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.
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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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