Sen. Joe Heck’s 2007 vote in the state legislature against a bill that mandated insurance coverage of the Gardasil vaccine has become a central issue during this election cycle (see the Las Vegas Sun article). Nevada NOW has been asking why a physician would oppose a bill that would demonstrably increase public health by making more widely available, at no public cost, a vaccine that is proven to prevent cervical cancer caused by the Human Papillomavirus (HPV).

According to the Centers for Disease Control, fully 80% of American women will contract at least one strain of genital HPV by the age of 50. One million women every year will be diagnosed with cervical dysplasia (CD), a precursor to cervical cancer that is also caused by HPV. The treatment for CD is costly, and for women can cause discomfort or severe pain depending on the severity of the disease. Nationally, over 10,000 women are diagnosed with cervical cancer each year, and about 3,700 women die each year from this disease. Additionally, six million new cases of genital warts will be diagnosed in both men and women every year. The HPV vaccine that prevents cervical cancer also prevents most forms of genital warts.

Leading American public health organizations that include the CDC, the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics recommend wide-spread vaccination, as do all public health agencies in Europe. Nevada NOW is baffled why Senator Joe Heck, as a doctor, would vote against a bill in the state legislature that brings such health benefits to Nevada’s women at no public cost. SB 409 does not mandate administration of the vaccine (as 22 other states plus the District of Columbia are considering or have passed). Four other states, in addition to Nevada, have passed bills like SB 409, which (as passed in 2007 and signed by Governor Gibbons) requires health insurance companies in Nevada to cover the vaccine for those who opt to have it administered to their daughters. Moreover, Prior to SB409, the vaccine was already covered by Medicaid (through the federally funded Vaccines for Children program), by Nevada Check-Up, and by most insurance plans in the state, so there was really no savings for any entity, public or private, in opposing the bill. There was, however, a great risk to the public health.

To explain himself, Heck compares the vast majority of women American women who will contract genital HPV to a smoker who contracts lung cancer. It is important to note here that conservative studies estimate one in five women nationally will be sexually assaulted in her lifetime, and that Nevada women are statistically more likely to be subject to coerced sex than the national average. We also understand from common sense that a woman cannot control the past or even the present partners of her husband, boyfriend or lover, so that a woman need not engage in “risky” behavior to be at risk for contracting HPV or cervical cancer. For these reasons, most in the Religious Right, including most conservative organizations in Nevada, have dropped their previously stalwart opposition to the vaccine. Senator Heck stands to the right of almost everyone in his opposition to making the vaccine more widely available.

If we were to draw Senator Heck’s analogy with smoking and lung cancer to the logical conclusion, all women should abstain from having sex. My advice to Senator Heck is to consult Mrs. Heck before he is tempted to make more misleading comparisons.

Jessica Brown
President, Nevada NOW Board

September 25, 2008