Daily Kos/SEIU Weekly State of the Nation Poll
When the Republican debate threw HPV vaccine into the news, public health officials cringed. When asked for comment Georges Benjamin, Executive Director of the American Public Health Association, said in part:
Vaccines save lives. The HPV vaccine in particular attacks cancer through its infectious source and will save the lives of thousands. It is the forerunner of a new approach to disease prevention; an approach that has enormous promise to save millions of lives in the future and be part of our 21st century tool chest to end cancer as we know it. Some vaccines should be required, as we do for some of our childhood vaccines. However the decision to mandate the vaccine in Texas did not go through an appropriate public policy decision making process, and we are now seeing the negative political and social ramifications of that decision.
What Texas actually did was mandate the HPV for girls entering the 6th grade, with an opt-out for parents not wishing to participate. However, it was done by executive order and quickly rescinded by the state legislature, leaving TX less likely to go there any time soon. It leaves Rick Perry with a political problem, but it also leaves public health officials with an unhappy public and a loose cannon in
Michele Bachmann:
During a debate last week for Republican presidential candidates and in interviews after it, Representative Michele Bachmann called the vaccine to prevent cervical cancer “dangerous.” Medical experts fired back quickly. Her statements were false, they said, emphasizing that the vaccine is safe and can save lives. Mrs. Bachmann was soon on the defensive, acknowledging that she was not a doctor or a scientist.
But the harm to public health may have already been done. When politicians or celebrities raise alarms about vaccines, even false alarms, vaccination rates drop.
Despite the efforts of health advocates who strongly recommend the vaccine but are cautious about mandates, such as the APHA, the
American Academy of Pediatrics and even Houston's
MD Anderson Cancer Center (that would be in Texas), the public is far from sold on the mandate part.
A new Daily Kos/SEIU Weekly State of the Nation Poll illustrates the dilemma (see chart above): when asked about requiring girls entering the 6th grade to require HPV vaccination (the language of the current Virginia law and the Texas attempt), support is at 22 while 57 oppose.
A careful inspection of the poll data shows not a single demographic comes close to approving a mandate. In fact, to illustrate Perry's political problem, in part caused by the executive order route rather than consensus building, the numbers are 18/65 oppose for the tea party and 17/64 for Republicans overall.
The end result from a public health perspective is that the vaccine is not given as often as it needs to be. From the New York Times:
Last month, the Centers for Disease Control and Prevention published a report on vaccination rates in girls that was “a call to action” to do a better job with the HPV vaccine, according to Dr. Melinda Wharton, deputy director of the National Center for Immunization and Respiratory Diseases.
“We’re not meeting our goals,” Dr. Wharton said. “Girls are not getting an important preventive measure that they need.”
A
New England Journal of Medicine article by
R. Alta Charo, J.D. in 2007 from HPV mandates still resonates:
Cancer prevention has fallen victim to the culture wars...
Since, without exception, the proposed laws permit parents to refuse to have their daughters vaccinated, the only valid objection is that parents must actively manifest such refusal. Such a slight burden on parents can hardly justify backing away from the most effective means of protecting a generation of women, and in particular, poor and disadvantaged women, from the scourge of cervical cancer.
Still true, and maybe as of now, set back even more.
In any case, HPV vaccine appears to be more collateral damage from the culture wars. Arguably, both Rick Perry and Michele Bachmann have already done this country harm, even if neither wins the GOP nomination. The vaccine will continue to be promoted and offered for good reason. The politics of mandating it are separate from the health science that recommends the vaccine.