What Republicans Talk About When They Talk About HPV: Amity Shlaes
Republicans can't stop talking about the vaccine for human papilloma virus. Governor Rick Perry of Texas, a presidential candidate, is under fire for having issued an executive order in 2007 that allowed his health commissioner to mandate inoculation against the virus for girls entering sixth grade.
Since HPV can lead to cancer, Perry thought he was saving lives. Some critics charged he was infringing on parents' rights with his rule. One of his opponents, Representative Michele Bachmann of Minnesota, even quoted a mother who alleged her child suffered brain damage from the vaccine, suggesting the dispute was about safety. That claim has served for debunking fodder for a week now.
So what is the HPV vaccine debate really about?
A look back at the year 1955 -- when a now uncontroversial inoculation, the polio vaccine, was first widely required -- illustrates the extent to which the public-health debate has shifted in the last half-century. It also reveals a deeper cultural shift, one that will prove disconcerting to today's parents.
What's interesting about the polio-vaccine story was how very risky the inoculations initially were. At first, Jonas Salk, the researcher who developed the vaccine, was hailed as a national hero. In April 1955, within days of a University of Michigan announcement that its scholars had deemed the vaccine safe, Warner Brothers licensed the right to use his name in a movie title. By May, 4.8 million children had received the vaccine.
Almost immediately, authorities uncovered more than 100 cases of polio among children just vaccinated, or people around them. A full 70,000 of those who had received the shot reported some effect, such as muscle weakness.
Alarmed, Surgeon General Leonard A. Scheele halted the delivery of millions of doses. The American Academy of Pediatrics recommended suspension of the vaccinations. Over the summer, it became clear the trouble was confined to a batch of vaccines from Cutter Laboratories.
Meanwhile, thousands of unvaccinated Americans came down with polio. By fall, the national consensus had settled: Individual vaccines might fail and sporadic instances of polio contracted from vaccine doses would continue. But the widespread social benefit of the inoculation was worth the risks, and polio began to disappear.
A similar argument about societal good is made about HPV, which is a worryingly common virus. But the risks posed by HPV are of a very different type from polio. HPV doesn't strike indiscriminately; it's a sexually transmitted disease. And this leads to the unvoiced question in the HPV debate, one that might explain why Perry's decision has proven controversial: Why might middle-schoolers need a shot to prevent a disease they can usually only get from activity that is almost universally deemed wrong for their age group?
That question, too, has an antecedent in 1955, and it's a cultural one.
Around the same time it was licensing "Salk" for a movie title, Warner Brothers was producing "Rebel Without a Cause," starring James Dean and Natalie Wood. Wood was shockingly young: 16. Viewers knew her as the star of a movie about the power of childhood to restore faith, the girl who sat with Santa in "Miracle on 34th Street." Society columnist Hedda Hopper euphemistically referred to Wood as "not yet 18" in a column in June of 1955, when Wood was not yet 17.
Even as health officials vaccinated on the principle that lives are precious, "Rebel Without a Cause" celebrated teenagers who wanted to prove the opposite. Remember the famous scene in which one teen drives a car off a cliff on a dare. The movie rode without seatbelts, showing teen rebellion and risky behavior in all its glory. Before its release, Dean underscored that point tragically when he died in a car crash.
The film's images of superior, beautiful teens speaking truth to power in the form of inferior, morally flawed parents lodged in the national consciousness.
Down the decades, teen power has been reinforced and expanded culturally, politically and legally. These days, few parents can stop children from playing chicken, buying video games or making a date on the Internet.
This, in turn, has led to a kind of parental abdication. The public playground may be treacherous, the thought runs, so the best that one can do is to inoculate youth before sending them out to play. One reason the middle-school vaccination mandate unnerves us is that it reflects an assumption that sex may now be engaged in by 12-year-olds. That's four years younger than Natalie Wood was in 1955.
Cecil Picard, a former Louisiana school superintendent, once called middle school "The Bermuda Triangle of Education," a risky, noisy place that youth must pass through, and adults can ignore.
This environment, where teens and preteens run free and parents give up, isn't entirely the fault of parents and schools. It reflects broader cultural pressures. The Supreme Court provided an example of such inadvertent reinforcement in June. The case Brown v. Entertainment Merchants Association asked whether a California law barring minors from purchasing violent video games -- such as "Mortal Kombat," a game whose nonstop decapitations makes "Rebel Without a Cause" seem like Sesame Street -- was constitutional.
The court ruled that the video games were protected under the First Amendment, and lightly suggested "that parents who care about the matter can readily evaluate the games their children bring home." In a dissent, Justice Clarence Thomas asked about parents’ rights to shield children from corruption.
Thomas's point, even if you quarrel with his legal reasoning, is important. Parents are the last line of defense. Perhaps today it is pre-teens, like the teens of 1955, who are rebels without a cause, entities that can't be stopped from engaging in behavior that might damage them. If that's the case, if the pressure on 12-year-olds from all quarters is simply irresistible, then parents should know that a mandatory vaccination is really only a Band-Aid.
It may ease the symptoms of an epidemic, but offers nothing close to a cure.
(Amity Shlaes, a senior fellow in economic history at the Council on Foreign Relations, is a Bloomberg View columnist. The opinions expressed are her own.)
This column does not necessarily reflect the opinion of Bloomberg View's editorial board or Bloomberg LP, its owners and investors.
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