Right for the Wrong Reason?

In 2007, Texas Governor Rick Perry signed an executive order mandating that teenage girls be vaccinated with Gardasil, a vaccine that helps prevent cervical cancer by providing protection against Human Pappillomavirus, or HPV. This was subsequently overturned by the Texas legislature. Now it’s a matter of discussion among Republican presidential candidates. Representative Michelle Bachmann has criticized not only that, ““To have innocent little 12-year-old girls be forced to have a government injection …is just flat out wrong,” but has also suggested that he was motivated by political donations from pharmaceutical company Merck.

We’ll have to see how things play out in regards to whether Governor Perry made his initial decision because of political donations, but it least has the appearance of impropriety.

From a medical point of view, I think he was right to mandate vaccination against HPV, even if he did so for the wrong reason. According to the CDC and the American Cancer Society, at least half of sexually active people will get infected with HPV in their life. Half of those people are infected between 15 and 24 year of age.

In the United States, about 12,000 women are diagnosed with cervical cancer, and 4,000 die from it, each year. HPV causes most of these, as well as many cases of anal and oropharyngeal (mouth and throat) cancer, and genital warts.

As a father of daughters, I get that when they’re 10 to 12-years-old, you don’t want to think of them being sexually active. But most people eventually are, and you can’t be certain that it will only be with one uninfected person the rest of their life. Once they’re infected, it’s too late.

The policy for vaccination against HPV should not be different than for other infectious disease, such as tetanus, polio, measles and chicken pox. If you love your children, you should seriously consider vaccinating them. Even if he had ulterior motives, I think Governor Perry had the right idea.

Author: Daniel Ginsberg, MD, FACP

I'm an internal medicine physician and have avidly applied computers to medicine since 1986, when I wrote my first medically oriented computer programs. So yes, that means I'm at least 35-years-old!

2 thoughts on “Right for the Wrong Reason?”

  1. Dear Dr Ginsberg

    Please don’t take this the wrong way. I am extremely passionate about the care of woman and children (no offense to men). They make up the majority of my practice. I would love more than anything to have HPV eradicated. I am a proponent of vaccines and in fact it drives me mad when moms don’t vaccinate aside from HPV.

    However, I would have to agree to disagree with you. It is never right to mandate the vaccination of young girls against HPV particularly since it has received so much controversy (has been linked to deaths) and may not do what it was intended to do: prevent cancer. Even without these above factors, I would still never advocate a mandatory vaccination for young girls. Yes, it is prevalent in 50% of women but is it life threatening no not immediately and potentially not ever. Until there is a better vaccine, I would say screen, counsel on safe sex practices and screen some more.

    Here is a link to a nice article which summarizes some of the controversy: http://articles.mercola.com/sites/articles/archive/2010/11/05/gardasil-vaccine-is-a-flop-for-good-reasons.aspx

    Thanks for your viewpoint, I enjoy reading and discussing even if it is opposing!
    Rajka Milanovic Galbraith, M.D.

    1. I appreciate your comments. To borrow the analogy of a tree falling in a forest, if my readers don’t make a sound, did my writing have an impact?

      Not being a pediatrician, I may not be attuned to all the concerns of vaccinating children. I didn’t mean to imply that the vaccination should truly be forced, but I think it would be reasonable to require it unless the parents actively decline.

      I don’t think it’s fair to say the vaccine should not be given as it has not proven that it prevents cervical cancer. The delay between getting infected and developing cervical cancer, not to mention the time between vaccination and infection, is so long that such a trial would not have results until after the vaccine has lost patent protection. It’s true that it doesn’t protect against all the viral subtypes that can cause cervical cancer, but it protects against the most common ones. We give lots of vaccines that don’t give perfect protection.

      Yes, preach safe sex. But given the incidence of sexually transmitted diseases, clearly it’s not sufficient.

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