The HPV Vaccine Debate Today and Why Preventing Syphilis Was “Immoral” Then

Jim Burroway

September 15th, 2011

On Monday’s Tea Party/CNN debate, Texas Gov. Rick Perry was blasted for signing an executive order requiring girls in Texas schools to be vaccinated for HPV, a virus which is the leading cause of cervical cancer in women (and, incidentally, the leading cause of anal cancer in men). The order included a parental op-out, but that did not mollify fellow conservatives who blasted him for trying to wipe out a sometimes sexually-transmitted cause of a horrible, painful death.

The argument is as old as the hills. Syphilis once played a similar role in public discourse at the turn of the last century. Untreated, syphilis leads to a slow breakdown of the body and nervous system that ultimately resulted in a premature dementia and death for its victims. And at the turn of the last century, it was not very curable — early cures were about as painful, time-consuming and deadly as the disease itself. In 1907, Dr. Elie Metchnikoff, of the Pasteur Institute in Paris, published what was later titled in English, The Prolongation of Life, in which he discussed a wide range of medical and moral issues facing society, including the debate about the morality of curing syphilis:

A large number of people, amongst them even men of science, regard as immoral any attempt to prevent to spread of venereal diseases. Recently, in connection with the investigations in the action mercurial ointment as a means of preventing syphilis, members of the Faculty of Medicine in France made a public protest, declaring that it would be “immoral to let people think that they could indulge in sexual vice without danger,” and that it was “wrong to give the public a means of protection in debauch.” None the less, other men of science, equally serious, were convinced that they were performing an absolutely moral work in attempting to find a prophylactic against syphilis which would preserve many people, including children and other innocent persons who, if no preventive measures existed, would suffer from the terrible disease.

…In the question of the prevention of syphilis, the moral problem is still more easy to settle. … The certainty of safety from this disease might render extra-conjugal relations more frequent, but if we compare the evil which might come from that with the immense benefit gained in preventing so many innocent persons from becoming diseased, it is easy to see which side the scale dips. The indignation of those who protest against the discovery of preventive measures can never either arrest the zeal of the investigators or hinder the use of the measures. This example again shows that reasoning is necessary in the solution of most moral questions. (Pages 302 and 304, American 1910 edition.)

Notice the debate taking place here, that it is a moral stand to withhold preventative treatment for a sexually transmitted disease, regardless of the consequences to those who do not undertake sexual activity of their own volition or who can acquire the disease non-sexually. HPV — and AIDS for that matter — also fit all of those characteristics. Little girls and women can acquire HPV through rape or molestation, and later develop cervical cancer. HPV, like syphilis and HIV, can also be transmitted prenatally from the mother. There are many routes of transmission, including casual skin contact, in addition to sexual transmission for HPV. But it’s that last aspect — remember how everyone on the debate panel, starting with moderator Wolf Blitzer, repeatedly called HPV a sexually transmitted disease? — which drove the debate on the morality of Rick Perry’s decision. There are similar mandates for vaccinations against measles, whooping cough and polio, but nobody was concerned about those mandates.

More than a hundred years ago, Dr. Metchnikoff found that “reasoning is necessary in the solution of most moral questions,” and that when one applies reasoning, the solution becomes obvious. But reasoning is non-existent among today’s GOP frontrunners. Dan Savage, like the good Dr. Metchnikoff more than 100 years before him, connects the dots:

Religious conservatives loved the HPV virus because it killed women. Here was a potentially fatal STI that condoms couldn’t protect you from. Abstinence educators pointed to HPV and jumped up and down—they loved to overstate HPV’s seriousness and its deadliness—in their efforts to scare kids into saving themselves for marriage. And they fought the introduction of the HPV vaccine tooth-and-nail because vaccinating women against HPV would “undermine” the abstinence message. Given a choice between your wife, daughter, sister, or mom dying of cervical cancer or no longer being to scream “HPV IS GOING TO KILL YOU!” at classrooms full of terrified teenagers, socially conservative abstinence “educators” preferred the former.

The state of scientific knowledge advances, but things never change for those of the earth-is-flat-and-God-is-on-his-throne mentality. If the day should ever come that the medical establishment is ready to role out a safe and effective vaccine against HIV, what you see today hints at the massive convulsion that will take place. If history is any guide (and why shouldn’t it be?) the apoplectic tantrums and scaremongering on the right will be epic, and you can guarantee that they will throw every roadblock imaginable to prevent its wide scale deployment.

BlackDog

September 15th, 2011

…until…one way or another, someone that’s important to THEM gets that disease.

They always seem to think it’s different when it’s them or someone they care about.

tristram

September 15th, 2011

Thanks, Jim. This article is the kind of cogent, intelligent analysis of important issues that BTB does so well (along with the excellent investigative reporting, international news, and historical perspective). I doff my virtual hat.

Regan DuCasse

September 15th, 2011

Yep, all we have to look at is the continued stigma against contraception and contraceptive sex.
We’ve had pharmacists refuse to fill prescriptions for female specific hormonal contraception, completely DISREGARDING the other conditions they treat OTHER than use as contraception.

However, Cialis and Viagra apparently is dispensed without considering why a man would want it or deciding to restrict it on moral grounds.

The disparity in how gender plays into this must be discussed. The HPV vaccine is being recommended for BOYS too.

We also, similar to the gender issue in such a discussion, cannot dismiss the stigma regarding sexuality in marginalized minorities.
The Tuskeegee Experiment is one such disgrace from the medical establishment.
And I’m convinced that the rampant egress into the gay community of HIV is a confluence of the tragedy of gay people being neglected, abused and deliberately misinformed by the medical establishment as well.
Distrust would be understandable because of such a difficult relationship.

I have reminded those who harp on HIV/AIDS as strictly a gay issue, of the historical significance of syphilis and who it affected and for how long.
The commitment for medical researchers and doctors to find cures or vaccinations for STD’s is considerably very brave.
Obviously in doing such work, OTHER types of cures could be found for other things based on the original work.

Every year, I read one or two books on medical history. Last year it was the history of the formation of the CDC and about Henrietta Lacks, a woman who died of cancer.
But her cancer lived outside of a host, and was replicated so much that it led to MAJOR breakthroughs in cancer research and cures.
Now I’m reading “The Emperor of All Maladies-A Biography of Cancer”, and seriously, I can’t get over the progress that’s been made and what unfortunate steps had to be followed to get to where we are now.

We are confronted all the time with people who are extremely shortsighted with their religious objections based on THEIR sense of morality. But we’d have gotten NOWHERE or would have been held back as a human race, much more had such religious zealots had their way.

If they don’t want to take advantage of such medical intervention as individuals, FINE.
But like contraception, for many, contraception is healthy and necessary for individual well being.

And those who object to it, cannot petition the government to keep others from having the choice, nor call it restriction of their religious beliefs and freedoms when others have the choice.
This is essential in what is deciding what is harmful or not to the well being of individuals as well as society. And obviously medical intervention for ANY kind of disease, however one acquires it cannot be argued as a bad thing for anyone.

Marauder

September 15th, 2011

I don’t think it’s fair to say that conservatives “love” HPV because it kills people. I especially don’t think anyone should take that opinion as fact on the say-so of Dan Savage, a man who, while his “It Gets Better” efforts have been commendable, seems hellbent on spreading misinformation and stereotypes about bisexual people. His own prejudices are clearly at work in that area and I think they’re clearly at work here too.

What I suspect lots of conservatives have a problem with concerning the HPV vaccine mandate is that it interjected government authority into a place where it didn’t necessarily belong. Measles, whooping cough, and polio are diseases kids can catch just by being around other kids at school. A kid would be at risk for them just by sitting in the same classroom as a kid carrying them – at least in the case of measles and whooping cough, I’m not sure about polio. Vaccinations for those diseases were necessary for a kid to be safe at school. People didn’t like the government saying, “Your daughter has to have this shot – even if she’s twelve years old – because she’s either going to be sexually active against you wishes or be raped or molested.” Why else would you give this vaccine to kids?

There’s a difference between supporting the availability of an HPV vaccine for people and families who want it and making it mandatory for seventh-graders unless their parents go out of their way to say no. Conservatives tend not to be fond of the government telling them what decisions to make in raising their children. Maybe I missed it, but I don’t see conservatives demanding that this vaccine be taken off the market so that lustful women will suffer for their sinning, sinning ways.

Andrew

September 15th, 2011

First of all, this is an argument that has “facts” that get in the way. HPV is actually a group of over 120 viruses.

Ever had a wart on your finger? Congrats. You’ve got HPV. At least one of them.

Some of them are linked to cancers. Some of them are transmitted PRIMARILY (but not exclusively) through sexual contact because they primarily infect the tissues found in genital areas… they infect those tissues, but can still be carried on hands… (in fact, this can frequently cause the virus to spread from genital to anal, etc.)

In other words… to be crass, one could contract “venereal” HPV by shaking hands with someone who didn’t wash after self-pleasuring, or using the rest room, theoretically, and then touching one’s own junk.

The point is, it’s a frickin virus. Stomp the damn thing out. I have no idea why we’re waiting until 12. What happens if a mother has HPV, has bad personal hygiene with respect to handwashing, and then changes her baby’s diaper?

Given the fact that 100% of cervical cancers are linked to HPV, and the lethality of cervical cancer, it’s unfathomable to me that anyone could take the immoral stance of not making this a required immunization for both genders…

Never thought I’d say this, but I liked Perry’s decision to require immunization…

Charles

September 15th, 2011

HPV is a virus that needs to be wiped out or at least reduced to as much as possible in our population. I think Perry’s opt-out was appropriate. It should have been recommended by the Texas state health officials. And, health officials of other states. Some people praised Santorium for saying it should have been an opt-in program. Frankly, I don’t see the difference. Young women and men should be encouraged to get the vaccine. I noticed that on the CDC website it is only recommended for men under the age of 27. For what reason, I have no idea why. My guess is that more testing has been done on women because HPV does cause cervical cancer. Today children are vaccinated for a host of viruses that I am not vaccinated against notably Hepatitis A and B. Perhaps they will have vaccines for HIV and Hepatitis C someday, which would be great. But there always new viruses popping-up seemingly out of no where. An influenza epidemic like the one of 1918-9 is way over due. And, with the world population now over 6 billion people …. something like that is bound to happen.

Martin

September 15th, 2011

People didn’t like the government saying, “Your daughter has to have this shot – even if she’s twelve years old – because she’s either going to be sexually active against you wishes or be raped or molested.” Why else would you give this vaccine to kids?

Because vaccination is more effective if it’s given well before one is likely to be exposed to infection.

Because even if your daughter does not engage in sexual activity before marriage, she may marry a man who is infected with HPV.

Because even if your daughter does not intend to have sex outside of marriage, she may be forced into sex against HER wishes, and become infected with HPV.

Because disease isn’t about morality. Microorganisms don’t care who thinks you’re a moral person.

darkmoonman

September 16th, 2011

More of the Abrahamicists’ inflict their anti-sex prejudices on everyone.

Marie Swanson

September 16th, 2011

I am completely offended that this debate has been diverted from the real issue, which is the safety of the vaccine. Instead of condemning Michele Bachmann for prejudice check the VEARs system for the injury rates of the HPV vaccine. You will discover it is not hearsay but fact that children have been killed and permanently injured by this vaccine.

Regan DuCasse

September 16th, 2011

Well said, Martin!
That’s the point. The vaccine is most effective when given prior to adolescence.

Would these same factions object if a cure or vaccine came along for Herpes Simplex II, or HIV/AIDS?
Because one’s sexual orientation or sexual frequency or marital status won’t save you from such stealthy diseases, and shame on those opposed who already are spreading misinformation counter to these truths.

And you’re absolutely right that herpes has different types of transmission OTHER than sex. So it’s well worth it to take advantage of ANY kinds of vaccines that prevent the contraction or spread of anything, regardless whether it’s airborne or not.

Some people are anti pharmaceutical companies and are willing to NOT take vaccines for reasons of paranoia and lack of accurate information.
But those are exactly the reasons how diseases are spread too.
I don’t know why anyone would be so down on the R&D and eventual result of effective medications on the market.

Anyone we know with HIV have an issue with the evolution of retrovirals?
The vaccine for shingles?

These people getting all hysterical over this miracle and PRO LIFE vaccine really have their heads up their asses.

Ben In Oakland

September 16th, 2011

Marie:

•From June 2006 to June 2008, the Vaccine Adverse Event Reporting System (VAERS) received just under 10,000 reports against Gardasil. Of those reports, 94 percent were regarded as non-serious, the remaining six percent were considered serious side effects (defined as death, requiring hospitalization, illness, or disability). According to the CDC, the percentage of serious side effects regarding Gardasil is about half of the average for vaccines overall. You should take the time to read what the CDC has to say about Gardasil and the safety of the vaccine.

Charles

September 16th, 2011

No vaccine or drug is 100% safe. If you want to commit suicide just get a bottle of common aspirin and consume the entire bottle. You will bleed to death. Printed warnings for every drug you take are so long no one reads them.

Marauder

September 18th, 2011

Martin: Right, someone’s daughter might grow up to marry a guy with HPV. Why would that mean she should get the HPV vaccine when she’s twelve, except if A) she voluntarily becomes sexually active at that age or B) she’s raped or molested? Correct me if I’m wrong, but I don’t think people get cervical cancer because they shook hands with someone who had HPV.

People don’t want to hear, “Your seventh-grader needs this vaccine now because she’s going to be exposed to STDs sooner or later anyway.” They especially don’t want to hear it from the government, and be told that they have to go out of their way to make sure their kid doesn’t get a shot they don’t want her to have. I think this controversy is much, much more about this vaccine being mandated by law than it is about an HPV vaccine existing in the first place.

Priya Lynn

September 18th, 2011

Marauder, the vaccine wasn’t mandated by law, there was an opt out.

Mark F.

September 19th, 2011

I have no problem with Perry’s policy as you could opt out.

Timothy Kincaid

September 20th, 2011

Maurader,

People don’t want to hear, “Your seventh-grader needs this vaccine now because she’s going to be exposed to STDs sooner or later anyway.” They especially don’t want to hear it from the government, and be told that they have to go out of their way to make sure their kid doesn’t get a shot they don’t want her to have.

No, they certainly don’t want to hear it. They also don’t want to hear that their Founding Fathers did not set up a Christian Nation and that many didn’t share their beliefs. They don’t want to hear that constitutional protections are intended to protect individuals against the will of the people, not enforce the whim of a majority. They don’t want to hear that if they insist on being obese that perhaps their health insurance will increase. They don’t want to hear that Jesus is not President and that their church doesn’t have veto power over the courts.

But mostly they don’t want to hear that they aren’t special.

Every Sunday down at The Comfortable Church they hear that God loves them and that, unlike the readers here, they are saved and going to Heaven. They hear that their beliefs about politics and economics are endorse by God and are right, regardless of what any researcher or scientist or theoretician (or the Bible) has to say about it. They hear that Parenting is a very very special thing that has been Entrusted to them by God and therefor is far more important that epidemiology. Why, Parental Rights are bestowed upon them by their Creator (which they don’t want to hear is a deist term) in the Bible or the Constitution of the Declaration of Independence or some other document they love to revere but have never read.

And they certainly don’t want to hear that its possible that someone just might know more about the health of their precious darlings than they do. And they don’t want to hear that this is really just misplaced moralism or over-aggressive theocratic zeal. Because they heard on Christian Radio that this was Parental Rights.

And they don’t want to hear anything that disagrees with their church or Christian Radio. Mega Dittos, you know.

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