Well, as is described in this AP story on the MSNBC site, Texas has become the first state to mandate Gardasil, the HPV vaccine from Merck, for all girls entering the 6th grade. Texas Governor Rick Perry imposed this measure by executive order. This is deeply disturbing, but unfortunately I suspect Texas will be only the first of many states to take this step. Governor Perry apparently is trying to pretend this is an obvious choice, claiming that this vaccine is no different from the polio vaccine. That is obviously false, and he knows it, unless he is extraordinarily uninformed. The comparison of this STD to the once universally dreaded disease of polio is absurd. For that matter, if mandating this vaccine is such an obviously good idea, why did he feel the need to do an end run around the legislature and unilaterally impose this rule?

It needs to be emphasized that the common characterization of Gardasil as a cancer vaccine is misleading. This is a vaccine for certain strains of human papillomavirus. Granted, HPV can cause cervical cancer, so this vaccine indirectly can prevent cervical cancer. However, calling Gardasil a cancer vaccine is clearly inaccurate, although proponents of the vaccine have a motive to promote that inaccuracy, because it sounds better than calling this product what it is, a vaccine against a particular type of sexually transmitted disease.

I think it is clearly immoral for the government to mandate the use of this vaccine, and I even think the vaccine itself raises some questions. Even without addressing deeper moral questions, the action by Perry in Texas seems to me like an unjustified public health experiment on a massive scale. Gardasil has not been on the market for very long. I do not see how anyone can even begin to guarantee at this point that Gardasil does not have the potential for any serious long-term side-effects. Certainly this is true of many products, but it seems especially relevant in this case considering that this vaccine will be applied to children, and in view of the fact that this vaccine serves no therapeutic purpose for a girl unless and until she has sexual contact.

For the most part, objections I have heard against the idea of the government mandating the use of Gardasil have focused on the issue of parental choice, while not questioning the general use of the vaccine. While the issue of intruding on the parent-child relationship is a crucial one, and certainly should be raised, I think focusing exclusively on that point, as if the vaccine itself is completely unproblematic and the only issue is consent, may skip over some important issues. I am disappointed that the usually excellent Catholic Medical Association, while rightly opposing any government mandate of Gardasil, has already encouraged widespread use of the vaccine, within the age range given by the government's Advisory Committee on Immunization Practices (PDF file at CMA). The ACIP recommendation suggests that girls be routinely vaccinated at the age of 11 or 12, and also allows the vaccine for girls and women from the ages of 9 to 26. The CMA statement claims that this support for the HPV vaccine "should not be used to undermine support for efforts to promote chastity," but that claim already assumes that we can simply choose whether our use of this vaccine undermines the promotion of chastity, as if the action of using the vaccine has no meaning within itself. I am not saying here that this vaccine is immoral in itself. However, I think it is troublesome, particularly in the case of the young.

Perhaps the most obvious issue in the case of giving this to children is that it seems difficult to avoid the implication that we are telling children the age (apparently 11 or 12) at which we expect that they will start having sex, obviously outside of marriage. However, it seems to me there is also a deeper problem here. This is part of a consistent pattern in modernity: we attack nature, and above all our own nature, and then we try to technologize our way out of the consequences. Technology is not a response to problems of sin. The action of this vaccine may be justified in some cases, but it is not simply neutral--it has a meaning, and we should ponder what that meaning is. Regardless of what short-term positive consequences such solutions may seem to produce, at some point we have to ask ourselves: are we becoming more or less human through this particular kind of technological activity? This question is particularly pertinent when the technology obviously applies in a particularly direct way to the nature of the human person, as technology certainly does in the case of vaccinating pre-teen girls for a sexually transmitted disease.

[Subsequent to Perry's action discussed here, the Texas Legislature later overturned Perry's mandate. Perhaps due to this immediate resistance in Texas, and the fact that the role of Merck in promoting such mandates became a public relations problem, since then there has not yet been a major movement to mandate the HPV vaccine in many other states. However, the larger issue of the HPV vaccine itself is still very much alive.]