Kenneth Anderson argues that it’s appropriate to require girls to be vaccinated against HPV, because those who aren’t vaccinated are in effect free-riding on those who are. That’s the usual argument for vaccination, and correct so far as it goes.
But, he continues, it would be wrong to require vaccination for boys, because they are only trivially at risk from HPV: a small number might get non-life-threatening genital warts, but the risk of cervical cancer, obviously, applies only to girls. Thus a vaccination requirement that applied to boys would invade their bodily integrity for the benefit of others. Anderson claims “a very, very strong presumption that you can’t do things to one group of people’s bodies in order to benefit another group.” Ergo, he says, parents should have their male children vaccinated on ethical grounds, but it would be wrong to require vaccination.
It seems to me that argument is (1) coherent and (2) obviously wrong in at least two different ways.
First, the power to quarantine carriers of infectious disease – the “Typhoid Mary” case – is well established in law. Note that Typhoid Mary was not herself sick; she was merely the cause of illness in others. And yet she was not merely required to take a fairly harmless vaccination; she was deprived of her liberty. Yes, the threat she posed was more acute and more immediate than the threat created by any one unvaccinated boy, but correspondingly the demands on the boy are orders of magnitude smaller than the burdens on Mary.
If it turned out that an identifiable half of all girls were not personally at risk of cervical cancer from HPV, but could still spread the infection, would there be an argument for exempting them from the requirement to be vaccinated? I don’t think so.
Second, the notion that HPV infection is harmless to males assumes that infection will not interfere with the male’s sex life. But knowingly exposing a sex partner to the risk of a sexually transmitted disease is a tort, and at least in some states a crime. That issue doesn’t generally arise because most men never bother to find out whether they are carrying HPV. But insofar as HPV infection doesn’t create a social disability, it’s only because of that ignorance.
To be in a position where every time you have sex you put your partner’s life at risk seems to me to be a genuine injury. If so, then it’s not the case that vaccination has no value for the male, even ignoring – as Anderson proposes to do – any emotional interest the male might have in his partners’ well-being.
The technical details of the HPV vaccination question are above my pay-grade. But it seems to me that the legal and moral principles involved aren’t really very hard.
If a vaccination of modest cost and trivial inconvenience and risk can prevent a substantial number of horrible deaths, then requiring everyone to be vaccinated, even people not themselves at risk of dying any of those horrible deaths, is a perfectly unobjectionable public-health measure. I doubt that the debate would have found much of an audience outside professional circles if it didn’t involve acknowledging the frequency of sex among minors.