Gardasil a Year Later: Cervical Cancer as a Model for Inequality of Access to Health Services

Authors

Micah Globerson, United States Agency for International Development

Abstract

This article updates a prior feminist legal analysis of Gardasil, the vaccine against Human Papillomavirus ("HPV"), in light of new developments. Recent discoveries confirming that HPV poses threats to men led Merck & Co. ("Merck") to apply for FDA approval to market Gardasil to males. These developments have renewed focus on the recurring question of whether making Gardasil vaccination a prerequisite for boys' school participation will arouse the same public condemnation that resulted from the prior mandate targeting girls. Another new development involves a vaccine panel recommendation by the Centers for Disease Control ("CDC") that inadvertently resulted in a policy change requiring proof of HPV vaccination from all female U.S. green card applicants between ages eleven and twenty-six. This article contrasts the new green card policy against the school vaccination policy, lamenting that the new immigration policy bypassed the opportunity for a critical cost-benefit analysis that would likely have shown that the new policy lacks substantial public benefit and is both over-inclusive and costinefficient. The article then observes how technologies such as the Pap smear and Gardasil served to widen the gap in equal access to medical services that initially emerged between the wealthy and the poor in the 1960s and 1970s with respect to cervical cancer. Particular attention is given to poor and minority women-groups identified to be at greater risk of contracting HPV-triggered cancers than others. The Visual Inspection with Acetic Acid ("VIA") technique is discussed as a possible option for meeting the immediate health needs of low-income populations. The case of Vietnamese-American women-the sub-population in the United States facing the greatest risk from cervical cancer-is discussed in detail, demonstrating that cultural norms and practices can be as important as access in determining the effectiveness of preventative screening programs. The paper concludes by considering how the policy changes proposed in the Obama-Biden reform plan, as well as the Obama-Biden pledge to double foreign assistance funding, might affect citizen and immigrant girls' and women's access to health insurance and services in the United States. Finally, HPV research over the past year teaches us that the problems that do not affect us directly today are ones that we may nonetheless need to solve as a community moving forward.

Disciplines

Civil Rights and Discrimination | Constitutional Law | Intellectual Property Law | Law | Law and Gender | Medical Jurisprudence

Recommended Citation

Micah Globerson, Gardasil a Year Later: Cervical Cancer as a Model for Inequality of Access to Health Services, 15 Cardozo J. Equal Rts. & Soc. Just. 247 (2009).
Available at: https://larc.cardozo.yu.edu/cardozoersj/vol15/iss2/3