Genital human papillomavirus (HPV)
More objections to, and acceptance
of, the Gardasil® HPV vaccine
Resistance to universal vaccination from various groups:
- Before the vaccine was approved for use, a 2005-OCT article in the Washington Post stated:
"A new vaccine that protects against cervical cancer has set up a clash between health advocates who want to use the shots aggressively to prevent
thousands of malignancies and social conservatives who say immunizing teenagers could encourage sexual activity. ... many conservatives oppose
making it mandatory, citing fears that it could send a subtle message condoning sexual activity before marriage. ... 'If you really want to have
cervical cancer rates fall as much as possible as quickly as possible, then you want as many people to get vaccinated as possible,' said Mark Feinberg,
Merck's vice president of medical affairs and policy, noting that 'school mandates have been one of the most effective ways to increase immunization
rates.' That is a view being pushed by cervical cancer experts and women's health advocates." 1
- At an Advisory Committee on Immunization Practices (ACIP) in
2005, a survey of 294 pediatricians present found that most were concerned that
parents of girls might refuse the vaccine. Eleven percent believed that
vaccinating against a sexually transmitted infection "may encourage risky
sexual behavior in my adolescent patients." 1
- Reginald Finger, a member of ACIP and former medical analyst for the
fundamentalist Christian group Focus on the Family commented:
"Some people have raised the issue of whether this vaccine may be
sending an overall message to teenagers that, 'We expect you to be sexually
active.' ... There are people who sense that it could cause people to feel
like sexual behaviors are safer if they are vaccinated and may lead to more
sexual behavior because they feel safe." 1
- Gene Rudd, associate executive director of the conservative Christian Medical and Dental Associations would probably want his children
immunized. He said: "I've talked to some who have said, 'This is going to sabotage our abstinence message'." However, most change their stance
once they learn the details of the vaccine. He believes that the vaccine should not be mandatory. He said:
"Parents should have the choice. There are those who would say, 'We can provide a better, healthier alternative than the vaccine, and that is to
Abstinence, of course, becomes a much less healthy alternative if rape occurs, or if the girl later marries a man who is already HPV positive.
- A Washington Post article in 2007-JAN commented that
compulsory vaccination on adolescent girls is:
"... a prospect that has some
parents fearful that it will promote promiscuity for girls who feel
protected from the disease." 2
- According to the Fortune Preview Guide, for 2005-OCT, the Family Research Council (FRC)
opposed the vaccine because its use: "... will undermine efforts to promote
abstinence among young people." 3This appears to be
an incorrect statement of FRC policy -- one that has been widely circulated.
On 2006-FEB-21, the FRC sent a clarification letter to the CDC saying, in part,
"Media reports suggesting that the Family Research Council opposes all
development or distribution of such vaccines are false. ..."
"Because parents have an inherent right to be the primary educator and
decision maker regarding their children's health, we would oppose any
measures to legally require vaccination or to coerce parents into
authorizing it. Because the cancer-causing strains of HPV are not
transmitted through casual contact, there is no justification for any
vaccination mandate as a condition of public school attendance. However, we
do support the widespread distribution and use of vaccines against HPV." 4
The FRC did not mention in their letter at what age they felt that a girl or young woman should have her wishes consulted, and at what age they should be able to decide by themselves whether to get the vaccine.
The FRC also noted that:
"Vaccination [of girls] at the beginning of adolescence may provide a
unique opportunity for both health care providers and parents to discuss
with young people the full range of issues related to sexual health."
However, the FRC "strongly encourages" sex-ed providers to promote only sexual abstinence information to preadolescents. They advocate not sharing information that will reduce the chances of pregnancy or
STD transmission through safer sex techniques in the event that individual teen
decides to become sexually active. 4
James Colgrove, an associate research scientist at the Center for the History and Ethics of Public Health at Columbia University wrote an article in the New England Journal of Medicine commenting:
"More than 6 million people in this country become infected with HPV every year, and nearly 10,000 women are diagnosed with cervical cancer. Because the vaccine has the greatest benefit when it is given before a person becomes sexually active, the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention recommended that it be given routinely to girls at 11 or 12 years of age. ..."
"Laws making vaccination compulsory raise unique ethical and policy issues. High levels of herd immunity protect all members of the community, including those who cannot receive vaccines because of medical contraindications. This protection provides a justification for compulsion. The availability of religious or philosophical exemptions mitigates concern about governmental intrusion on individual decision making. Opinions vary, however, about the permissible scope of exemptions. Data show that schools with exemption rates as low as 2 to 4% are at increased risk for disease outbreaks and that children who have been exempted from vaccine requirements have a much greater risk of acquiring infectious diseases than their vaccinated peers. Minors have a right to be protected against vaccine-preventable illness, and society has an interest in safeguarding the welfare of children who may be harmed by the choices of their parents or guardians.
Bioethicists, who generally hold the values of patient autonomy and informed consent to be preeminent, tend to be skeptical about compulsory vaccination laws. Not surprisingly, some have expressed wariness about or opposition to mandating HPV vaccination. Because HPV is not casually transmissible, they argue, there is a less compelling rationale for requiring protection against it than against measles or pertussis, for instance; in the absence of potential harm to a third party, such laws may be considered unacceptably paternalistic. ..."
"Although issues of religion and adolescent sexuality have dominated the discussion, the move to require HPV vaccination raises broad questions about the acceptability of mandatory public health measures, the scope of parental autonomy, and the role of political advocacy in determining how preventive health measures are implemented." 5
The following information sources were used to prepare and update the above
essay. The hyperlinks are not necessarily still active today.
- Rob Stein, "Cervical Cancer Vaccine Gets Injected With a Social Issue: Some
Fear a Shot For Teens Could Encourage Sex," Washington Post, 2005-OCT-31, Page
A03. Online at: http://www.washingtonpost.com/
- Joyce Howard Price, "Sex-disease shot urged for girls," Washington
2007-JAN-05, at: http://washingtontimes.com/
- Chris Smith, "Herpes Simplex Virus Fact File," Health matters library,
- Moira Gaul, "Family Research Council Statement Regarding HPV Vaccines,"
Family Research Council, 2006-FEB-21, at: http://www.frc.org/
- James Colgrove, "The Ethics and Politics of Compulsory HPV Vaccination," New England Journal of Medicine, 2006-DEC-07, at: http://www.nejm.org/
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Copyright © 2007 to 2012 by Ontario Consultants on
Originally published: 2007-JAN-08
Last updated 2012-OCT-16
Author: Bruce A Robinson