HPV and vaccination: one blogger’s obsession
I think I'm mildly obsessed with the HPV vaccination and the resistance to it. The whole thing is a perfect storm of important issues for me: science and skepticism, feminism, public health policy, sexual health, religious delusions, the power that folk beliefs have over human choices, emotional vs. rational decision-making, and the ideological conflict between reality-based policy and aspirational policy. (Not that I think that conservative aspirations towards a sexual system where every human being has one other they touch in a sexual way—including hand-holding and kissing—and no more is a good aspiration. It's creepy.) I wish the conflict over this vaccine got more attention from wonky sorts, who I think are mildly wary of the sex thing, because it's really a perfect example of the various forces coming into conflict in our culture. I wrote about it again today for XX Factor, and was pleased to finally see a criticism of my point of view that wasn't coming from a place of squeamishness about sex, weirdness about preventive health, or just illogic. KJ at XX Factor argued that we shouldn't rush into making the vaccine mandatory (she does think it should be mandated eventually), because there would be a backlash, and that if we wait until it's become more normal, it will be easier to pass mandates. That's a reasonable position and she may be right. That is a typical pattern for many vaccine roll-outs, though not all of them. I tend to think that the HPV vaccine's reputation as the "sex shot" may make it a special case, and that we need to address often unspoken fears about female sexuality as much as we do unwarranted fears of the vaccine's safety. Some times what it takes to get over these fears is seeing with our own eyes that positive choices about sexual health in minors don't result in more sexual risk-taking. But I admit that we're all just guessing here; I've never seen any empirical proof either way that mandating a specific vaccine erodes opposition to it faster than an education campaign can.
Some more thoughts on this as the whole issue has gotten more coverage after Bachmann's glaringly stupid remarks:
*For a lot of conservative Christians, disease really is a judgment from god. Not always, but they really put a lot of energy into what they perceive are the supernatural causes of disease instead of boring old germ theory. This is how they can convince themselves that condoms don't work even though it never even occurs to them to question why therefore health care and food workers wear latex gloves. Bachmann's claim that the HPV vaccine can cause mental retardation comes directly from this way of thinking; it's that god allows it to happen as judgment for trying to prevent a disease he invented to control female sexuality.
*Anti-vax liberals actually have a not-dissimiliar point of view, though. When I was on MPR's morning show discussing this issue, a woman called in and basically explained her theory that she didn't have HPV any longer because she cured herself through diet and exercise. I don't want to say with 100% certainty, but I will say it with 99% certainty that she's wrong. HPV actually works itself out in the majority of cases, and from what I understand, age is a bigger factor than any other. (The older you are, the better your body is at killing the virus, though in some cases it sticks around for a long time.) You see this attitude with a lot of anti-vaccine liberals, that they don't need medical interventions to prevent disease because they can do it with organic food and yoga. It's a liberal version of the Christian right rejection of the germ theory of disease, but in this case your moral goodness is measured by your nutrition instead of your sexual choices (though I've found a LOT of liberal anti-vaccination folks get shockingly prudish about the fact that HPV is an STI). In reality, you cannot "boost your immunity" through organic food or praying/not sinning.
*:People's responses to this debate really oversell the idea that celibacy is an option. The "two virgins could marry each other and be free of HPV" argument is favored by conservatives, but it's a red herring. We could also wipe out deaths from car crashes if all Americans chose to quit driving and revert to a horse-and-buggy transportation system, but so what? I wish liberals would react to that argument by laughing wildly instead of coming up with rather irrelevant rejoinders like, "If your daughter stayed a virgin, she could still be raped or marry a man who isn't a virgin." Okay, sure, but she's not going to stay a virgin until she's married. So why are we talking about it like it's a real option?
*Seriously, it's not a real option. Fundamentalist Christians should stop preening like their daughters don't need the mandatory vaccinations in junior high school, because in reality, their daughters need it more. Evangelical Christians actually have younger ages of sexual initiation than pretty much any other religious group. Your average fundie 10th grader is a lot more likely to be fucking than your average atheist 10th grader, in part because research has shown that kids who get accurate, comprehensive sex education from their parents are more likely to delay having intercourse. (I'll leave it to you to speculate why—my theory is that it's a combination of willingness to use non-intercourse behaviors to stall the urge for intercourse and a sense that sex is something you really have to plan for, which discourages spontaneous sexual intercourse.) It's irresponsible to engage in speculation that their daughters could wait until marriage, because not only will they not be doing that, they'll be having sex at much younger ages. And with more partners; nearly 14 percent of evangelicals have 3 or more partners by 18, whereas only 9 percent of mainline Protestants do.
*Did you know that kissing with tongue raises the chance you'll get HPV? The requirements for being a "virgin who marries a virgin" in order to prevent the disease are so high that probably no Americans actually reach them.
*I think the most important conversation this country needs to have is one about how it's not a big moral deal if you get an STI. Viruses and other infections aren't moral agents, casting judgment on your sluttiness. They're just germs. That your odds of getting an STI go up the more people you sleep with—all other things being equal, that is—is as remarkable as pointing out that your odds of getting the flu go up the more people you shake hands with. Part of the problem is that sexual shaming has been an aspect of STI public health campaigns in the past. What we need are public health campaigns that treat it as completely normal that one would have more than one partner in a lifetime, because you almost certainly will. A lifetime is a long fucking time, you know. It's not enough to promote condom usage. We have to treat someone who has a lot of partners with the same moral neutrality as we'd treat someone who gets a job in a public school around a bunch of kids who can give them the flu. They have an elevated risk, but that's part of the price they pay to live the life that they want.