The past few weeks have brought the political equivalent of a UFO sighting, a rare opportunity to witness a spectacular, possibly staged, event. The Religious Right appears to have made an about-face on a sexual-health issue, a turn all the more extraordinary because it affects teens. Just months ago, the Christian Right opposed the new breakthrough vaccine against the most common sexually transmitted disease, the human papilloma virus (or HPV); today, they embrace it. It's a display that reproductive health advocates find entrancing — and not entirely credible.
On June 8th, the FDA approved Merck's Gardasil, which is 100% effective at immunizing against the two HPV strains that cause 70% of all cervical cancers. In the months preceding the FDA approval of this groundbreaking cancer-prevention method — this is one of the world's first cancer vaccines — the Religious Right seemed prepared to (characteristically) camp out on the wrong side of history.
Their argument against the vaccine was familiar: it threatens to seduce unmarried people into thinking that sex is not so risky. Ipso facto, the pro-life movement opposed it. This might be a technological advance so stunning it promises to save hundreds of thousands of lives every year, but spokespeople trotted out arguments best summarized by Bridget Maher, of the Family Research Council, who told New Scientist magazine in April 2005, "Giving the HPV vaccine to young women could be potentially harmful. They may see it as a license to engage in premarital sex."
Just last year, pro-lifers used the very same promiscuity forecast to derail the application to make emergency contraception available over the counter. "We are very concerned that no data is available to suggest what impact this decision will have on the sexual behavior of adolescents," wrote forty-nine pro-life members of Congress to President Bush. Their successful campaign revealed a startling paradox: pro-life political forces are willing to forego the best chance at dramatically reducing the nation's abortion rate if they perceive the slightest possibility that sex will become less risky.
To shamelessly oppose a cancer vaccine is to play the bogeyman a little too well.
Initially, the script for the Right's opposition to the HPV vaccine seemed like it would play out the same way. The opening act was the December 2005 announcement by Merck that it would be best to inoculate girls against HPV while they're still virgins, probably at age eleven or twelve. The reasoning was simple. By current estimates, each year about 10,000 American women will get cervical cancer, and 3,700 will die from it. The vaccine will significantly reduce the threat of the disease. (Imagine the public frenzy in support of an avian flu vaccine if 3,700 Americans a year were to die from an outbreak.) However with HPV, as with abortion, prevention is simply not on religious conservatives' to-do list. As Jim Sedlak, vice president of the American Life League, wrote on the group's website, "It appears that Planned Parenthood wants this new HPV vaccine so it can continue leading our children into a destructive lifestyle while giving them a 'shot' to avoid some of the complications of that lifestyle."
But to shamelessly oppose a cancer vaccine is to play the bogeyman a little too well. "The Religious Right just didn't see much fun in setting themselves up as the piñata on this," says Kirsten Moore, of the Reproductive Health Technologies Project, a group that helped bring emergency contraception's over-the-counter application to the FDA. "The press was desperate for a cat fight, and our opposition didn't take the bait."
In the course of the past few months, one by one, conservative groups began to come out in favor of the vaccine. But their new message feels like a well-worn page from the Bush playbook: Say you're for it but work furtively against it. Focus on the Family hailed the vaccine as "a tremendous breakthrough in science that will likely save millions of women's lives around the world," but said it would oppose mandatory HPV vaccinations. Likewise, The Family Research Council may now "support the widespread distribution of vaccines against HPV," but "would oppose any measures to legally require vaccination."
Women's health proponents expect the Religious Right will battle the HPV vaccine state-by-state.
According to Dr. Gregory Zimet, chair of the vaccine committee at the Society for Adolescent Medicine, this is the Right's attempt to repackage its original agenda. "The softening of their position came, at least in part, from the recognition that being labeled as pro-cancer didn't really fit well with their attempt to present themselves as pro-life," said Zimet. "Many of them are now saying, 'We've never been opposed to it,' even though I looked at their websites a year and a half ago and they were. What they've done is said, 'Of course we're not opposed to this vaccine that can save the lives of our daughters, our wives and our mothers — but we just don't think it should be forced on people.' So, I think partly [the new message] is cover and partly it may be a warning — as they say, a shot across the bow." It will be up to the states to decide whether the HPV vaccine is, like inoculations against polio and diphtheria, required for a child to proceed through school. "As states begin to consider the potential for mandating a vaccine like this," says Zimet, "They are forewarned that these groups will put resources to fight it."
The Advisory Committee on Immunization Practices (ACIP) is a fifteen-member panel that advises the CDC on which vaccines should be recommended nationwide. Their decisions have a significant effect on whether private insurers will pay for the vaccine. ACIP also recommends whether a vaccine should be included in the Vaccines for Children program, run by the CDC. (This is crucial if poor people — those most at risk for sexually transmitted diseases — are to get the vaccine. The Vaccines for Children program supplies vaccinations to Medicaid, the uninsured and some underinsured patients, but only if the CDC designates it as recommended.) The ACIP meets June 29th to make recommendations to the CDC on the HPV vaccine. The CDC traditionally follows the ACIP's advice. Also traditional is for states, individually, to adopt ACIP advice and require a vaccine for public-school admission.
And here is the area in which many are bracing for a fight. Women's-health proponents expect the Religious Right to battle the HPV vaccine state-by-state in an attempt to convince parents and legislators that mandatory vaccination amounts to a confiscation of parental authority. As the Family Research Council spokesman explained, "There is no justification for any vaccination mandate as a condition of public-school attendance."