So yesterday a government panel recommended that all young women and girls be vaccinated against the human papillomavirus. Here is a quote from the New York Times:
A federal vaccine advisory panel voted unanimously yesterday to recommend that all girls and women ages 11 to 26 receive a new vaccine that prevents most cases of cervical cancer.
The vote all but commits the federal government to spend as much as $2 billion alone on a program to buy the vaccine for the nation’s poorest girls from 11 to 18.
The vaccine, Gardasil, protects against cancer and genital warts by preventing infection from four strains of the human papillomavirus, the most common sexually transmitted disease, according to federal health officials. The virus is also a cause of other cancers in women.
The development and subsequent approval of this vaccine is very good news considering that HPV (aka-genital warts) is the most common sexually transmitted disease here in the US. (I should note that HVP is a group of several different viruses. The strains of HPV that cause visible warts seem to be less carcenogic than the strains that do not show visible symptoms.)
I thought it was interesting that this is being promoted as a “cervical cancer vaccine” because it really isn’t a cervical cancer vaccine, it’s a HPV vaccine. From what I have read the vaccine only works in people who do not have the strains of HPV it inoculates against and it decreases the risk of cervical cancer by preventing HVP infection. I suspect that framing this as cancer prevention is probably more acceptable to those parents who would reject the idea of a sexually transmitted infection (STI) vaccine, but there is something that bothers me about framing it in that way.
I’m also curious as to why the vaccine is being recommended for only girls and women. It seems to me that the best way to slow down the infection is to vaccinate everybody. One study indicated that vaccinating men would reduce the prevalence of HPV, but it would not be cost effective. Upon doing some further research, I found that there is a vaccine produced by Merk that can be used in men or women, but the vaccine was not universally recommended by the panel yesterday. I think even if it is more costly we should vaccinate everybody. In particular, vaccinating only women would not help men who have sex with men. This would be a non-issue if cervical cancer was the only type of cancer caused by this virus, but the HPV (which is really a group of several different viruses) viruses also can lead to cancer in the anus, penis, vagina, and vulva. The good news is that these cancers are less common than cervical cancer, but they are still costly and deadly cancers that we should try to eradicate. It seems to me that the vaccine should not be gender specific. I understand the practical reasons for calling it a “cancer vaccine” not a HPV vaccine, and I suppose it could still be called a cancer vaccine since HPV seems to increase the risk of several kinds of cancer.
I’m not trying to dampen the good news. I think the development of this vaccine is great, but I think it should be universally recommended without regard to gender. The current vaccination strategy seems to be modeled on heterosexist assumptions about sexual behavior, and it will not eradicate the disease. Universal vaccination would do this.