It is rare to read a news story that describes a win-win situation, but occasionally one comes along that, on the face of it, is entirely good. This weekend, for instance, it emerged that a government advisory group, the Joint Committee on Vaccination and Immunisation (JCVI), looks likely to recommend giving a vaccination against the human papilloma virus to all 12-year-old girls. HPV is the extremely nasty sexually transmitted disease that causes 70% of cervical cancers - a cancer that affects approximately 3,000 women in the UK annually and causes 1,120 deaths.
Should the Department of Health take the JCVI's advice (there is a chance it will not, not least because the vaccination will cost £300 per person) it is an exciting development for a whole host of reasons. Most important, of course, is the fact that, given to women who have had no previous sexual contact, this vaccine is 99% effective against the two virus strains that cause most cervical cancers. It is also (no small thing) effective against another pair of virus strains that cause most of the non-life threatening, but extremely unpleasant, genital warts.
And, given all these undeniable positives, there are already quite a few people who are keen to see their children immunised. As a former nurse practitioner and the chief executive of a private primary healthcare group, for example, Sarah Dean is intent on using every tool at her disposal to protect her five children's health. For the past six months, her company, Direct Health 2000, has been offering its customers the vaccination against HPV (until the Department of Health approves it, it is only available privately) and, having looked into the vaccination's efficacy, Dean is determined that her nine-year-old daughter, Freya, will be vaccinated within the next year.
"This is a fantastic opportunity and I can see no reason for deliberating about it when we know that it's a life-saving vaccine. The fact of the matter is that if you don't want your daughter to get cancer of the cervix, you should get this vaccination done," she says.
In many ways, offering this vaccination to all the nation's 12-year-old girls seems, as Dean suggests, "a no-brainer". But wait! Both here and in the US - where debates about the vaccine have been raging for several years - a strong, and, in some ways, surprising strain of opposition has developed. This argument isn't based on concern voiced by some doctors that the vaccination might harbour unknown long-term side effects. It is not based on the fact that, as yet, we don't know whether the vaccine is effective more than five years after it has been administered. It is not based on the fear expressed by some, that older women might take the vaccine at a time of their lives when it is much less effective and feel, wrongly, that they have been immunised - subsequently giving up potentially life-saving screening. It is not based on the idea that this type of programme needs to be rolled out in a careful and timely fashion, so as to avoid public misinformation and confusion.
No, the most vociferous argument against the vaccination is that it will encourage young women to have sex. Opponents say that if you vaccinate young women against a sexually transmitted disease, you are giving them a green light to become sexually active, plunging them into a dark, grown-up world for which they are not ready. So, for example, Hugh McKinney of the National Family Campaign has said that the proposed vaccination programme "could be seen as helping to promote or encourage sexual activity in girls before they are physically or mentally mature".
A spokesman for the Catholic Church has said that any vaccination programme should be supported by the promotion of "sex within marriage" and that "the promotion of marriage should remain the number one social policy priority". Taking up this tack, several newspapers have run stories about the vaccine under inflammatory headlines - for example, the Daily Mail's "NHS offers jab that 'promotes underage sex'" and "Girls of 11 'should be given sex disease jab'".
That this argument is being made in opposition to a potentially enormous step forward for women's health is frustrating, as well as quite clearly wrong-headed. The idea of administering the vaccine at the age of 12 is obviously to ensure that all women are protected from cervical cancer. There is no doubt that a minority of 13- and 14-year-old girls are sexually active, and this vaccination could protect them from one of the worst possible outcomes of that early sexual contact. The idea that immunisation should be withheld on moral or social grounds until the age of consent, or even marriage, would be a particularly nasty way of punishing those who happen to have sex at an early age. And it is hard to see that having the vaccination will encourage girls to start having sex any earlier than they otherwise would. The fact is that, rightly or wrongly, fear of cervical cancer probably comes very far down the list when a girl is weighing up the risk factors in having sex. (Pregnancy surely comes first, followed by more prominent sexually transmitted diseases such as HIV/Aids, syphilis and gonorrhoea). It seems unlikely, then, that any young women who have yet to consider having sex will suddenly decide, "Hey, I'm protected from cervical cancer - I'll throw all caution to the wind."
Dean has come up against many of these arguments herself. Her husband, Paul, was horrified when she announced her decision to immunise Freya. "I couldn't believe she was thinking of it," he has said. "I said, 'No way', not my daughter. It made no sense to me. She was far too young. She wasn't having sex. She wasn't going to be having sex for an awfully long time - or over my dead body ... I immediately told Sarah that we should wait until she was 16 or 18, or until she felt the time was right herself."
It is understandable for a father - or any parent - to feel protective towards their children, and to be appalled by the idea of them having sex at an early age. But Dean argues that sex must be taken out of the equation. "My responsibility as a mother is to protect my daughter. I've vaccinated her against mumps, measles and rubella, and I see no reason not to vaccinate her against cervical cancer," she says.
"As she gets older I will explain it all to her and I'll make it clear that this doesn't give her carte blanche - it won't stop her from getting pregnant, or from getting any of the horrible diseases out there, gonorrhoea, HIV and all the rest of it. What it will do is to stop her developing cancer of the cervix."
