Box Turtle Bulletin

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

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.