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On a recent episode of Friday Night Lights, mother Tami Taylor tries to talk her 15-year-old daughter out of having sex with her boyfriend.

The second thing that pops out of her mouth is a warning about the diseases that can be contracted during sex. The first thing is a warning about pregnancy, which is often treated by our culture as if it, too, were a disease.

Such is our culture's knee-jerk fear when it comes to sex. We are not primarily worried about emotional entanglements or personal integrity or dishonoring God. Just disease. Thus, our culture's fevered talk about "protection" and the desperate search for gadgets and vaccines that will make sex "safe."

From this point of view, the vaccine against human papillomavirus (HPV) is a stride forward.

HPV, which causes genital warts, afflicts more than 6 million Americans annually (half of them between 15 and 25 years of age) and can only be spread through sexual contact. A total of about 20 million Americans are infected. People without symptoms can pass on the infection to unsuspecting partners, and condoms provide little defense.

Worse, several strains of HPV can lead to cervical cancer years later, as well as to other serious conditions in both men and women. According to the American Cancer Society, about 9,700 women in the U.S. are diagnosed with cervical cancer annually, and 3,700 of them will die from the disease.

Last June, the Centers for Disease Control's Advisory Committee on Immunization Practices (ACIP) recommended that all girls 11 and 12 years old receive Gardasil, a new vaccine against only four of the one hundred or so strains of HPV. These four strains are associated with 70 percent of the cases of cervical cancer. In October, the ACIP added Gardasil, manufactured only by Merck, to the list of recommended childhood vaccinations. (Merck, which gets a whopping $360 per vaccination, blitzed state governments to mandate Gardasil before calling off the lobbyists following bad publicity.) At least 20 states are considering ways to implement the ACIP's recommendation, even though HPV is not readily communicable in the way measles is.

At the forefront is Texas governor Rick Perry, a Republican. Perry grabbed headlines in February when he bypassed the state legislature and signed an executive order requiring that girls entering the 6th grade get the expensive vaccine. Perry did, however, provide an "opt-out" procedure for parents.

Given our culture's commitment to people's right to practice safe sex at any age, and our culture's assumption that human beings, like animals, are utterly subject to their passions, mandating this vaccine makes sense.

But many are not pleased. Some are troubled by the high cost of the vaccine, when arguably there are higher health priorities. Others note that Gardasil will not help the average cervical cancer patient, who contracts HPV in her 30s. The vaccine's effect wears off after 10 years. Still others feel the state is trying to become Big Nanny. Regarding a similar measure, David Edmunds of the Family Foundation of Kentucky stated, "The forced vaccination … takes away parental rights. This should be in the hands of physicians, parents, and the daughters … having this shot." Still others feel the state is undermining the message they teach their children: that abstinence is morally (and statistically) the best way to avoid sexually transmitted infections (STIs).

And some of us are frustrated because this is just one more illustration of a continuing cultural fact: We have little interest in talking nationally about any consequence of premarital sex that cannot be neatly measured by the Centers for Disease Control.

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April 2007, Vol. 51, No. 4