Socializing sexual risk

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A movement has started in this country that ought to permanently dispel the myth that liberals embrace a right to privacy.

Here is the issue: Can the government compel a pre-teen girl to undergo an invasive procedure she does not want and may not need, whose long-term adverse affects cannot yet be known and which, according to the Food and Drug Administration, opens her to the already demonstrated, albeit minor, risk of certain short-term adverse affects? You might think liberals would rank an invasion of privacy of this magnitude right up there with, say, warrantless eavesdropping on al Qaeda. Strangely, they do not.

Why not? Well, the specific procedure envisioned here is a series of injections to immunize girls against the Human Papilloma Virus (HPV). Unlike the measles, which a girl could give to a classmate simply by showing up at school contagious, HPV can only be transmitted by intimate contact of a sort that as far as I know has not yet become officially sanctioned classroom activity even in the most progressive school districts. Infection with some forms of this venereal virus can lead to cervical cancer.

Several states, as well as the District of Columbia, are now contemplating legislation that would mandate these injections for girls enrolling in sixth grade. The Lancet, a British medical journal, recently editorialized that the injections ought to be mandated for boys, as well.

On June 8, 2006, the U.S. Food and Drug Administration approved Gardasil, an HPV vaccine manufactured by Merck, for use in females 9 to 26 years of age. It costs about $360 per three-shot series, and protects against four types of HPV, two of which cause 70 percent of cervical cancer. This year, the FDA is reportedly likely to approve another HPV vaccine, manufactured by GlaxoSmithKline. It will target just the two forms of HPV responsible for most cervical cancer cases.

Shortly after the FDA approved Merck's vaccine, the federal Centers for Disease Control added it to its list of immunizations recommended for routine administration to children. In this case, CDC limited the recommendation to "females 11-12 years of age."

CDC's recommendation paves the way for insurance companies to cover HPV vaccination and for the federal government to pay the cost of immunizing children whose families are uninsured.

On Jan. 8, Business Week cited an analyst with T. Rowe Price who estimated sales of Merck's HPV vaccine "will peak at $2 billion per year, but could go as high as $4 billion if the states require it." Fortune magazine reported that Merck's and GlaxoSmithKline's HPV vaccines are together "projected to spawn an $8 billion-a-year global market by 2010."

There can be no disputing that these vaccines are good things in themselves. For those who put themselves at risk of infection, they can prevent a deadly cancer. The only questions are: Should people be forced to take them? Who should bear the cost?

Ultimately, any mandate for a venereal-disease vaccine is aimed at socializing the risk of promiscuous sexual behavior. It is about using the power of government to make all of the people bear some of the cost created by the reckless behavior of some of the people.

The costs are not just monetary. There are physical and cultural costs, as well. When it approved the HPV vaccine, for example, FDA reported that in double-blind placebo-based tests, girls given the actual vaccine had certain "adverse experiences" at a marginally higher rate than girls given a placebo. These included fever, nausea, dizziness, diarrhea and vomiting.

It is also impossible to predict the long-term affects of the vaccine. Joseph A. Bocchini, who chairs the American Academy of Pediatrics' committee on infectious diseases, told The Washington Post last week why he did not support making it mandatory. "I think it's too early," he said. "This is a new vaccine. It would be wise to wait until we have additional information about the safety of the vaccine."

Yet, the greatest costs will be moral and cultural, as the venereal-vaccine promoters clearly know. "But realizing the vaccine's potential will depend on addressing worldwide issues of social and cultural resistance, which are already threatening to slow Gardasil's roll-out in the U.S.A.," the Lancet editorialized last June. "Such issues of social and cultural acceptability are important to address now, not least because similar arguments will apply to an HIV vaccine, if one is ever developed."

Advocates of universal vaccination against venereal diseases realize that traditional cultural values are an obstacle to creating their sought-after, if never attainable, Utopia where people can engage in promiscuous sex without fear of consequence. So, traditional cultural values must go.

Terence P. Jeffrey is a nationally syndicated columnist.