Posted by: bridget | 5 February 2007

Promoting Health by Educational Fiat

Two recent news items: the Democrat governor of Arkansas is moving to drop mandatory school weigh-ins and will not have schools send letters to the parents of overweight children. Texas will require that all middle-school girls receive the HPV vaccine. Childhood obesity and cancer are big issues, so it is no wonder that schools should want to get involved and try to ameliorate these issues. Nevertheless, the idea of requiring the vaccine is misguided at best. There are several problems with the new Texas requirement:

  • Gardasil has not been tested long-term (i.e. decades) for side effects. Texas girls should not be required to be the test cases.
  • Girls can take the vaccine, with equal efficacy, until age 26. Why require that middle schoolers receive a vaccine that can be taken at age 18? This is not polio, which can strike a child: this is a vaccine for a sexually transmitted disease. Let the girls (and their parents) decide if they want to take it, but don’t require it at the earliest possible time.
  • Talk about undermining parental autonomy. While parents are allowed to opt-out of the vaccine, the government should not be micromanaging their decisions.
  • Over-vaccination results in reduced efficacy of the vaccine and may negatively effect the immune system. Viruses mutate, which renders vaccines (and, for bacteria, antibiotics) less effectual over time. 80% of people will end up carrying the HPV virus during their lifetimes, but only 4,000 women die of cervical cancer. Assuming a life expectancy of 75 years, only 0.25% of infected people die of cervical cancer, which hardly justifies the mass vaccination. Also, the proliferation of vaccines for non-lethal diseases (i.e. chicken pox) may be one cause of increased autoimmune diseases.
  • State-sponsored monopoly – and a billion for Merck: as Gardasil is the only HPV vaccine on the market, a state requirement amounts to a state-sponsored forced purchase of a private product. While the pachyderm is all for patent rights and making money off of a socially beneficial product, she believes in the free market. Absent government intrusion, parents can choose to wait until a generic comes on the market (usually, about six years). This will have the effect of ensuring that Merck charges a reasonable amount for Gardasil; however, state-required vaccines allow Merck to charge an above-market price for its vaccine. Merck stands to make a billion dollars if all states require the vaccination of middle-school girls.
  • No men. Some of the justification for mass vaccination is herd immunity: those who are immune do not become carriers and pass the disease on to those who are suspectible to it. By requiring vaccination for girls but not boys, Texas allows men to transmit the disease to women. Vaccinating men also sends the message that sexual health is not just a female issue – that men who have sex are responsible for keeping their partners healthy.

There are a lot of good reasons to require vaccinations against MMR or polio before children enter school. With the crowded conditions, diseases spread rapidly and undermine children’s health while in school. Should the measles or pertussis spread among children, the school would be forced to close to stop the spread of disease. HPV poses no such threat to education – or even to the health of middle school children.

Likewise, obese children don’t cause a public health hazard in schools, either. Obesity, unlike eyesight or hearing issues, is readily detectable by any parent who actually looks at her child. Furthermore, mandatory yearly physicals ensure that children are getting medical attention. There is little justification for turning middle schools into doctor’s offices. Despite this, the pachyderm snorts at the justification for removing the annual weigh-ins: it is damaging to children’s self-esteem. Arkansas says: better happy and fat than knowing that obesity will lead to a lifetime of negative health effects. “Obese” isn’t about appearance (frizzy hair, acne, height, or any of the other ailments suffered by teenagers ’round the world); it’s about health. Diabetes, joint disorders, lower energy, poor nutrition, and increased risk of heart attacks aren’t really self-esteem issues.



  1. My daughter would not get this vaccine. Merck would have to start their billion dollar profit elsewhere.

  2. Thanks for stopping in, Tammi!

    A billion dollars – for 3,700 women a year. This isn’t heart disease, colon cancer, or breast cancer; it, like lung cancer, is almost entirely preventable.

    Kudos to Merck for trying to save the lives of those 3,700 women, but the cost is truly staggering.

  3. […] same cannot be said for chicken pox, Hepatitis B, and HPV (the latter previously blogged here), which are either minimally communicable or nominally […]

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