April 4th, 2008

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Should We Mandate HPV Vaccination?

It is axiomatic that in the U.S. anything relating to sex will be handled in an hysterical and irrational manner. Such is the case with the issue of the genital human papillomavirus (HPV) vaccine. Becuase HPV is sexually transmitted, and because the Centers for Disease Control recommends that girls/women ages 9-26 get the vaccine to ensure that they are innoculated before they become sexually active, an imediate fight has broken out on whether to make HPV vaccine's mandatory. Also unsurprisingly, the debate for or against revolves heavily around questions of sexual activity. As a result, the fight over mandatory HPV vaccination, and at what age, has become a proxy fight for the standard arguments about sex eduction and reproductive rights. Those individuals and groups that generally oppose sex education in the curriculum (especially those that include discussion of birth control), oppose abortion rights, and are associated with social conservatives generally oppose mandating HPV vacination. Groups that support these things generally support mandatory HPV vacination as a condition of attending High School, Middle School, or as early as 9 (the youngest age recommended by CDC).

While both sides purport to address this as a public health issue, the dialog to date has been remarkable free of the insanely boring cost benenefit analysis usually associated with public health issues and has instead contained the usual energy, accusations and other indicia of psychodrama that mark the reproductive rights fights and cause some large percentage of the public to tune out on vital issues. (Yes, the MSM bears responsibility for cherrypicking the most controversial and insane people. But private sampling has not yieled much rational discussion on this for me outside the realm of health professionals and policy wonks.)

I suggest below the cut that the analysis is proceeding irrationally and in the wrong direction. If we could stop thinking about sex for a minute, we could actually ask ourselves the relevant policy question: When do we mandate a vaccine or other form of medical care as a condition of sending your kid to school? Getting back to first principles discloses that the cost-benefit analysis . . . .

Your thinking about sex again aren't you?

Yes you are! You zoned out as soon as I made this about something other than a proxy reproductive rights fight! No? O.K., test for you -- what is my conclusion?