Simone Davis, a 17-year-old British immigrant and devout Christian, will be denied U.S. citizenship unless she agrees to a new immigration requirement that she be vaccinated with Gardasil, a compound that targets human papillomavirus (HPV), which can cause cervical cancer and genital warts.
Davis, who was adopted by her paternal grandmother in Port St. Joe, Florida, applied to Citizenship and Immigration Services for an exemption on moral and religious grounds, saying she is not sexually active and does not plan to be in the near future. Her exemption application was denied. Davis's citizenship quest has been funded thus far by church groups, but her grandmother, Jean Davis, says she cannot afford an appeal. Other opponents say the requirement places an unfair financial burden on women because a three-shot series of Gardasil costs between $300-$1,400.
Citizenship and Immigration Services spokesman Chris Rhatigan told ABC News, "The decision to include HPV as a required vaccine was made by the Centers for Disease Control and Prevention [CDC] … The objection to a waiver would have to be to all vaccines, not just Gardasil." But the requirement differs from other vaccines in that it is the only one that targets a virus spread through sexual contact. The other 13 target highly contagious diseases.
Davis's grandmother says her objection is not only religious and moral. In an interview with ABC News, she said, "All I want is the rights of a U.S. citizen. It's not mandatory for them to get this …. My choice to make an informed decision for the health of my child has been taken away."
What strikes me as a serious blind spot in the moral-religious opposition argument is its failure to consider the risk of sexual assault. The CDC reports that 10.6 percent of women will experience forced sex at some point in their lives, and 20-25 percent of women in college report having experienced rape or attempted rape. Clearly even young women who live chaste lives can contract sexually transmitted diseases. Therefore, young women and their parents must weigh the risks of vaccination against other potential dangers.
According to the CDC, as of June 1, 2009, 25 million doses of Gardasil have been distributed in the U.S. In that pool, there were 14,072 reports of adverse events. Ninety-three percent were considered to be non-serious, while seven percent were considered to be serious. Thirty-two unconfirmed deaths were linked to the vaccine as well as incidents of blood clots and neurological disorders. More commonly, non-life-threatening side effects included fainting, nausea, and headaches.
Despite concerns about Gardasil's safety, the CDC continues to recommend the vaccination for the prevention of four types of HPV in females ages 11-26, and a Food and Drug Administration panel recently voted to recommend Gardsil for males ages 9-26 for the prevention of genital warts and rare forms of cancer.
In all of this, one thing is clear to me: Governments have both a right and a responsibility to protect citizens from potential health threats and the future burdens that such threats may bring. What is less clear is whether or not a U.S. citizen who adopts a foreign child should have her parenting decisions imposed upon in pursuit of that end, and whether or not HPV poses a serious enough threat to justify Gardasil's inclusion as a citizenship requirement. On both counts, I think not.
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