HPV Immunization and Risky Personal Choices:

I've heard some argue that HPV is different, and a less proper candidate for a government-mandated (or even government-strongly-pressured) immunization, because HPV is acquired through risky, and usually personally chosen, behavior. This, though, strikes me as mistaken.

Though having multiple sexual partners increases one's risk of getting HPV, all it takes is one sexual partner. Nearly every woman will have sex at some point in her life. Even if she is a virgin bride, she can get HPV from her husband on her wedding night. True, if she marries a virgin, and her husband never cheats on her, then she's not at risk (setting aside the possibility of rape). But even the most moral behavior on her part, under any definition of morality short of lifelong abstinence from sex (including marital sex), won't protect her. The vaccine, on the other hand, likely will protect her.

There's also a very different kind of risky behavior argument: I'm told that regular pap smears, and the medical procedures used when the pap smears show a dangerous result, are very reliable in preventing even HPV-infected women (about 50% of the population, I have read) from developing cervical cancer. In a sense, then, actually getting cervical cancer may be said to be the woman's "fault" not because of her sexual behavior but because of her medical laxness. (That sounds harsh, but I take it that we do say that in some measure, though not without sympathy, in other contexts: If someone dies of untreated pneumonia -- consider, for instance, Jim Henson -- we might think that this death was in some measure his fault.)

Yet that seems to me to be a not very good argument against immunization. Many women don't get pap smears because they're fairly poor. Even those that could easily get them but don't seem to deserve some protection. And even for those who get them and thus don't get cervical cancer, the treatment used to avoid death from cervical cancer is expensive, unpleasant, and emotionally distressing -- and it can lead to infertility.

Of course, all this then raises the broader libertarian objection: Why should some people be forced to be immunized (assuming the Texas law mandated immunization, which this one seems not to, given its broad exemption for parents with conscientious or religious objections) in order to protect others? I'll turn to that in the next post.