Third Way Dispatch

It really must be the 21st century, because at last we have in our hands the first-of-its kind vaccine against cancer. But at times it seems like the political debate over the vaccine – yes, there is actually a DEBATE over a cancer vaccine – is rooted firmly in centuries past.

Specifically, this vaccine can prevent the strands of the human papillomavirus (HPV) – otherwise known as genital warts (our nation’s most common sexually transmitted disease) – that are most likely to result in cervical cancer. The American Academy of Family Physicians, the Centers for Disease Control and Prevention (along with its Advisory Committee on Immunization Practices), the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists all recommend the HPV vaccine for girls aged 11-12.

So why not require this vaccine for girls before they are sexually active and can contract the virus? Some states are doing exactly that. In Virginia and New Mexico, Democratic Governors Tim Kaine and Bill Richardson (who is also running for president) have pledged to sign legislation that requires all girls entering sixth grade beginning in September 2008 receive an HPV vaccine.

Dog Bites Man you say – those are Democrats. Well how about this: the national leader on this issue is the very Republican Governor of Texas, Rick Perry. In February, Governor Perry issued an executive order and made his state the first to mandate the vaccine for all girls. “The HPV vaccine provides us with an incredible opportunity to effectively target and prevent cervical cancer” he noted. “Requiring young girls to get vaccinated before they come into contact with HPV is responsible health and fiscal policy that has the potential to significantly reduce cases of cervical cancer and mitigate future medical costs.”

The first ever of its kind cancer vaccination, Republican and Democratic Governors alike and from different regions of the country supporting mandatory vaccination – isn’t this all straightforward?

Ah – the answer, as with so many culture issues, is that there is more to it than initially meets the eye. Think about it for a minute – isn’t it freaky and unsettling for a parent to think of their 11 year-old girl being sexually active, even some day? And, if you’re the kind of parent who takes the time to explain the reason for your child’s shots, it’s quite a dance to explain this one. In a culture where pre-teen girls are already overly sexualized, many Americans have to overcome worries that a vaccine for an STD would give their daughters a false sense of security, leading them to become even more prone to sexual promiscuity. And should anyone be forcing parents to do anything when it comes to this delicate subject area?

These concerns run very deep, and they are shaping – and in some cases derailing – good public policy. In Texas (as in Virginia), Governor Perry’s vaccine policy includes a provision allowing parents to opt out of having their daughters vaccinated. Yet the State House of Representatives voted 119-21 in favor of a bill that would nullify the Governor’s order. The outcome in Texas isn’t yet clear – to prevail, opponents of the mandatory vaccine would have to pass the same bill in the State Senate and then overcome Governor Perry’s potential veto.

But figuring out the best public policy isn’t nearly so cloudy. Governor Perry has it right. His policy embodies the concept of responsible progress. It takes the moral high ground, by ensuring that all Americans benefit from the genius of modern science and this first-ever cancer vaccine, and still addresses the moral complexity of the issue by allowing parents an opt-out. It follows America’s finest tradition of progress and responsibility – it is good for girls and for our public health system, and it protects core American values.

What’s the lesson here? Before they wade into anything involving sexual activity, policy-makers must understand and respectfully address a myriad of moral concerns if they are ultimately to prevail. And even still, they may only prevail in the long run.