Table of Contents
INTRODUCTION
The Human Papillomavirus (HPV) is double-stranded DNA genome which is transmitted through fluid contact and mostly affects the mucosal parts of the body. The mucosal parts are those internal body parts that have numerous cavities thus have mucus linings. The HPV concentrates on this parts such as the epithelial lining of the anogenital tract among other surfaces. The prevalence of the Human Papilloma virus is high in both males and females and is associated with a number of healthcare issues, including cervical and penile carcinomas, genital warts, and genital condylomata in both females and males. In certain reported cases, the HPV infection persists and eventually results to warts and lesions. These increase the risk of the cancer infection of the cervix, vagina, vulva, penis, mouth and anus. According to the “Link between HPV and cancer”, CDC, an average of 70% of cancer reported cases are attributed to the Human Papilloma virus infection. The vast healthcare infections linked to the human papilloma virus has generated the human attention on designing an efficient and effective HPV vaccination for HPV infection. Vaccination of the Human Papilloma Infection has been administered in its victim for long period of time. However, is has been disputed by a wide range social-economic reasons in a significant number of societies. Great controversies have arisen due to the adoption of the HPV infection vaccination around the globe. Many states in America have adopted and implemented vaccination for teenage girls and some of these states are extending these programs to include males of between ages 11 to 25 after the FDA approved the first preventive HPV vaccine, marketed by Merck & Co. under the trade name Gardasil. The vaccination of boys and girls helps curb on the infectious HPV virus and this is attributed to its level of adoption in the global society. However, there are diverse side effect caused by the prevailing vaccination programs. This renders the vaccination program safe yet with significant side effects.
Background Information
Diverse healthcare articles and other works are subjected to a study in this argumentative paper in the attempt to validate whether to or not adopt the mandatory vaccination of the Human Papilloma Virus (HPV). The CDC provides resourceful information used in this essay to achieve its intended purpose. Throughout the essay, various terms are employed to relay key information to the reader. The HPV abbreviation often used across the paper represents the Human Papilloma Virus.
The Mandatory Vaccination of HPV
HPV vaccination is most efficient and effective in teenage boys and girls since it is administered to them before they are have any form of sexual exposure. Therefore, teenage boys and girls are recommended to participate in the administering of the HPV vaccination. According to the CDC, “vaccination of teenage boys and girls should be conducted at the dire age of 11-14 years”. This is aimed at reducing the risk of infection of cervical, vulvar, penile, mouth and throat, anal and pharyngeal cancers for the girls. As for the boys, the HPV vaccination plays a key role in curbing on infection by the cancers of anus, penis, and the mouth/throat area. Supporters of the mandatory teenage HPV vaccination argue that implementation of this vaccination program among the teenagers would help in decreasing the chance of sexual transmission of HPV to girls, who might be at risk of acquiring cervical cancer (Colgrove et al. 790) as well as related infection on both boys and girls. This argument expounds on the nature of benefits enjoyed from the vaccination of the HPV where there is total prevention against HPV related diseases before their actual exposure to sexual activities. The preventive measures employed in the vaccination of the HPV infection in teenagers can function for up to 10years. To back up this argument, statistics have been analyzed on the effectiveness of the vaccination. Statistics clearly show that the vaccination may prevent cervical, anal, vaginal, vulvar, and mouth cancer among the teenage boys and girls vaccinated at the age of 11 – 12 years. They additionally prevent some genital warts with the vaccines against 4 and 9 HPV types providing greater protection. From these certified sources, the vaccination of the HPV infection plays a key role in the curbing of HPV infection and its related diseases among the teenage boys and girls. Studies have been conducted to compare the body’s immune system response to the vaccine between teenage boys and girls at various age sets. These studies established that vaccinated teenage boys and girls at much younger age sets experienced close to zero side effects and also developed more antibodies for HPV resistance. Higher immune systems have been recorded among the teenage boys and girls who have been vaccinated at the early stages of their lives specifically at the age of 10years. This developed immune system helps this kids fight off any potential infectious disease-causing viruses. This observations ascertain the effectiveness of vaccinating the teenagers by bringing out its positive effects. Therefore, the prevention and curbing of sexual infections among teenagers accredits the vaccination programs conducted for teenagers.
The Human Papilloma Virus (HPV) Infection is considered safe but however has adverse side effects after its administration. The most common side effects of the HPV vaccination include pain, redness, and swelling. The pregnancy safety of the vaccination is under review and the vaccination of females in early stages of pregnancy is not recommended ( Gullion et al. 405). Currently, the vaccine is recommended for females in their early teenage ages, with a follow-up vaccination for females aged 15 to 25 years. This recommendation is based on the sexual activity statistics in the United States of America, where one-quarter of adolescent girls’ reports being sexually active at the age of 16 years. HPV vaccination is most efficient and effective when used before any sexual exposure. This healthcare concerns which are consequent effects of the HPV vaccination has raised concerns on the mandatory vaccination of HPV among teenage boys and girls.
In the implementation of the mandatory administration of HPV vaccinations, ethical issues are multi-faceted with debates falling on both sides of the arguments. One of the major issues of implementing vaccines mandatory is the ability to interfere with the parental autonomy is upbringing of their kids, particularly in issues related to sexual behaviors. This has continued to raise concerns among some parents that giving their children HPV vaccination at a teenage age, particularly at 12 to 15 years, is giving the children an implicit permission to participate in risky sexual debut. However, this assumption lacks enough evidence to support it. Studies indicate that adolescent and teenagers are unaware of sexually transmitted infection vaccines, and the fear of these vaccines has very little impact on their personal decisions of engaging in sexual activities (Kausz et al. 10). According to Ohri (1899), the issue of parental autonomy is much concerned with the ethical analysis of cost-benefit rather than the parental control on mandatory HPV vaccination. It seems that scarifying a small price to cater for the prevention of a critical or terrible disorder that can cost the life of a child at their prime age and can also lead to significant psychological distress to over a million females in a year with just pre-cancer lesions is a high price to pay. Generally, HPV vaccination is beneficial to both the child and the parent as it uses the ethically accepted medical procedure to prevent serious sexually transmitted infection. This vaccination also uses basic medical technologies to reduce the pain and suffering of the recipient. HPV vaccination has been accepted and recommended by the medical societies as the best way of preventing serious sexual disorders from striking the society, unlike the advanced cancerous cervix (Harper et al. 594). Some the sexually transmitted infections have more effective and efficient treatment and preventive measures, but the use of HPV vaccination is still considered necessary for the treatment of these infections. The level this vaccination prevents cancer is relatively evident and the mandatory application of this vaccine is a major boost to public healthcare.
Ethical concerns have arisen from the HPV vaccination that the vaccines can only prevent to up to 70th percentile of cervical cancer, indicating that regular follow-up or checkup through Pap smears must continuously be applied to the recipient. Studies posit that vaccinated females can also develop a false sense of security and forego or neglect the recommendation of cancer screening. In this regard, HPV vaccinations can resultin a paradoxical increase in cervical cancer consequences, which is quite possible when less than the70th percentile of the overall population in our society is screened. The lack of willful screening of cervical cancer among the younger women is already happening and further false security can continue to occur if vaccination protection is limited, particularly in teenagers below 15 years of age. Generally, females may not understand the need for a booster to ensure retention of herd immunity, coupled with limited screening. This issue has led to the protests against the mandatory use of vaccination raise concerns of the need for proper education and training by the healthcare providers when giving the vaccines and the need of continuous address to cervical cancer consequences to females during hospital visits. This collective concerns make the mandatory administration of the HPV vaccination in doubt.
Similarly, related economic concerns displays the need for service inclusion of the vaccination in a federal vaccine for children programs and initiatives and mandatory insurance coverage for HPV vaccine (Gullion et al. 404). Although there are families who are uninsured or cannot afford the price of vaccination and do not qualify for the federal vaccination initiatives, it is essential to include an exclusion clause for families with low socioeconomic status in any policies that mandate vaccinations, so that children from these families are as well allowed to use vaccine at school. The adoption of mandatory vaccination of the HPV would greatly affect the low-income earners thus creating a disparity among citizens of the country under study.
The opponents of the mandatory use of HPV vaccination argument is based on the prevalence of cervical cancer in our societies. As reported, a good number of HPV infections lack clear healthcare sequel, and it is not cost effective to use an expensive vaccine like HPV in females who will still continue to seek for cervical cancer screening services. According to Vamos et al. (304) the vaccine that offers incomplete protection against the virus, particularly an infection that is classified as rare in the United States of America, and may never develop many pathological conditions, constitutes to the inadequate medical justification for mandatory use. However, there are multiple analyses that analyze thecost-effectiveness of HPV vaccination. This analysis indicates that vaccination for girls aged 11 years is $3500 per quality-adjusted life yearly. Thus this analysis is considered cost-effective for HPV vaccination (Lehtinen et al. 1-3). Furthermore, the vaccine can as well become more cost-effectively when genital wart prevention is incorporated. Considering the financial status of the individual and cost-effectiveness data of the vaccine to include quality of life as well as improvement of the children’s lives is important in eliminating the fear of what might be found in Pap smears among women. In this regard, it is clear that HPV vaccination is cost-effective in treatment and prevention of cervical cancer in females.
Moreover, religious organization argues that mandatory use of the vaccination can undermine abstinence, the only religious method preventing sexual activities. They argue that remaining abstinent and the use of vaccination to prevent sexually transmitted diseases would be the same as advocating for birth control accompanied with abstinence. The issue of expanding the vaccination program to the school makes many feel that it is overpowering the authorities of schools in mandating the vaccines for disorders that cannot be infected in school compound or classroom and it is the result of immorality but preventable behaviors. HPV vaccination is quite different from other forms of vaccination needed by the school authorities and it is argued that mandating vaccine as a safety measure should base on infectiousness within the school compound. Also, the issue of expanding the vaccination program to the school makes many feel that it is overpowering the authorities of schools in mandating the vaccines for disorders that cannot be infected in school compound or classroom and it is the result of immorality but preventable behaviors. HPV vaccination is quite different from other forms of vaccination needed by the school authorities and it is argued that mandating vaccine as a safety measure should base on infectiousness within the school compound.
In conclusion, after analyzing different legible arguments for and against the mandatory use of HPV vaccination; I do believe that HPV vaccination should be made mandatory for all the children aged 11 years. This vaccination is effective in treatment and prevention of several infections caused by HPV infection in females and males, the vaccine is cost effective and it does not add any risks associated with sexual behaviors (Choi et al. 48). Despite its lack of infection in the classroom or school compound, the best technique of ensuring that the vaccine is made available and accessible to all children including those in low socioeconomic status is by mandating the vaccine at the school level. This will increase the percentage of children receiving the vaccine in our society, thereby preventing any form of cervical cancer. In America, no state has passed policies that make HPV vaccination mandatory for school authorities, but close to 30 states have considered school-based mandated HPV vaccination bill. In order ensure successful protective measures of the vaccine, further research should be done to know about the duration of protection offered by vaccines, and education, as well as training, should be enhanced to ensure continuous screening through Pap smear is part of the vaccination process. While parental autonomy should be respected, there are some cases where the public health system should infringe this autonomy to protect the large population from infection with minor intervention measures. HPV vaccination is a major milestone in public health system and there is a need for themandatory use of the vaccines to protect boys and girls from sexually transmitted infections.
Works Cited
- “Fact Sheet for Public Health Personnel | Condom Effectiveness | CDC”. www.cdc.gov. 25 March 2013. Archived from the original on 27 May 2017. Retrieved 05 Dec 2017.
- “CDC Features.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 21 Nov. 2016, www.cdc.gov/features/hpvvaccineboys/index.html
- “For Parents: Vaccines for Your Children.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 19 June 2017, www.cdc.gov/vaccines/parents/diseases/teen/hpv.html.
- The Link Between HPV and Cancer”. CDC. September 30, 2015. Archived from the original on 9 November 2015. Retrieved 11 August 2016.
- “Condom Effectiveness.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 25 Mar. 2013, www.cdc.gov/condomeffectiveness/latex.html.
- Ohri, L. K. “HPV Vaccine: Immersed In Controversy.” Annals Of Pharmacotherapy, vol 41, no. 11, 2007, pp. 1899-1902. SAGE Publications, doi:10.1345/aph.1k247
- MedlinePlus, Warts, https://www.nlm.nih.gov/medlineplus/warts.html#cat42 Archived 04 Dec 2017 at the Wayback Machine.
- Gullion, Jessica Smartt et al. “Deciding To Opt Out Of Childhood Vaccination Mandates.” Public Health Nursing, vol 25, no. 5, 2008, pp. 401-408. Wiley-Blackwell, doi:10.1111/j.1525-1446.2008.00724.x
- Lehtinen TA, Natunen K. “Cost-Effectiveness Of HPV-Vaccination In Medium Or Low-Income Countries With High Cervical Cancer Incidence – A Systematic Review.” Journal Of Vaccines & Vaccination, vol 04, no. 01, 2013, OMICS Publishing Group, doi:10.4172/2157-7560.1000172.
- Centers for Disease Control and Prevention. National and state vaccination coverage among adolescents aged 13-17 years—United States, 2011. MMWR. 2012; 61(34):671-7.