Human Papillomavirus Vaccine in Teens- Ethical Debate
Background
HPV or Human Papillomavirus is the causative organism of cervical cancer. This virus is primarily acquired sexually, when a person is in sexual contact with an infected person. Infection takes years to decades before appearing in the form of cervical cancer. It is the most prevalent sexually transmitted infection in the United States (Balog, 2009). There is not much awareness of the HPV and the infection it causes. There are more than 100 types of HPV. The HPV types 16 and 18 cause 70 percent of cervical cancer (Navarro-Illana, Aznar & Diez-Domingo, 2014). 6 million US population is affected by HPV infection. Half of this population falls under 15-25 years of age group (Navarro-Illana, Aznar & Diez-Domingo, 2014). More than 10,000 cases of cervical cancer are diagnosed every year, with about 4,000 deaths (Navarro-Illana, Aznar & Diez-Domingo, 2014). The median age for diagnosis is about 45-47 years old (Navarro-Illana, Aznar & Diez-Domingo, 2014). HPV represents the clash between the provision of mandatory vaccination and sexuality of youth.
Step 1: Analysing the ethical issue
The ethical issue involves prevention of mortality and morbidity with apprehensions about morality concerning the sexual behaviour among the youth. Opposing group believes that exposing the younger population to HPV vaccination will encourage the children and adolescents to get involved in sexual activities. Ethical issue thus engrosses presumption of early onset of sexual activities among the youngsters (Navarro-Illana, Aznar & Diez-Domingo, 2014). Education about cervical cancer and abstinence of sex is preferred by the larger population. It is believed that only because of commercial interests of the vaccine manufacturing companies, this vaccine is made mandatory for the younger women. Better communication between children and parents is encouraged to foster morality and familial values that prohibits sexual relationships before marriage and unsafe sexual practices. Ethical consideration involves possible existence of negative side effects of the vaccine, in spite of the fact that the vaccine has been approved by FDA and EMEA in 2006 (Balog, 2009). The vaccination gives an implicit permission to the youngsters to get involved in risky sexual activities.
Step 2: Evaluation of Ethical Dimensions of Public Health Dimensions
Utility
The vaccination is useful in the prevention of HPV virus, thus reduced in the number of cervical cancer cases in the US. This has possibly reduced the frequency of cervical cytological examinations, and, for the HPV vaccines containing antigens against the notorious HPV type 6 and HPV type 11. This vaccination has led in the decrease of the number of cases of genital warts (Balog, 2009).
Justice
The vaccination has although decreased the number of cervical cancer cases and genital warts, it has led to the increase in increased sexual activities among the younger population, greater number of sexual partners and decrease in the barrier protection and contraception methods like use of condoms. This in turn, has prompted the rise in cases of unplanned pregnancies, other types of HPV infections, abortions and other forms of sexually transmitted diseases, including HIV. Compulsory HPV vaccination of young girls has been proposed on the name of public health intervention. It is important to weigh the possible risks and benefits before going for the option (Navarro-Illana, Aznar & Diez-Domingo, 2014).
Respect for Liberty
There are two groups divided on the matter of vaccination. One group advocates the vaccination and the other discourages its use. Till now, there is no forceful interventions of authorities and the police to restrict the autonomy and liberty of the parents for the purpose of vaccination. Health care services should be available to each and every person irrespective of age, gender, socio-economic status, ethnicity and race. Mandatory provision is believed to take away the control of parents on their children, over the matter of vaccination (Balog, 2009).
Autonomy
It is a bigger question that whose autonomy should be considered of high priority- the parents’ or the children’s or the authorities’? Well, the right to have access to preventive measures for a child should always be of high priority and must override the desire and autonomy of the parents to educate the social and family beliefs because any health issue is related to the life of the child.
Step 3: Public Health Action
Necessity
Prevention of illness, disease or any infection is the primary objective of any public health action. Rate of incidence, its prevalence and possible threats of HPV are drastically similar to some of the deadly diseases that have prompted public health authorities to go for mandatory vaccination programs and immediate preventive actions. HPV is the leading cause of sexually transmitted infection among the younger generation and about 6.2 million people get infected with HPV every year which results in more than 4000 deaths due to cervical cancer in the US ((Navarro-Illana, Aznar & Diez-Domingo, 2014). The HPV vaccination has low incidences to zero incidences of any serious harms (Balog, 2009). To withhold the population from getting access to available and accessible preventive measures and letting the people die is immoral.
References:
Balog, J. E. (2009). The moral justification for a compulsory human papillomavirus vaccination program. American journal of public health, 99(4), 616-622.
Navarro-Illana, P., Aznar, J., & Díez-Domingo, J. (2014). Ethical considerations of universal vaccination against human papilloma virus. BMC medical ethics, 15(1), 29.
