Mandatory Vaccines?

What is behind this whole mandatory vaccine thing? Before I moved my blog to blogger, I posted a bit about immunizations on October 12, 2006. I basically pointed out that the former CEO of Merck, Raymond Gilmartin, gave money to Texas Congressman Henry Bonilla, an advocate of "Shots Across Texas," a campaign to immunize all Texas' infants, a campaign which was triggered by a measles outbreak, and it just so happens that Merck makes two of the most popular measles vaccines on the market.

Now, an article that ran in yesterday's New York Times reports on a new Texas campaign for the mandatory inoculation of all 11 & 12 year old girls with Gardasil, a Merck vaccine that prevents against 4 (6, 11, 16, 18) of the over one hundred total types of human papillomavirus (HPV). The article hints at the political and financial conflicts of interest, but other articles from various sources have detailed the issue and similar pieces of legislature in other states.

About Gardasil and HPV: Gardasil only works in women, so man cannot directly benefit from the vaccine. HPV is a virus that causes warts. HPV can cause genital warts and lead to cervical and vulvar cancers in women, penile cancer in men, and anal, head and neck cancers in men and women. HPV is considered a sexually transmitted disease (STD) because about 30 types are transmitted through sexually contact. So, even though the majority of HPV types are transmitted through casual contact (70+ casually transmitted:about 30 sexually transmitted), HPV is still considered a STD.

Of the 4 types of HPV that Gardasil protects against, 2 (6 & 11) are known to cause 90% of the cases of genital warts while the other 2 (16 & 18) belong to a group of 8 (16, 18, 31, 33, 35, 39, 45 & 51) "high risk" types, where "high risk" indicates association with cervical cancer. So, even if a woman (or girl) is vaccinated, she can still become infected with any of the other approximately 24 types of sexually transmitted HPV or 70+ types of casually transmmitted HPV; she can still get warts or cancer. Merck states this point through their advertising of Gardasil, but is the point really getting across? Will Gardasil really be taken as an extra precaution against sexually transmitted HPV, or will it be taken as a substitute for other precautions such as safe-sex and regular medical screenings? Gardasil's marketing campaign slogan is "One Less," used to mean that through Gardasil you or your daughter could be one less case of cervical cancer. I think this marketing campaign makes people think that Gardasil immunizes you against cervical cancer itself, rather than only 1/4 of the types of HPV associated with cervical cancer. And, for that reason, I think people will use Gardasil as a substitute for other precautionary measures.

Aside from the problematic political and financial ties and the perception of total immunity, there are major issues regarding gender, power, control, etc. going on with this legislation. With all these issues running through my mind, I wonder, has someone written an anthropology of the vaccine? I can't find a definitive body of work on the subject, only case studies. Any suggestions on some good articles or books?