Ever since the HPV prevention drug Gardasil hit the market in 2006, I've been very suspicious. The marketing campaign says that it is the "only vaccine for cervical cancer," but what Gardasil actually protects against are some strains of HPV, a sexually transmitted disease that may cause cervical cancer. This is very misleading, not to mention that it is possible to prevent HPV infections through safe sex practices. What also got my dander was how quickly it got pushed on the public.

A few years ago, I became friendly with a statistician who worked for a drug company in New Jersey. "All the clinical studies are manipulated," she told me. She was tired of their unethical practices, and she was looking to find a new way to use her statistics skills and her insight to help the American public understand how new "cures" we are sold are potentially more harmful than what ails us in the first place. Her insider knowledge put all the prescription drug recalls and lawsuits into perspective for me. I decided that, unless I had no other alternative (i.e. - I'd die anyway), I would not use any drugs unless they'd be around for at least five years, and preferably ten.

Which brings me back to Gardasil. A vaccine is even more serious than a pill. Someone can always stop taking a pill if there are side effects, but once she is inoculated, there's no way to get it out of one's system that I am aware of. In that case, it seems like before the FDA approves and health organizations recommend a vaccine, there better be a lot of evidence that it is safe. I wasn't sure how this worked for Gardasil, but according to Lisa at The Looney Bin, there's plenty to worry about:

The FDA allows “fast tracking” of certain drugs that are considered important to human health. Gardasil was allowed through the system this way. This process allowed Gardasil to be available to the public within six months of development.

Six months!!!!! It took almost more than twice the amount of time for Gardasil manufacturer, Merck, to move onto their next profit center - er, I mean, health beneficiary. By 2008, Merck was pushing for boys to also get a vaccine against cervical cancer.

What? How does this make any sense? It all goes back to the fact that Gardasil is not an inoculation against cervical cancer, but rather HPV. Since HPV is carried and transmitted by men, it makes at least as much sense to give them an HPV vaccine. If they don't get HPV, which can cause really gross genital warts as well as cervical cancer, then their partners won't get it. A 2008 New York Times article noted:

How do you pitch.. Gardasil Boy’s parents?

Think altruism. Responsibility. Chivalry, even? Oh, and yes: some explicit details about genital warts and sexual transmission.

What's really interesting is the resistance Merck is facing in trying to make it a routine vaccine for boys. On Tuesday, October 21, the New York Times reported that Merck was successful in its bid to get Gardasil approved for boys to protect them from genital warts. However:

...the panel of independent medical experts stopped short of urging its routine use in boys, as it has recommended for girls. And members questioned whether vaccinating boys was a cost-effective way to protect their future sexual partners against cervical and other types of cancer caused by human papillomavirus, or HPV.

And in an article that is ostensibly about protecting boys, the focus was as much on what Gardasil can do for women. Again, it seems like not much that couldn't be done through safe sex and routine pap smears. (One doctor interviewed said that focusing on an HPV vaccine to prevent cervical cancer was a waste of resources. Offering routine pap smears to women without access to gynecologists "would have a greater effect than Gardasil.") Not one to miss out on 50% of the market, though, Merck promised to come back with more data showing how Gardasil can prevent HPV-related male cancers.

The blogspohere had a mixed reaction to this decision, worrying about the extra burden that women continue to carry when it comes to sexual health. At Picture of Health, Kelly Brewington wrote:

Others hoped that the approval would signal gender parity in the war against sexually transmitted diseases. After all, it takes two doesn't it? If girls can contract HPV from sex, shouldn't their partners help protect them from the virus?

On that same line of thinking, Cynthia at The Attached Feminist asks:

Meanwhile will the pap smear become less routine over the next 20 years? Might some women slip through the cracks? And meanwhile, what about the men? What sort of HPV testing will our country encourage for young men? It seems like the men should have to know if they are spreading a disease that causes cervical cancer. Would our government be inclined to fund a mandatory vaccine for young boys? Especially if it had any scary reproductive side effect at all? I wonder...

Caitlin at Feminists for Choice points out another double standard surrounding Gardasil. When the vaccine first came out, certain communities freaked out that it would cause girls to become sluts, since obviously getting a vaccine against a semi-obscure sexually transmitted disease that may cause cervical cancer causes girls to throw all caution to the wind and fuck any guy that approaches her. That is not the case when it comes to Gardasil for boys:

There isn’t worry about boys becoming promiscuous. In fact there is only talk of making sure the vaccine was safe enough for them. Where was this safety conversation when the drug was approved for girls? As a nation, do we still feel our girls are more expendable than our boys? That thinking is more suitable for the eighteenth century, not the twenty-first.

Across the pond, a drug called Cervarix is being treated in much the same manner as Gardasil when it comes to determining whether boys should get vaccinated against HPV. (I don't know if more clinical trials and stringent testing standards are in effect over there, but I certainly hope so.) Vagina Dentata argues against the reasoning of both the American CDC panel and the Joint Committee on Vaccination and Immunisation in the UK, which decided that it is only cost-effective to inoculate girls against HPV. She wrote:

This is not just a political point or an abstract notion of ‘fairness’, it is also a public health one. Due largely to the risk of pregnancy, women routinely take more responsibility for sexual health then men (I won’t go into it here but this still has implications for lesbian and gay people). Therefore, gender discrimination and inequality impacts on sexually transmitted infections when for example, women are not in a position to insist on condom use. This is not just the role of sexual or public health education, our systems and programmes need to support the principle of men and women taking responsibility for sexual health matters.

So, in summary, I hate that Gardasil was not thoroughly vetted before it was unleashed upon Americans with a scare-tactic campaign suggesting that anyone who did not get the vaccine was condemning their daughters to cervical cancer and death. I hate that Merck is using another scare-tactic campaign to foist Gardasil onto boys. I hate that arguments for or against Gardasil for girls rely on ludicrous ideas about female sexuality, and when it comes to whether or not boys should get vaccinated, we discuss whether the vaccine is safe and/or cost-effective. I hate that by determining that it is not worth the cost of preventing HPV in men, the notion that only women are responsible for sexual health is reinforced. Gardasil seems, in fact, to be credited with the potential for preventing every disease under the sun except for sexism.

Suzanne also blogs at Campaign for Unshaved Snatch (CUSS) & Other Rants and Always.