Stamping Out Disease

In 1803, popular mythology has it, Edward Jenner noticed that milkmaids were less likely to get smallpox. He hypothesized that this might be because they had been exposed to cowpox, a related disease, and had developed immunity to the deadly scourge of smallpox. He tested his theory by inoculating patients with cowpox: lo and behold, he had discovered a safe inoculation to protect people from smallpox. He called the inoculation a “vaccine,” derived from the Latin word for cow, and it was such a breakthrough for medical science that we now use the term generally to refer to all inoculations.

176 years later, the international health community proudly announced that smallpox had been eradicated, thanks to dedicated efforts all over the world to vaccinate citizens at risk. Today, the spectre of smallpox still haunts us, although vaccinations for it are not required.

The global eradication effort was supported at home in the United States, as part of a historical record of heavy vaccination. When vaccines for horrible diseases like polio and measles were developed, states required children to be vaccinated: most Americans, at least, are of the position that these diseases are fully preventable, and there’s no good reason not to vaccinate for them. Schools require children to show proof of vaccinations before they can enroll, as do colleges—I remember a frantic hunt for a rare vaccine when I went to [liberal arts college] because it wasn’t required by California law, so I’d never received it. I’m all for vaccines: I’m vaccinated, and so are the cats, because to get a preventable disease would be a great tragedy. I’m also all for the development of new vaccines.

In 2006, the Food and Drug Administration approved the use of Merck’s Gardasil vaccine in women. The vaccine is touted as a “cervival cancer vaccine,” which it technically is not. Gardasil protects against several strains of the human papilloma virus, which has been directly linked with cervical cancer. But studies support the assertion that the strains Gardasil vaccinates against are those which cause cervical cancer, so in theory, vaccination with Gardasil will prevent cervical cancer. Pretty neat, eh?

So guess which state was the first to require the use of Gardasil in young women, to premptively prevent HPV infection and cervical cancer? Was it progressive, free wheeling California, with one of the best women’s health programs in the nation? No. Was it radical Vermont? Guess again.

Texas is the first state to require use of Gardasil, unless families object due to religious convictions. Texans, apparently, are more concerned about young women’s health than Californians. Perish the thought.

Arguments against the requirement are fierce, but the caveat that families can refuse to participate has defused any really bitter fighting. I hope that all families comply: even Christian women in upstanding marriages can get HPV and cervical cancer: it’s not just something that happens to harlots. I hope the requirement is followed in other states, and that they also follow suit to make it available to people of low income. When I researched the possibility of taking Gardasil in San Francisco, I discovered that the three shot series would cost me over $150. While cervical cancer would cost me significantly more, the fact is that I don’t have $150 now, so I have to take my chances with cervical cancer later. Bummer.

The development of Gardasil was a great thing for women’s health, and I hope that it will be followed with other medical advances. Hopefully, with time the vaccine will become accessible to all, not just the wealthy, and we can say that cervical cancer has been eliminated as well.