Well this is effed up.
The federal government is considering making Gardasil vaccination, made by Merk pharmaceuticals, mandatory for female immigrants applying for citizenship. These shots, which vaccinate against certain types of HPV related to potential development of cervical cancer, are not mandatory for U.S. citizens.
I am all for making Gardasil more accessible and affordable. I think there’s a good argument to be made for making it a mandatory vaccine for school-age children — with an easy voluntary opt-out clause — because in many states that’s the only way that low-income families will be able to afford it, since mandatory vaccines are more likely to be covered by Medicaid (I also think there’s a better argument against it, but that’s another post). I think there’s a very good (and obviously widely-accepted) common-sense argument to be made for making certain vaccines mandatory for new immigrants or visitors to the U.S. — and some vaccines for highly communicable and airborne diseases are mandatory. That’s reasonable.
But making the HPV vaccine a requirement? It’s both unnecessary and frightening. It’s also shamelessly xenophobic.
As WOC PhD describes, immigrant women and women of color in the United States have long been used as test subjects for experimental medications and treatments, especially in the reproductive area (head over and read her post — she has great details). When it comes to Gardasil, it’s increasingly clear that Merck is more concerned about their profit margin than health care.
And since it’s no big secret that Republicans are in bed with Big Pharma, we shouldn’t be surprised when that relationship props up other right-wing policies — like keeping certain kinds of immigrants out. Gardasil is expensive, and requiring it means that immigrants of a certain income level will have a much easier time meeting American health requirements than lower-income immigrants. It puts more barriers in the way of women and families seeking to live in the U.S., and has a disproportionately negative impact on immigrants who are coming from difficult financial situations — immigrants who are less “desirable” to the current political administration.
For a lot of feminists and reproductive rights activists, Gardasil is a soft spot. Just a couple of years ago we were fighting to get it on the market, against right-wing ideologues who were convinced that protecting women and girls from cervical cancer would turn them into big sluts — the underlying message being that the threat of death should be a sexual deterrent, and women who don’t abide by the rules don’t deserve to live. The initial narrative was full-throated support of Gardasil, because the political debate over it was another example of social conservatives demonizing female sexuality and going out of their way to punish women who have sex.
But singular narratives rarely work out in the real world, and Gardasil is no exception. Like many forms of birth control — access to which feminists also support, and rightly — Gardasil is not patented and sold solely for the good of womankind. Like birth control, it has side effects and certain risks that individuals should weigh and evaluate. And like many forms of birth control, it’s being tried out on communities of color and incarcerated communities. That’s unconscionable.
You don’t have to be anti-vaccine (or anti-Gardasil) to maintain a healthy skepticism when Big Pharma is pushing a drug with all its might. I love my birth control; once I start getting paid, I will probably be vaccinated against HPV. This isn’t about making blanket judgments about whether Gardasil or other reproductive medications and technologies are good or bad; it’s about recognizing that our goal as reproductive justice advocates should be to give women as many options as possible, and to situate those options in a broader context that takes into account our individual and collective histories within a system that treats us differently based on our race, class, physical ability, and other factors. As WOC PhD says:
I know people who worked on the research that eventually led to the creation of Gardasil. And I believe that they had the best intentions about supporting women’s health and curing cancer in mind. Obviously, they had HSB/IRB approval. I do not mean to disparage their work by questioning this potential legislation. Instead, I’m trying to encourage some introspection on the potential for abuse on the part of the nation and big pharma at the expense of women post-approval, post-official research project(s). I’m trying to track a pattern, however loose it may be, of big pharma getting around HSB and returning to the very kinds of research that we swore would never happen again. When a marginalized population, in this case immigrant women, is singled out for mandated medical procedures that no other population is nationally mandated to undergo, we should be concerned.
It seems to me that we need to pay close attention to the ongoing connection between intentional use or coerced use (which a state or national law requiring use is) of vulnerable populations and medicine with known major side effects. We need to be concerned not only because of what it could say about how human subjects are once again rendered unwitting research subjects without HSB approval but also because of what this pattern says about the state’s growing interference in women’s bodies.
At a time when outcry about reproductive rights is so loud, I find myself wondering where is the similar outcry about medical testing targeting women who are members of vulnerable populations. Gardasil in particular seems to mobilize a feminist discourse to sell its product and the realities of this potential legislation forcing immigrant women to take medicine they may not otherwise take, and which non-immigrant women have not been universally forced to take, is antithetical to feminism which claims women should have sole control over their bodies. It is not about Gardasil, its effectiveness or lack there of (of which there is ample evidence in both directions), it is about women’s rights, women’s health, and women’s bodies. No matter how bad cervical cancer is, and as someone who has lost family members to cervical cancer I can tell you first hand it is bad, we cannot afford to sacrifice a woman’s right to choose what she does with her body based on her legal status, race, class, location, or any other marginalizing identity. Nor should we settle for a product that may not have been studied enough because it is all we have.
Cervical cancer kills thousands of women, many of whom are lower-income women with limited health care access — that’s part of the reason why an affordable and accessible HPV vaccine is so important. And millions of women live with HPV, which can have serious impacts on one’s health even if it never develops into cervical cancer. But every woman deserves the right to decide for herself if the benefits of Gardasil outweigh the risks. And we all need to be vigilant when we see the history of reproductive exploitation of bodies of color repeating itself.