Three Shots at Prevention: The HPV Vaccine and the Politics of Medicine’s Simple Solutions

351 Pages·2010·23.875 MB·English

by  Keith Wailoo, Julie Livingston, Steven Epstein, Robert Aronowitz

Three Shots at Prevention
This page intentionally left blank
Three Shots at Prevention
The HPV Vaccine and the Politics of Medicine’s
Simple Solutions
Edited by Keith Wailoo, Julie Livingston,
Steven Epstein, and Robert Aronowitz
The Johns Hopkins University Press
Baltimore
© 2010 The Johns Hopkins University Press
All rights reserved. Published 2010
Printed in the United States of America on acid-f ree paper
9 8 7 6 5 4 3 2 1
The Johns Hopkins University Press
2715 North Charles Street
Baltimore, Maryl and 21218-4 363
www .press .jhu. edu
Library of Congress Cataloging- in-P ublication Data
Three shots at prevention : the HPV vaccine and the politics of
medicine’s simple solutions / edited by Keith Wailoo . . . [et al.].
p. ; cm.
I ncludes bibliographical references and index.
I SBN-1 3: 978- 0- 8018- 9671-2 (hardcover : alk. paper)
ISBN-1 0: 0-8 018- 9671-1 (hardcover : alk. paper)
ISBN-1 3: 978- 0-8 018- 9672- 9 (pbk : alk. paper)
ISBN-1 0: 0-8 018- 9672- X (pbk : alk. paper)
1. Papillomavirus vaccines—S ocial aspects. I. Wailoo, Keith.
[DNLM: 1. Papillomavirus Vaccines—t herapeutic use.
2. Uterine Cervical Neoplasms—p revention & control. 3. Policy
Making. 4. Risk Factors. 5. Sexual Behavior— psychology.
6. Vaccination—e thics. WP 480 T531 2010]
QR189.5.P36T48 2010
612.6'2—dc22 2009052693
A cata log record for this book is available from the British Library.
Special discounts are available for bulk purchases of this book. For more
information, please contact Special Sales at 410- 516- 6936 or specialsales@
press.jhu.edu.
The Johns Hopkins University Press uses environmentally friendly
book materials, including recycled text paper that is composed of at
least 30 percent post-c onsumer waste, whenever possible. All of our
book papers are acid- free, and our jackets and covers are printed on
paper with recycled content.
Contents
Ack now ledgm ents ix
Introduction: A Cancer Vaccine for Girls? HPV, Sexuality,
and the New Politics of Prevention xi
Vaccine Time Lines xix
I. Establishing the HPV- Cancer Link xx
II. The Contentious History of Vaccine Policy xxii
III. Vaccine Policy: Agendas and Perspectives xxiv
IV. Mandating Prevention? Legislation, Sexuality, and State Power xxvi
V. States and Citizens at the Crossroads of Prevention xxviii
part i: The Known and the Unknown: Vaccination Decisions
amid Risk and Uncertainty
1. The Coercive Hand, the Benefi cent Hand: What the History
of Compulsory Vaccination Can Tell Us about HPV Vaccine
Mandates 3
James Colgrove
2. Gardasil: A Vaccine against Cancer and a Drug to Reduce Risk 21
Robert Aronowitz
3. HPV Vaccination Campaigns: Masking Uncertainty, Erasing
Complexity 39
Lundy Braun and Ling Phoun
4. The Great Undiscussable: Anal Cancer, HPV, and Gay Men’s
Health 61
Steven Epstein
5. Cervical Cancer, HIV, and the HPV Vaccine in Botswana 91
Doreen Ramogola-M asire
vi Contents
part ii: Girls at the Center of the Storm: Marketing and
Managing Gendered Risk
6. Safeguarding Girls: Morality, Risk, and Activism 103
Heather Munro Prescott
7. Producing and Protecting Risky Girlhoods 121
Laura Mamo, Amber Nelson, and Aleia Clark
8. Re-P resenting Choice: Tune in HPV 146
Giovanna Chesler and Bree Kessler
part iii: Focus on the Family: Parents Assessing Morality,
Risk, and Opting Out
9. Parenting and Prevention: Views of HPV Vaccines among
Parents Challenging Childhood Immunizations 165
Jennifer A. Reich
10. Decision Psychology and the HPV Vaccine 182
Gretchen Chapman
11. Nonmedical Exemptions to Mandatory Vaccination:
Personal Belief, Public Policy, and the Ethics of Refusal 196
Nancy Berlinger and Alison Jost
12. Sex, Science, and the Politics of Biomedicine: Gardasil
in Comparative Perspective 213
Steven Epstein and April N. Huff
part iv: In Search of Good Government: Eur ope, Africa,
and America at the Crossroads of Cancer Prevention
13. Vaccination as Governance: HPV Skepticism in the
United States and Africa, and the North- South Divide 231
Julie Livingston, Keith Wailoo, and Barbara M. Cooper
14. Public Discourses and Policymaking: The HPV Vaccination
from the Eur o pea n Perspective 254
Andrea Stöckl
Contents vii
15. HPV Vaccination in Context: A View from France 270
Ilana Löwy
Conclusion: Individualized Risk and Public Health:
Medical Perils, Pol iti cal Pathways, and the Cultural Framing
of Vaccination under the Shadow of Sexuality 293
Keith Wailoo, Julie Livingston, Steven Epstein, and Robert Aronowitz
Notes on Contributors 303
Index 309
This page intentionally left blank
Ack now ledg ments
The science of immunology has spawned many dramatic developments over the
years, yet its by-p roducts, from transplantation to vaccination, are frequently
shadowed by debate and controversy. In 2008, Julie Livingston, Steven Epstein,
Robert Aronowitz, and I brought together a group of scholars (from sociology,
history, medicine, medical ethics, pathology, psychology, communication
arts, and health policy) for two meetings to refl ect on one of the latest unfolding
controversies: the then- new HPV vaccine, Gardasil. Because the vaccine had
become a focal point for contentious debate—a bout pharmaceutical advertising;
scientifi c evidence; cancer prevention and risk; the role of government in public
health; girls, families, and sexuality; and global health inequalities— we envi-
sioned this volume as a case study of the fraught intersection where the science
of immunology, medical practice, and public health collide with society, culture,
and politics. The resulting volume can be read both as a chronicle of the evolution
of the debate and as an analysis of the perspectives, values, and policy questions
unearthed by the vaccine in par tic ul ar and by immunology more generally.
This multidisciplinary analysis could not have been possible without the gen-
erous support I received from the James S. McDonnell Foundation’s Centennial