Does the HPV vaccine "promote" promiscuity?
Read more from Slate's Sex Issue.
In recent months, you may have seen a TV ad featuring striking young women skateboarding and drumming as a voice-over intones, "Every year, thousands of women die from cervical cancer. I want to be one less woman who will battle cancer." The women represented are self-confident, accomplished, artistic, and independent. Only one boy shows up in the ad—in a still photo. But what is most striking about the ad is that it is just one part of a much larger cultural and political battle about young women and sex.
America declared a "war on cancer" 30 years ago, and yet few cures or vaccines have been discovered since. So when Merck announced that it had a created a drug that could prevent some 70 percent of cervical cancers from developing, you would think Americans would rejoice. Instead, there was a backlash. Last February, Republican Gov. Rick Perry signed an executive order that would have made Texas the first state to mandate the vaccination of schoolgirls against HPV, the sexually transmitted virus that is a frequent cause of cervical cancer. He promptly came under fierce attack. The Texas Legislature expressed its deep reservations about the vaccine, and the media reported that Perry had received a campaign contribution from Merck prior to signing the order. Ultimately, the order was vetoed by the legislature. Earlier this year, 24 states were contemplating making Gardasil—as the cervical-cancer vaccine is known—a mandatory vaccination for young women. Today, only one state, Virginia, has such a law, and it leaves a loophole for parents to opt out.
In one sense, this reluctance seems understandable. Merck is the same company that made headlines in 2004 for failing to disclose that its painkiller Vioxx raised the risk of cardiac arrest and stroke in patients. Gardasil is a brand-new drug, and the company has conducted only limited testing on it. Though the pre-release studies suggest it is highly efficacious, the vaccine's long-term side effects are not fully known. What's more, the vaccination comprises three painful shots, at an estimated cost of $360. Given all this, it is hard to blame parents who resist putting their daughters on the drug's front line, preferring to wait until more is known about it.
Much less understandable, though, is the position taken by many opponents: namely, that a cervical-cancer vaccination would "promote promiscuity" among teenage girls. Implicit in this argument is the assumption that good girls don't get cervical cancer; only "loose" ones do—and they may get what they deserve. Earlier this year, State Sen. George Runner of California told the Los Angeles Times that American money would be much better spent on other types of vaccines, since cervical cancer is a result of lifestyle choices, rather than bad genetic luck.
This view involves a hefty dose of ignorance, as well as a dollop of old-fashioned magical thinking. As any doctor can tell you, it takes only one sexual contact to contract a strain of HPV that can lead to cervical cancer. The CDC reports that at least 50 percent of Americans are infected with HPV over the course of their lives, and a whopping 80 percent of American women are infected by age 50. Admittedly, the chances are slim that HPV would lead to cervical cancer: Only a small portion of HPV infections become cancerous. Still, according to the National Cancer Institute, roughly 11,000 women will be diagnosed with cervical cancer this year in the United States. Nearly 3,700 women will die. If you are one of those 3,700 women, you might feel that a vaccine could have changed everything. And—contrary to Runner's insinuations—you needn't be a slut to be among them: You could have married a guy who slept with just one other girl. Or, of course, you could be one of the approximately 13 percent of American women who, according to a 2003 study, are or will be a victim of rape over the course of their lives.
Meanwhile, the idea that a mere vaccination could "promote promiscuity" is bizarrely simplistic—as if the prick of a needle in the arm of a pre-adolescent girl stands in for a, well, prick of another kind. For one thing, no evidence suggests a connection between a decrease in HPV and an increase in sexual activity, nor is it likely to: HPV is hardly a major deterrent to kids who might be squeamish about STDs, since it has few short-term effects and cervical cancer usually takes years to develop. Adolescents have a hard enough time thinking about next week, let alone a decade from now. They're more likely to be worried about the immediate effects of herpes, gonorrhea, or syphilis, or even AIDS, which is still more prevalent than cervical cancer. For another thing, there's already a vaccine out there designed to prevent a sexually transmitted disease—and it's not being protested by anyone on the grounds that it might encourage promiscuity. That vaccine is for hepatitis B, and it is given to approximately 88 percent of all American children by the time they are 19 months old. Finally, it's not as if adolescents are incredibly rationalabout their sexual calculations, as the vaccine-promiscuity argument would have Americans believe.
Meghan O'Rourke is Slate's culture critic and an advisory editor. She was previously an editor at The New Yorker. The Long Goodbye, a memoir about her mother's death, is now out in paperback.
Illustration by Alex Eben Meyer.