Federal approval of the first vaccine against cancer has ripped open a riveting debate about how far lawmakers should go to protect us from ourselves.
It's an age-old question. Most parents were delighted in the 1950s to bring their kids in to be inoculated with the new polio vaccine. Yet, in that same decade, the lunatic fringe persuaded many communities to reject water fluoridation, which is good for young teeth, as some sort of a communist plot.
Flashbacks to those old debates are stirred up by the new controversies surrounding Gardasil, the new Merck & Co. vaccine that blocks two strains of human papillomavirus (HPV), which are responsible for most cases of cervical cancer.
Although most cervical cancer occurs in older adult women, the vaccine has been found to be most effective if injected before puberty.
Although the vaccine is effective in women as late as age 26, the Centers for Disease Control and Prevention recommends routine vaccination for girls age 11 and 12 - and as young as 9.
At least 20 states have been debating whether to require all girls to receive Gardasil to prevent cervical cancer and genital warts. In the meantime, the vaccine works and that's good news. According to the CDC, each year, more than 12,000 U.S. women are diagnosed with cervical cancer, and more than 4,000 die of the disease.
So this would be a much quicker and quieter debate were it not for one glaring difference between HPV and most of the rest of the other diseases in the alphabet soup of vaccinations (Hib, HepA, HepB, IPV, PCV, DPT, etc.) that children and teenagers already receive: HPV is spread through sexual contact.
When I think about my 12-year-old niece in Chicago while the debate goes on in the Illinois General Assembly, I understand the squeamishness that many parents feel about this particular inoculation. Social conservatives, in particular, already fear any talk of sex with young people, other than that which advises them to abstain from it.
Yet, a large minority (42 percent) of the population has not even heard of HPV, according to a Wall Street Journal Online/Harris Interactive Health-Care Poll, even though a large majority (70 percent) reacted favorably in the same poll to the use of the new vaccine to prevent it. Obviously, a lot more public education is needed.
That's a big reason why Texans were not the only ones surprised on Groundhog's Day when Gov. Rick Perry jumped way out ahead of that national debate. Without going through the usual niceties of a legislative debate, Perry issued an executive order to make his state the first to require the vaccination for schoolgirls aged 11 and 12.
Texans have good reason to wonder about Perry's haste; he's a usually conservative Republican. If any issue calls for reasoned debate and public education, this one does.
Nor did it calm anyone's nerves to learn that Merck, which stands to make billions from the drug, had hired as one of its top lobbyists, Mike Toomey, who once served as Perry's chief of staff and is very popular with the legislatures. Merck also doubled its spending on lobbyists in Texas this year, according to news reports, as lawmakers considered a vaccine bill that had not yet been voted on when Perry announced his executive order.
For a state that has been reluctant to provide other more urgently needed health-care coverage for the uninsured, it also seems odd for Perry to be in such a hurry to provide the vaccine in this case. Perry's plan allows parents to opt-out for religious reasons, as they can for other shots. But, for an innovation this new, they should be allowed to opt in.
With the rest of the country looking at Texas in this issue, Perry's bold move has been praised in some quarters, but his haste may have done harm to his cause. Predictably legislators say they have received a flood of mail from concerned constituents. Several lawmakers took immediate steps to reopen debate, this time on Perry's order, which takes effect in the fall of '08.
With emotions heated up, a lot of misinformation and unnecessary anxieties already are being stirred up over the new vaccine. The least grounded appears to be the fear that it will encourage more sexual activity outside marriage. Our society unfortunately has many larger reasons for that and it is a worthy debate for another time.
For now, Gardasil appears to be a very important and welcome life-saving step forward in the fight against cancer. Don't judge it by the political confusion it has caused.
