Title: Guard Us All? Immigrants and the HPV Vaccine #30-09 July 29, 2009

" Wu who -- this week on making contacts. -- if you don't get this vaccination and I can't pass you on this medical exam. So obviously it didn't really have a choice but why -- they requiring it to us that you are we some sort of medical experiments. They're talking about the widely distributed HPV vaccine artists sound. The Centers for Disease Control also scarred his -- helps prevent certain types of cervical cancer it. But since its approval in 2006. The vaccine has been mired in controversy over alleged side effects. Even more controversial. Is the current CDC health mandate that requires an immigrant women to get the vaccination. If they wanna stay permanently in the US. On -- public health policy versus personal health night. Making contacts Celine about the Levy talks to people on both sides of the debate over the mandatory vaccination. I'm Tina rubio and decision making contact a program connecting people out of ideas and important information."

" I can't see an accident because I'll do everything I can't help protect myself and cervical cancer. And -- this sound of a camera snapping is accompanied by close ups snapshots of hip young women in their twenty's. In the commercial the women are painting studying petting and -- each telling the TV viewer -- she chooses to get vaccinated each PD disease and I just get vaccinated estimates are digital music artist -- You might have heard about it it's a widely distributed and relatively new vaccine for HPV. That's the human -- alone a virus a sexually transmitted disease that can cause cervical cancer. The Centers for Disease Control says Carter so prevent some types of HPV. The one must commercial campaign first started airing on US TV stations Bakken 2006. Manufactured by pharmaceutical giant American company the marketing campaign capitalized on the language of women's choice. Since its approval in 2006. Cardoso has been recommended for girls and young women ages nine through 26. But the vaccine is not a choice for everyone. I don't feel like I had a choice in this matter and really feel like I was forests to get a vaccination that day you know I didn't wanna get. That's 26 year old -- to not -- she. My doctor gave me a small pamphlet that was basically was going into the side of the potential side effects that I could have. Other than that any questions I asked about whether really needed to learn we're not really answered. They really -- the doctors aren't there to help me they just wanted to. You get this process over with then I have do you get the vaccine or they're going. Unlike the young women in the commercial -- timid did not have a choice she was required by law to start the HPV vaccination she wanted to apply for permanent residency in the United States. That's because Akamai is not the US citizen even though she's been here for the past fifteen years. I spoke of facts not on a night where she and her husband can cook dinner in the high ceiling locked in Brooklyn New York."

" It's the."

" I was going the United Arab Emirates and Abu Dhabi which is the capital. I lived there for about eleven years with my family. Came to United States in 1993. My father mother. Myself and my brother all moved to Connecticut which is where my two other Brothers weren't going to college. -- family used to live in the United Arab Emirates but they were forced to leave. Well what did happen was an early ninety's and the Middle East and specifically in you may eat there is this movement called Arab eyes Haitian aren't. Localization basically. Where you know the government decided that there are too many foreigners in the country anyone -- to replace the foreigners. Who had higher level jobs live Arab nationals. After her father was fired from his job he tried to return to Pakistan for the family has citizenship. -- happen when he went back there was he was persecuted. He's what you call them high do which is an Indian immigrant to Pakistan and at the time. Indian immigrants and Pakistan -- being persecuted. -- he was kidnapped and tortured and you know all sorts of horrible things happen to him and he was lucky enough to make us so for -- family sought political asylum in the US. But the process is complicated. Her father is still an asylum proceedings today fifteen years after they first came to the last. But optima has pulled herself out of the attack on proceedings. She married can who she met in grad school in New York University. Nash is applying for residency through marriage petition. But this has come with a whole list of requirements. Passing a medical Examiner's ones every immigrant has to go to the governments or if -- clinic. And they have to get a physical they have to show truth that these received. Particular vaccinations and that their healthy and diseased tree. And based on whatever their results are -- Doctor who's been certified by the government is there gives you -- clean bill of how author says he didn't past. And that can affect whether you get a permanent residents here -- I went to clinic -- men."

" It was not her medical exam that fact in the first learned about card itself. And that US Slough would require her to get vaccinated even though it's not required for US citizens. This came as a surprise not only to her but also to many doctors attorneys. Immigrants rights and reproductive justice organizations around the country. Priscilla Kwan is the policy and programs director at the national Asian Pacific American women's forum. -- immigrants rights and reproductive justice organization. Priscilla explains how this requirement became a law."

" Basically what happened was back in 1996. Congress meets some changes to our immigration. Law. And among one of those changes was a requirement. That. Any sort the vaccine that becomes a recommendation and by a a specific division in CDC the Centers for Disease Control. When you become an automatic requirements. For immigrants. That."

" Division of the CDC is known as the advisory committee for immigration practices -- Doctor dobrynin dot works in the CDC's division of -- prevention. She says the -- committee is made up of a group of physicians and vaccine experts they meet regularly to look over new scientific data on vaccines. And -- responsible for developing new vaccination recommendations."

" In the -- you peace strive to make recommendations that are in the best interests of individual and public health. But these KP did not include in its purview -- is any sort. Mandates and the purview of state legislators as well as congress. So basically the complete blanket. Connection between any recommendation that came out of eight. To a mandate that requires that vaccine for immigration."

" The CDC. And specifically a sip to not recommend that today's TV vaccine be requirement for anybody. Priscilla -- from what we understand. The never had an intention from making -- Carmen for even. US citizen girls and young women and so. From what we understand they wear equally -- as surprised as we learn when they found at that it would become are cramming for immigrants. But regardless of their intention women like -- left without a choice in the matter and I asked him you know to I have to get it is -- because as far as I."

" Knew. It was news to me. And he gave me an answer that was pretty suspicious. To me was cyclone yet -- Clara meant everybody has to get it. And I asked to community you know why is there is an exception can I sign something that are applied for some kind of exception and you know he didn't really give me an answer so I said well -- think about it and I'll come back. And need to file -- he pretty much said well if you don't get this vaccination and I can't. Passing on this medical exam and I can't give your medical paperwork. So obviously I didn't really have a choice that I wanted to. You know I think about it."

" When -- island home she did some research to learn everything she cut about HPV in the vaccine. She found that she was required to get the first steps in order to pass her medical exam. I did some research to doctored data from the CDC helped me understand a bit more about HPV and that's vaccine."

" HPV stand for human couple -- virus which is a very common sexually transmitted infection. In the US we estimate about sixty million infections occur every year. We know that virtually all of cervical cancer cases are -- HPV infection."

" The CDC says that at least 80% of women wolf contracted an HPV infection by the time their fifty years old. Most of the time our bodies processed the disease without any symptoms but a few strains of HPD can lead to cervical cancer. "

" If you left about 10000 cases of cervical cancer diagnosed each year. And there are about 4000 deaths each year due to cervical cancer. And I wanna point out that in the US we have lower rates of cervical cancer because we -- cervical screening. Worldwide about 300000. Women die from cervical cancer each year. And it's the second most common cause of cancer death in women globally."

" And the American social health associations has about twenty million people in the United States are currently infected with HPV. But many of these woman we'll never know they have an HPV infection because their asymptomatic. Or don't have access to health care. He's here in the US thousands of women learn they have cervical cancer. I could be one -- Well as yeah. I do wanna clarify though and not against a vaccine for saying the woody plants. Forests fascination of immigrant women when it's not a heart -- women. Jessica Gonzales as the director of policy and advocacy at the national Latina institute for reproductive health and New York City. As a reproductive justice organization. The institute looks at women's health not as an isolated issue but in the context of their lions experiences environments and social identity -- Artists still."

" And this HPV vaccine in this issue related to requiring different immigrant women is a reproductive justice issue because we look at. Reproductive justice is a very intersection issues that really looks at. Woman's ability make decisions about themselves their families their communities. So by enforcing this vaccine on immigrant women again looking at a population which are mostly women of color. And marginalized population. That it's a reproductive justice issues could be Tommy's been taken away from them."

" This isn't the first time women of color and immigrant women have been subject to federal policies that control their bodies. Women in the reproductive justice movement CB HPV vaccination requirement. As a new chapter in the history of reproductive oppression."

" In the past. Women of color and immigrant women have been subjected to birth control testing. For sterilization and upper -- which is -- shot. There have fertility has been controlled RA policies that would prevent them from having children if there's drug users -- prison and and as a -- next movement that has seen women of color. And immigrant women is unfit to reproduce so this is a history that we carry with us we're looking at policies. Such as the vaccine mandate that it does the government has just issued for immigrant women."

" Between 1920s and sixties more than a 100000 women were coerced or forced to get sterilized in the United States. -- predominantly poor women women of color and welfare recipients. One of these woman was the right Iraq's. A renowned activist an expert on human rights and women's issues it -- is a founding member of sister signed -- women of color reproductive health collective."

" Now the development that we probably need to pay close attention to. -- at the -- of the 1900."

" There was a movement developed that would actually badly based on Darwin science that was -- that began to."

" Promote positive breeding."

" So that we can improve the rate."

" And they met the white race -- play."

" became sterilized after she was given falcons shields and intra uterine device or IAD. At this time it was marketed as the hottest and newest form of birth control but these IUDs ended up sterilizing thousands of women in the US. And -- 300000. Women to file a class action lawsuit against the manufacture."

" There were positive incentives. That were created during Perry. White couples to have more children. And then there -- disincentives created. Including massive sterilization. Of people of color and anybody that they felt was a bit. We need to -- passed eugenics laws that allow -- they can just sterilize anybody they want it to. That they deemed as not fit to reproduce. And so we have that history."

" Racist assumptions about over population developed alongside the eugenics movement. Fueled by these ideas state policies tried to control the reproduction of women of color porn immigrant women. In many states welfare recipients could get sterilized or were forced to lose their welfare benefits. -- Cox Ramirez is one of these women. She shared her story with against -- well. It's a project of the Winston-Salem journal that documented North Carolina sterilization program that affected more than 7000 women. The Ellis eighteen years old in 1965. When she got pregnant with her boyfriend she was also on welfare. A white woman from the Washington county department of public welfare started coming over their house more often."

" Hugh always tell me -- fan. He's a -- because with huge he did you know do this. We don't take -- hit away from that. -- No I don't want you what you got that you pray you do it then they hit they want what they wanna -- be done and if it. What right that I. Would that because what. Oh run."

" Elaine -- Jesse is another woman he shared her story with the against their will project. She was sterilized at fourteen without her consent and explains how it felt. They took away my life in Kuwait our rights to be a woman and."

" Right to have children to be happy to. My biggest fill me up. This fill me up Hillary."

" And yeah."

" You're listening to making contact a production of the national radio project. If you'd like more information can offer CD copies of this program please call 805295736. Full length interviews with guest on today's show and other women in the reproductive justice movement are available on our website. You can also download programs are get our podcast at radio project dot --"

" It's. It's."

" We now return to guard us all immigrant women an HPV vaccine."

" women have also struggled with control over their reproductive health. In the late 1970s. And a landmark case smog and he -- equally and ten Mexican women in California testified that a Los Angeles medical center. Violated their right to reproduce by coercing them to get sterilized. The national coalition for immigrant women's rights is helping to pick up the fight against the control of women's bodies. It's a newly formed group of reproductive justice and immigrants rights organizations. The coalition has come out and strong opposition to the new vaccination requirement. And a letter to the CDC they may at a series of reasons why they believe this requirement should be rescind it Priscilla -- from knock off which is also part of the coalition. Explains. It's extremely cost prohibitive. For example on we -- that they HPV vaccine is currently. The most expensive one on the market FDA has approved it and recommends that people receiving the vaccine get it in three doses. And each dose costs a minimum of 120 dollars. And that's without considering the costs associated with going on an office visit transportation and physician he is anything else that's associated. -- administering the vaccine. Well I think that the challenges just it's it's so expensive. That's stick me as an attorney and the executive director of the immigrant legal advocacy project. They are the only organization and meantime offer legal aid to low income immigrants."

" We surveyed all of the doctors that are approved by immigration to provide the immigration medical exam in Maine. And that cheapest cost for getting this vaccination from one of those approved doctors is. 600 dollars for the series of three shots and it goes up as high as a thousand dollars for the series of three shots."

" Additionally the cost for guard vessels not covered by insurance Medicaid or state health care programs for immigrant women. Women in the US on the other hand can get the costs covered through some insurance plans. And children and teens under eighteen may be eligible for free vaccinations through the vaccines for children program. But immigrant women are required to pay for their own series of doses a cost they usually cannot afford. One of best clients in Maine is 26. Once she turns 27 at their requirement no longer clients. Says she's waiting till -- to finish her medical exam the last step in getting her green card. She says she heard about the vaccine from the Cardoso commercials on TV but did not mention is required to GAAP net. Initially when the nurse told her she needed the vaccine she'd create."

" Make it okay. -- Because something that -- precaution. Yeah. Didn't get -- as they -- completion cloud cap and how it -- have been. And I would like you shot had been prepared to act shocked I didn't even know I had to take it."

" To see how much cost of the HPV vaccine really very. I called five medical offices in the San Francisco Bay Area that offer immigration medical exam. -- four different offices the price of varied and went as high as 250 dollars for one dose. -- took office receptionist said she'd never even heard of DH TV vaccination. Meanwhile best -- tells me the new vaccine requirement hasn't changed the number of people coming into her office for legal help. But she says that's probably because most people don't even know about the mandate."

" It can be an interesting discussion because there are some people who ask the question of well. Are all women in the United States during his -- is required to have this vaccine. And the answer to that is no and then there there have been some people are simple why are they requiring it to us then you know are we some sort of medical experiments."

" So my daughter vaccinated because I want her to be one less unaffected by cervical cancer. I chose to give my daughter vaccinated what had not to tell you my -- other things means it's NAFTA needs and the only."

" Got missiles commercials emphasized choice but immigrant moms don't have the right to oppose this vaccination for dared batters. Reproductive justice and immigrants rights groups who make up the national coalition for immigrant women's rights say that's wrong. Priscilla Hwang from -- tells me they see this forced vaccination. As a serious threat to women's choices about their own bodies it made a lot of sense for us to take on this issue. -- the HPV vaccine requirement. Because as any an American and Pacific islander organization. We know that there is a high percentage of us to come from ever break -- these are happy immigrant parents. In 2007 more than a million people obtain permanent residency status in the last. 60% of the people came from Latin America with 16% coming from east and southeast Asia. More than a 100000 where women under the age of tiny. Women who could be directly affected by the -- And as every aspect of justice issue we know that's making. Something like the HPV vaccine are cramming it really limits the ability for immigrant women in particular. To make informed decisions about themselves and about their daughter -- and their own health. Then there are other reported side effects. Since Cardoso was approved in 2000 sex more than 10000 reports of adverse side effects have been documented. Even reports of death. But the CDC stands by their assertion back artists Phyllis safe and effective. Doctor dot."

" Right now I think that there is the general consensus in the vaccination community. That Garnet Hill quite safe and the -- that we have so far. Completely bears out that conclusion."

" But attorney -- techniques has other lines as I understand that it's not a settled question. And the medical community as to whether this vaccine should be universally given. Two young women and you know if it should be given what's the -- to start getting it side effects include."

" Pain swelling itching and redness at injection -- Fever and nausea dizziness vomiting and judicial watch is a public interest group that looks at government corruption and has been tracking Arkansas. They say the total number of deaths from -- vaccination are as many as to when he. And they've collected more than 3000 reports of their own relating to adverse effects from the vaccine. Still the CDC stands by their findings but says it's an issue they take seriously. In particular their requirement for young immigrant women."

" I think that the CDC feels that that is an issue which deserves some attention. And PC is responding to that by convening a work group. To address whether this sort of blanket. Coverage of the mandate for all these PHP recommended vaccines is the best way. You look you know protect our immigrant. Or whether each vaccine should be considered on a vaccine buybacks he beat -- about. Whether or not it's medically appropriate. For the purpose -- the immigration."

" Many advocates are arguing that this requirement is not the best way to protect the health of immigrants. One a file to his biggest concerns with their own vaccination. Is that she says it was not administered with their health or best interest in mind the had to get it because I needed the paperwork in order to be eligible for permanent residency. So. I -- got it I got the vaccine you know I I know that you need more than one dose in order for the vaccine to be. Effective but I was told that you only actually are required to get one dose. Man after that they don't really care whether you complete the vaccination and knocked. So -- and didn't complete the vaccination series it was too expensive she's married and she didn't feel she's our risk. It only took one dose for her to pass the medical exam. But the CDC is doctor dot that says that one dose of -- is not an effective form of HTT prevention."

" there are still studies looking at that question. We really hits with our message that. Three doses are necessary to derive the kind of benefits that we're talking about."

" The wonders of artists all that often attempt probably won't prevent the four strains of -- peavy even -- optimist says she still won't complete the vaccination. You know I honestly can't think of one good reason why. The US government is imposing this requirement. And young girls and women who seek to become immigrants to the United States. I just feel like it's sad. Big financial burden and because. People are not required to complete the -- that -- ninety government doesn't have the women's health and mind either. Women's health and ability to make choices about their own -- is is -- priority for members of the national coalition for immigrant women's rights. Priscilla -- from snap off says it's also important to recognize that cervical cancer is a serious health issue for immigrants. There many."

" Immigrant communities that -- face health disparities specific to issues like cervical cancer. And so. Korean women Vietnamese women and certain Latino women to you have. Disproportionately high -- for cancer rates. And that is a problem that's we think this CDC has a role in addressing and all of our king he's cover -- and adjusting. However we don't think that a requirement for an HPV vaccine is the rates. Path towards eliminating have a cancer and the disparities in these communities."

" And it is back kind of reproductive health care that the coalition wants all women to have access to. Ultimately they want the HPV vaccination requirement overturned. But while they fight against this mandate Jessica Gonzales from the national Latina institute another member of the coalition. Says it's equally as important to fight for comprehensive women's health care."

" So instead of mandating this vaccine what's important for immigrant women to ensure access to health care services. To ensure they have access to -- confident Karen linguistically competent care and ensure that their dignity. Is intact and that when you require them just take vaccines. Are not required for the general population. -- can teach timing indeed -- com our immigrant women."

" Reproductive justice advocates have made it clear that women's bodies are battleground for control. -- the Dow concealed IED in the 1970s. Many women today's TB HPV vaccine as another attempt to test reproductive tools and women of color. In this case young immigrant women. These advocates for immigrants rights and reproductive justice have a similar vision. The right to live on our society without fear of discrimination. Access to education and health care and to decide when and if to have children but they each TV vaccination requirement any -- is a barrier to those right."

" I really didn't think that the US would impose this kind of requirement which I feel it's so unfair to immigrant women. And I have to do anyway I just. I feel like the process in general -- extremely difficult to go through. Financially emotionally. And then to see one more barrier that's just really disappointing to me."

" Yeah they're making contact I'm Alina -- meeting. That's it for this edition of making contact. Special thanks to the reproductive justice front of the tides foundation from making a show possible. For a CD copy of this program called the national media project at 805295736. -- you can get our podcast at radio projects outward. Lisa Bettman is our executive director and just us and Colleen are so many producers. Con San associate director. I'm -- about the Levy RJ production coordinator. And making my ten need an -- a sunny interns. And I -- really you know thanks for listening to making contact."