Risk, choice and the ‘girl vaccine’: Unpacking human papillomavirus (HPV) immunisation

Abstract

The marketing of Gardasil® and Cervarix™ vaccines for the prevention of human papillomavirus (HPV) targeted pre-sexual girls and cervical cancer, representing young women as practicing ‘decision autonomy’ in acquiring the ‘facts‘ about HPV and cancer. We challenge this overly simple explanatory model of vaccine choice. Through interviews with vaccine scientists and public health nurses in Canada, we illustrate the clinical, political and practical complexities of introducing a new and controversial vaccine. The omission of provocative sexual themes in the marketing of the vaccine strategically created an object marked for ‘women only’. The public acceptability of the vaccine was promoted by neglecting the clinical and sexual facts of the spread and prevalence of HPV infection and related cancers across genders and sexual orientations. This strategic omission generated a blockbuster vaccine embedded in a discourse of individualised risk and pharmaceutical control centred on female bodies.

Keywords:

• human papillomavirus
• vaccine
• risk
• heteronormative
• gender
• choice

Acknowledgements

This work was supported by the Canadian Institutes of Health Research (CIHR Catalyst Grant CVC-99978). This project, ‘Regulatory challenges to the development of new vaccines: Mapping emergent relations between science, evidence and policy’ was approved by the Research Ethics Board of the IWK Health Centre, Halifax, Nova Scotia, Canada.