As expected, the advisory committee to the Centers for Disease Control and Prevention recently recommended that adolescent girls and young women receive a new vaccine with the trade name Gardasil, which targets the human papillomavirus (HPV). Various strains of HPV are sexually transmitted and produce infections that are responsible for virtually all cases of cervical cancer. Cervical cancer kills 10 American women a day. The Food and Drug Administration (FDA) has already found the vaccine to be both safe and effective.
Development of a vaccine for HPV is a tremendous medical achievement and a boon to public health. It holds the potential to protect the health of millions and preserve the lives of thousands of American women each year. After extensive study, we and other pro-family groups have concluded that the clear benefits of developing an HPV vaccine outweigh any potential costs. The groups welcoming it include leading conservative pro-family organizations such as the Family Research Council, Focus on the Family, Concerned Women for America and the Medical Institute for Sexual Health.
There are, however, two important concerns that must be emphasized.
The first is the accurate communication to the public of what the vaccine does, and does not, prevent. Gardasil is being touted by its manufacturer, Merck, as the world's first vaccine to prevent cancer. And approval of the vaccine has been greeted by breathless headlines declaring that the vaccine was found to be "100 percent effective."
Actually, the vaccine targets only four out of the dozens of strains of HPV. Gardasil targets two strains responsible for 70 percent of cervical cancer cases and another two responsible for most cases of genital warts (the most unpleasant external symptom of HPV infection).
But 70 percent is not the same as eradication. The public must understand the undisputed scientific facts regarding the HPV vaccine. Most important, it is only "100 percent effective" against the strains of HPV it targets, leaving 30 percent of cervical cancer cases untouched. This means that even if every person in the country were vaccinated, women would still need to get yearly Pap tests. And, tragically, some women will still die even when all precautionary measures are taken against cervical cancer. Claims that "the new vaccine, when used appropriately, will virtually eliminate cervical cancer" are simply false.
Our second concern is the argument we hear from some groups that the HPV vaccine should be made mandatory. Pro-family groups are united in believing that parents should decide what is best for their children. We oppose any effort by states to make Gardasil mandatory (for example, making it a requirement for school attendance). If use of the vaccine becomes part of the recommended standard of care, and if the federal Vaccines for Children program pays for vaccination of those children whose families cannot afford it, then vaccination should become widespread without school mandates.
Mandating vaccination may be justified when the disease in question is easily transmitted through casual contact or blood. But in this case the strains of HPV that cause cervical cancer are transmitted only through sexual contact. The paternalistic view that just because something is good for you the government should force you to do it is not one that most American families would welcome, especially when transmission of the virus can be prevented through behavioral change alone.
The scientific advance that the HPV vaccine represents should not distract us from the primary truth that abstinence until marriage and fidelity within marriage constitute the single best formula for sexual health. Behavioral self-restraint and vaccination are not mutually exclusive, since even someone who practices abstinence and fidelity could be exposed to HPV through sexual assault or marriage to an infected partner. But, as with other public health issues such as smoking, we should not limit ourselves to risk-reduction strategies when risk elimination is the ultimate goal.