Abstract
In February 2014 Austria became the first European country to offer the human papillomavirus (HPV) vaccine to both girls and boys for free. This chapter discusses how this has involved a discursive shift from the individual girl “at risk” to the population of children as the vaccination recipient. With the help of Adele Clarke’s social worlds/arenas approach, we discuss the discursive positions taken by a range of different governmental and non-governmental actors concerning the HPV vaccine. Combining an analysis of public information material with an analysis of interviews with administration and health-care staff, the chapter highlights how gender, sexual disease transmission and immunization are articulated and discussed in the chosen social worlds of the Austrian HPV vaccination arena. In relation to that, we stress how a changed management of HPV vaccine evidence has crucial consequences for how the vaccination recipient and, in a broader sense, the Austrian population are constructed. We argue that the current discourse in Austria differs fundamentally from how the HPV vaccine often is framed as an individual, yet gendered, risk responsibility. In the current dominant Austrian discourse, herd immunity is anticipated through transformed relations between the individual and the population.
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Notes
- 1.
“[The] human papillomavirus (HPV) is a highly contagious infection transmitted through sexual or skin-to-skin contact” (WHO 2013). The virus is transmitted by men and women alike. There are over 100 different HPV strains (Gesundheitsinformation 2012). While most HPV infections disappear without treatment, a chronic infection with high-risk strains can develop into cervical cancer and genital cancer, including cancer of the anus, penis, vulva and vagina as well as mouth and throat cancers (Mishra and Graham 2012; Charles 2014). Gardasil, one of the two HPV vaccines on the market, has also been proven to prevent the infection with the HPV strains 6 and 11 that cause 90 percent of genital warts (WHO 2013). After the HPV vaccine’s launch, it was mostly directed at the female population and constructed as “the girls’ vaccine” (Mishra and Graham 2012).
- 2.
As is also the case elsewhere, in Austria the HPV vaccine is currently given for free only to boys and girls in fourth grade (nine years of age). The vaccine is not intended for everyone independent of age.
- 3.
To secure their anonymity our informants’ names have been changed and their positions at ACA and the Health Ministry are not revealed.
- 4.
There are no links or references made to the campaign in the current empirical data.
- 5.
All translation from German to English is completed by Busse.
- 6.
This resonates with Stöckl’s (2010) argument that the absence of a national HPV vaccination program in Austria has been connected to claims from Austrian health economists about the need to medicate both boys and girls to reach a state of herd immunity. According to her this led the Health Ministry to emphasize the Pap smear test as more cost-effective than the HPV vaccine.
References
ACA (Austrian Cancer Aid) [Österreichische Krebshilfe]. 2012. Brochure: Humane Papillomaviren (HPV). Chronische HPV-Infektionen können Krebs auslösen. https://www.krebshilfe.net. Accessed 15 October 2016.
Aronowitz, R. 2010. Gardasil. A Vaccine Against Cancer and a Drug to Reduce Risk. In Three Shots at Prevention. The HPV Vaccine and the Politics of Medicine’s Simple Solutions, ed. K. Wailoo, J. Livingston, S. Epstein, and R. Aronowitz, 21–38. Baltimore, MD: The Johns Hopkins University Press.
Ashmore, M., M.J. Mulkay, and T.J. Pinch. 1989. Health and Efficiency: A Sociology of Health Economics. Milton Keynes: Open University Press.
Australian Government. 2013. Immunise Australia Program: The HPV Vaccine. https://www.bka.gv.at/site/7569/default.aspx. Accessed 15 October 2016.
BMG (Bundesministerium für Gesundheit) [Austrian Ministry of Health]. 2013. Parents’ Information—HPV Vaccination. http://www.bmgf.gv.at. Accessed 15 October 2016.
———. 2014a. HPV-Impfung Gratis. http://www.bmgf.gv.at. Accessed 15 October 2016.
———. 2014b. Informed Consent Form for Immunization: Gardasil. http://www.bmgf.gv.at. Accessed 15 October 2016.
———. 2016. Fact Sheet. http://www.bmgf.gv.at/home/Gesundheit/Gesundheitsfoerderung_Praevention/Impfen/HPV_Impfung. Accessed 15 October 2016.
Burns, K., and C. Davies. 2015. Constructions of Young Women’s Health and Wellbeing in Neoliberal Times: A Case Study of the HPV Vaccination Program in Australia. In Rethinking Youth Wellbeing, ed. K. Wright and J. McLeod, 71–89. Singapore: Springer.
Casper, M.J., and L.M. Carpenter. 2008. Sex, Drugs and Politics: The HPV Vaccine for Cervical Cancer. Sociology of Health and Illness 30(6): 886–899.
Charles, N. 2014. Injecting and Rejecting, Framing and Failing. The HPV Vaccine and the Subjectification of Citizens’ Identities. Feminist Media Studies 14(6): 1071–1089.
Clarke, A.E. 1991. Social Worlds/Arenas Theory as Organizational Theory. In Social Organization and Social Process. Essays in Honor of Anselm Strauss, ed. D.R. Maines, 119–158. New York: A. de Gruyter.
———. 2003. Situational Analyses: Grounded Theory Mapping After the Postmodern Turn. Symbolic Interactionism 26(4): 553–576.
———. 2005. Situational Analysis: Grounded Theory After the Postmodern Turn. Thousand Oaks, CA: Sage Publications.
Daykin, N., and J. Naidoo. 1995. Feminist Critiques of Health Promotion. In The Sociology of Health Promotion: Critical Analyses of Consumption, Lifestyle and Risk, ed. R. Bunton, S. Nettleton, and R. Burrows, 59–69. London: Routledge.
Epstein, S. 2010. The Great Undiscussable. Anal Cancer, HPV, and Gay Men’s Health. In Three Shots at Prevention. The HPV Vaccine and the Politics of Medicine’s Simple Solutions, ed. K. Wailoo, J. Livingston, S. Epstein, and R. Aronowitz, 61–90. Baltimore, MD: The Johns Hopkins University Press.
Fishman, J.R. 2004. Manufacturing Desire: The Commodification of Female Sexual Dysfunction. Social Studies of Science 34(2): 187–218.
Gesundheitsinformation. 2012. Humane Papillomviren (HPV). http://www.gesundheitsinformation.de/humane-papillomviren-hpv.2109.de.html?part=ursachen-fc. Accessed 22 May 2014.
Groth, S. 2014. Geimpft mit Information. http://www.fgz.co.at/fileadmin/hochgeladene_dateien/pdfs/Artikel_2012_2013/2014_2_17_geimpft_mit_information_sylvia_groth.pdf. Accessed 17 May 2014.
Johnson, E., and E. Sjögren. 2012. Governing by Drugs: The Denial of Subsidy for Viagra Use in Sweden. In Transformations of the Swedish Welfare State: From Social Engineering to Governance? ed. B. Larsson, M. Letell, and H. Thörn, 181–194. New York: Palgrave Macmillan.
Lindén, Lisa. 2016. Communicating Care: The Contradictions of HPV Vaccination Campaigns. Lund: Arkiv förlag.
Mamo, L., A. Nelson, and A. Clark. 2010. Producing and Protecting Risky Girlhoods. In Three Shots at Prevention. The HPV Vaccine and the Politics of Medicine’s Simple Solutions, ed. K. Wailoo, J. Livingston, S. Epstein, and R. Aronowitz, 121–145. Baltimore, MD: The Johns Hopkins University Press.
Mishra, A., and J.E. Graham. 2012. Risk, Choice and ‘The Girl Vaccine’: Unpacking Human Papillomavirus (HPV) Immunization. Health, Risk and Society 14(1): 57–69.
Moore, S.E. 2010. Is the Healthy Body Gendered? Toward a Feminist Critique of the New Paradigm of Health. Body and Society 16(2): 95–118.
Niezen, M.G., R. Bal, and A. de Bont. 2013. Reconfiguring Policy and Clinical Practice How Databases Have Transformed the Regulation of Pharmaceutical Care? Science. Technology and Human Values 38(1): 44–66.
OEGGG (Österreichische Gesellschaft für Gynäkologie und Geburtshilfe) and AGO (Arbeitsgemeinschaft für Gynäkologische Onkologie). 2014. Humane Papillomviren und Krebs: Antworten auf häufige Fragen. https://www.krebsinformationsdienst.de/vorbeugung/risiken/hpv2.php. Accessed 15 October 2016.
Paul, Katharina T. 2016. “Saving Lives”: Adapting and Adopting Human Papilloma Virus (HPV) Vaccination in Austria. Social Science & Medicine. doi:10.1016/j.socscimed.2016.02.006.
Rose, D., and S. Blume. 2003. Citizens as Users of Technology: An Exploratory Study of Vaccines and Vaccination. In How Users Matter. The Co-Construction of Users and Technologies, ed. N. Oudshoorn and T. Pinch, 103–132. Cambridge, MA: MIT Press.
Sjögren, E., and C.-F. Helgesson. 2007. The Q(u)ALYfying Hand: Health Economics and Medicine in the Shaping of Swedish Markets for Subsidized Pharmaceuticals. The Sociological Review 55(2): 215–240.
Stöckl, A. 2010. Public Discourses and Policymaking. The HPV Vaccination from the European Perspective. In Three Shots at Prevention. The HPV Vaccine and the Politics of Medicine’s Simple Solutions, ed. K. Wailoo, J. Livingston, S. Epstein, and R. Aronowitz, 254–269. Baltimore, MD: The Johns Hopkins University Press.
Wailoo, K., J. Livingston, S. Epstein, and R. Aronowitz. 2010. Three Shots at Prevention. The HPV Vaccine and the Politics of Medicine’s Simple Solutions. Baltimore, MD: The Johns Hopkins University Press.
WHO (World Health Organization). 2013. Talking with Patients and Parents about HPV Vaccination for Girls. http://www.euro.who.int/__data/assets/pdf_file/0006/187152/Talking-with-patients-and-parents-about-HPV-vaccination-for-girls-final.pdf?ua=1. Accessed 26 April 2014.
Will, C.M. 2009. Identifying Effectiveness in ‘The Old Old’. Principles and Values in the Age of Clinical Trials. Science, Technology and Human Values 34(5): 607–628.
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Lindén, L., Busse, S. (2017). Two Shots for Children. In: Johnson, E. (eds) Gendering Drugs. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-51487-1_9
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