Legal Commentary

Last week I took my daughter to the pediatrician to receive her MMR vaccine (measles, mumps, rubella).  The trip to the doctor?s was spurred by two factors, the first was age, my daughter was now at the recommended age for receiving the vaccine but the second was the fact that she was about to enter daycare and state law requires  the shot as a condition of enrollment.  Vaccine laws vary but state, but every state requires the receipt of multiple vaccines before a child may enroll in school and these requirements appear to be highly effective at ensuring school age children are vaccinated.  Given this fact, I have been struck by a number of the aspects of the Gardasil debate.

                Gardasil is the vaccine given to prevent HPV, the Human Papillomavirus, the virus responsible for the majority of cervical cancers.  Both the CDC and the American Academy of Pediatrics recommend the vaccine and nearly every state as well as the District  of Columbia has considered making it a requirement of school attendance.  However, currently, only one state, Virginia, actually requires girls to receive the vaccine.  The result of leaving the vaccine optional almost certainly means fewer girls will receive the shot.  Whether this is a good or bad thing depends on your point of view about the vaccine. Although rare, serious medical conditions have been linked to the HPV vaccine.  In addition, the strongest opposition has come from religious groups concerned that  the HPV vaccine will lead to sexual promiscuity among young women. 

                However, what I find particularly interesting about the  debate surrounding the HPV vaccine is that fact that although it is optional for the majority of Americans, it is mandatory for those seeking to become Americans.  As of July 1, 2008, all women seeking to obtain permanent residency in the United states are now required to receive the HPV vaccine.  Some commentators have argued, here, that this disparate treatment is problematic because it indicates a lesser regard for the health and welfare of immigrant women and therefore must be repealed.  I wonder however, if such disparate treatment should lead to the opposite conclusion, i.e. that the vaccine should be mandatory for US citizen women as well.  If the federal government believes that the HPV virus is such a danger that it would withhold citizenship in order to ensure vaccination doesn?t this imply the severity of the problem and the drastic steps that must be taken to halt its spread? How can we be concerned about the potential for immigrant women to become infected with HPV but not have the same concern for US citizen women.  Either HPV is a problem requiring outside intervention or it isn?t, I don?t see how we can have it both ways.