Cervical cancer, the disease that killed Henrietta Lacks, strikes 11,000-13,000 women in the United States every year, killing 4,000. While the Pap smear (developed by Greek scientist Georgio Papanikolaou) remains the most widely used and effective method for detecting pre-cancerous cells on the cervix, a new vaccine protects women from developing certain kinds of human papillomavirus (HPV), the condition that causes most cervical cancers. Yet controversy swirls around this vaccine in the United States, raising ethical issues such as whether to require mandatory vaccination for girls entering school and sparking fears that vaccinations might reduce the practice of safer sex methods or even lead to promiscuity. Others worry that the vaccine has been rushed to market without enough testing.
The Internet has proven both a blessing and a curse for disseminating information, especially health-based information: although it has made previously esoteric knowledge instantly available, the Internet has also allowed an outpouring of individual opinions that may counter unbiased facts. In other words, for every Mayo Clinic webpage about the benefits of a particular drug, hundreds if not thousands of blogs, posts, and chat rooms provide access to a dizzying range of personal experiences with that same drug, from demonizing to idealizing it. Meanwhile, a growing backlash against the pharmaceutical industry and established medical organizations like the Centers for Disease Control and Prevention (CDC) has raised suspicion of new drugs and treatments. Vaccines have been particularly singled out for their alleged side effects, so it's no surprise that Gardasil, the Merck-manufactured HPV vaccine that also targets genital warts, has come in for its share of criticism.
Much of this criticism centers around the fact that Gardasil vaccinations are recommended for pre-teen girls, since the vaccine proves most effective when administered prior to the onset of sexual activity. When Texas governor Rick Perry introduced legislation in 2007 to make vaccination mandatory for all girls entering the sixth grade in his state, the public outcry quickly led to the mandate's demise. Many questioned Perry's financial ties to Merck, finding it odd that a Christian conservative lawmaker would so vigorously campaign for a vaccine that most of his constituency believed would thwart parental control and encourage premarital sex. Merck itself has since backed away from lobbying for mandatory Gardasil vaccination, changing its tactics to advocacy on behalf of the vaccine's benefits and informed decision-making on the part of parents and pediatricians. This in itself confirms the suspicions of those who believe that the pharmaceutical industry prizes money in its coffers above the health of its customers, and represents one more wrinkle in the Gardasil saga. Sadly, the politicization of the vaccine has obscured rational discussions of its pros and cons; a quick web search will reveal a plethora of websites devoted to suing health care practitioners who have administered Gardasil, along with anti-vaccine websites that blame Gardasil for everything from migraines and seizures to Guillain-Barré syndrome and death.
Just as Henrietta Lacks's case has prompted a book-length investigation of informed consent, so Gardasil's labyrinthine legacy will likely earn a similar entry in the annals of scientific literature. Readers can only hope that a writer as even-handed as Rebecca Skloot will come along to illuminate that story when the time comes.
This article was originally published in March 2010, and has been updated for the
March 2011 paperback release.
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