Everything you need to know about HPV, cervical cancer and a brand new vaccine that the right wing is crusading to stop.
By Rhian Kohashi O’Rourke, Center for American Progress
Monday November 21, 2005
My best friend has HPV. Two of my relatives, who are both happily married, have been exposed to HPV. Every day, a friend who works at a public health clinic explains what HPV is to dozens of patients who have never heard of it before.
Eighty percent of Americans are exposed to HPV (short for human papillomavirus) at some point during their lives. So why does only a third of our population even know that this ultra common virus exists?
During a happy hour this past summer, friends in medical school told me a story about the time their class covered the sexually transmitted infection HPV. When the professor announced that 20 million people in the U.S. are currently infected with genital HPV and that half of all sexually active women between 18 and 22 in the U.S. have it, relief rippled through the classroom: “’We were all thinking: ‘Thank God I’m not alone!’”
Another friend who had HPV told me this: “I never talk about HPV – not even with people I have sex with – because it’s so common, transient and usually symptom-free. It’s not at all like AIDS.”
There are roughly 200 different types of HPV and about 40 of those strains are spread through sexual contact. Many people are carriers of the virus without even realizing it – the infection can live in the skin without causing symptoms. In over 90 percent of cases, HPV infections are harmless and disappear without treatment.
However, there are two dangerous strains of HPV that lead to cervical cancer. Cervical cancer strikes more than 10,000 American women a year and causes almost 4,000 deaths annually in the U.S.—making it the second most deadly form of cancer for women. Already, half a million new cases pop up each year worldwide. By 2050, experts predict that deaths from cervical cancer worldwide may jump to a million a year.
But luckily, two brand new, 100 percent effective vaccines that will protect women against the two most dangerous strains of HPV that cause cervical cancer have just been announced. Two companies, Merck and GlaxoSmithKline, will be seeking FDA approval in the upcoming year for their separate vaccines, which may completely eradicate the threat of cervical cancer.
Thanks to this groundbreaking vaccine, the once elusive HPV is now in the spotlight as a key player in yet another stage of the culture war.
The Holy Grail
Medical experts are ecstatic about this first ever cancer vaccine, seeing it as a sure way to prevent future deaths from cervical cancer. Eliav Barr, who works with Merck, has even equated the medical breakthrough to the Holy Grail.
Health advocates are recommending that we make the vaccines part of the routine school vaccines that teenagers – especially girls – receive before they hit puberty and become sexually active. So far, studies demonstrate that the vaccine is more effective among young adolescents than young adult women.
Advocates are therefore encouraging a branch of the Centers for Disease Control – the Advisory Committee on Immunization Practices (ACIP) – to add the cervical cancer vaccines to a list of recommended immunizations for the nation. Cervical cancer would join a list of other diseases such as polio, measles and rubella. A spot on ACIP’s list would encourage states to mandate that the vaccines be given in schools to protect public health. It would also most likely lead to public funding of the vaccines.
By providing them in schools, we would ensure that every young woman in our country, regardless of class, race, and economic background, has access to these lifesaving vaccines.
Studies show that low-income and minority women are at a higher risk of developing cervical cancer because of limited access to health care. Latinas, for instance, have the highest cervical cancer rates in the U.S. – they have double the number of cervical cancer incidents than non-Latina whites. Asian Americans and Pacific Islander communities are also being hit hard. In California, cervical cancer is the most common form of cancer among Laotian American women, and the second most common for Cambodian American women. By offering the vaccine to all students, we would avoid putting minorities at risk – and would avoid penalizing those who cannot afford Pap smears that detect cervical cancer while there is still time for effective treatment.
We would also significantly reduce the billions of dollars we are now pouring into follow-up and treatment of women who have HPV and abnormal cervical cells. The total cost to evaluate and treat women with abnormal Pap smears has been estimated at $6 billion annually. This is not including the social costs of emotional distress and anxiety. Finally, cervical cancer attacks women’s fertility. By giving all people access to the vaccine, we are not only saving women’s lives; we are also preserving women’s ability to have children.
Backlash
Despite these inarguable benefits, social conservatives have geared up to oppose the vaccinations. They claim that making the vaccines part of standard school immunizations will give a green light to young adolescents to have sex before marriage – an assertion that is not backed up by any scientific evidence.
Conservatives have claimed that administering the shots will encourage promiscuity. For instance, Tony Perkins, President of the Family Research Council, says he would refuse to inoculate his own daughter. “Our concern is that this vaccine will be marketed to a segment of the population that should be getting a message about abstinence.… It sends the wrong message.”
Despite the fact that experts say that thousands of malignancies and needless deaths could be prevented, Leslie Unruh, Executive Director of the National Abstinence Clearinghouse, stated, “I personally object to vaccinating children against a disease that is 100 percent preventable with proper sexual behavior.”
Virginity Trumps Life
So, does the cervical cancer vaccination issue really boil down to social conservatives caring more about our youth’s virginity than their lives, as some have criticized?
Conservatives have long used HPV as a main deterrent to sex. Because HPV is spread by skin-to-skin contact, condoms reduce the chances of passing the virus but do not always fully protect against the virus. So social conservatives have used HPV as the primary example for why only abstinence, if correctly practiced, works. When progressives urge condom use, conservatives trot out HPV as the reason people should not rely on condoms to protect them.
As Representative Jo Ann Davis, R-VA, says: “…we’re sending the wrong message when we use taxpayer dollars to give condoms out to these kids and we don’t tell them, ‘By the way, you’ll probably be dead at age 24 by cervical cancer. But we’re giving you condoms, so go do your thing.’”
The new cervical cancer vaccine undermines this claim that abstinence-until-marriage is the sole way to prevent HPV.
But if girls were just abstinent and just kept their legs crossed, we wouldn’t need the HPV vaccination in the first place, right?
Wrong. Even abstinent women can be raped or molested – and women who remain virgins until marriage may have a spouse who is unfaithful or an unknowing carrier of HPV.
In addition, many teens who take virginity pledges still engage in risky, unprotected sexual activity that does not include sexual intercourse. In fact, one study found that the sexually transmitted diseases rates are the same for virginity pledgers and non-pledgers alike.
Approximately 90 percent of Americans are not virgins on their wedding nights and 67 percent of young people are sexually active by age 18. And this is how people act even with the threat of AIDS, which they already associate with sexual risk.
By ignoring this reality and denying these cervical cancer vaccines to our youth, we would be putting their lives in danger – whether we want to face the fact that they are having sex or not.
Plan B Parallel
The right-wing viewpoints echo arguments that are being made in the current Plan B debate. Conservatives say that if girls under the age of 18 have access to the “morning after pill,” they will engage in riskier sexual activities. However, studies show that women who have access to emergency contraception do not experience an increase in STDs or pregnancy.
Progressives’ response is that we can prevent thousands of deaths from cervical cancer, educate our youth about contraception, and encourage abstinence all at the same time. We must ensure that what has happened with Plan B is not repeated, and that conservatives’ unfounded fears of promiscuity are not allowed to derail access to these anti-cancer, lifesaving vaccines.
Top 5 Things You Should Know about Cervical Cancer Vaccine
Rhian Kohashi O’Rourke is a research associate for the domestic policy team at the Center for American Progress. She can be reached at rorourke@americanprogress.org.