the Dobsonites’ opposition is not to the vaccine itself but to making it mandatory, which makes just as much sense (i.e., none).

This entry was posted on Thursday, March 16th, 2006 at 12:25 and is filed under politics, science. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.