Good girls do…get vaccinated: HPV, mass marketing and moral dilemmas for sexually active young women

Current media representations of human papillomavirus (HPV) vaccination communicate a potent message that concerns about sexually transmitted infection (STI) are no longer restricted to sexually active “bad girls”. The mass marketing of vaccines against HPV – whether to serve industry efforts to establish markets for products or public health efforts to minimise STIs and cancer morbidity and mortality – firmly yet carefully inscribes the not-yet-sexually-active “good girl” as the primary target in the control of sexually transmitted disease. The rationale for HPV vaccination of girls prior to sexual contact in Canada and elsewhere derives from the high prevalence of the virus (which is typically described as the most common STI worldwide), its ease of transmission through non-penetrative, skin-to-skin contact and the relatively high incidence of HPV infection after onset of sexual relations.1 Because all forms of sexual contact are considered likely to expose girls/teens to HPV, the delivery and mass marketing of HPV vaccination prior to sexual activity frame parental decisions to vaccinate as the right, reasonable and responsible choice to “protect” their daughters and arm them “for life” in the ongoing war against cancer.2 3

Unlike the girls targeted by the school-based vaccination programmes, young women who fall outside the recommended age range for vaccination, and those who are already sexually active, are left in a kind of limbo that stems from the disconnect between mass marketing messages and clinical evidence. On the one hand, the …