Mandating the Human Papillomavirus Vaccine
Human Papillomavirus is the most common sexually transmitted infection that most sexually active men and women will get at some point in their lifetime. In recent years there has been two vaccines produced to prevent this disease, Gardasil and Cervarix. As of right now, in our country, there is no nationwide laws mandating children to receive this vaccine but that needs to change. The HPV vaccine should be required for boys and girls ages 11 and 12. This is an appropriate age for the vaccine because teenagers need to be treated for the disease before they have a chance of exposure to it. Along with the help of different hospital networks such as UPMC and Allegheny Health Network located in southwestern Pennsylvania the hope is that the spread for this want to mandate will occur and eventually become aware and significant to higher up officials both in Pennsylvania and nationally.
Human Papillomavirus
The human papillomavirus is transmitted through intimate skin to skin contact between individuals but can also enter the body through cuts, abrasions, or small tears of the skin. According to the Center for Disease and Control Prevention, there are 6 million new cases of genital HPV infections in the United States each year. This accounts for 74 percent of 15 to 24 year olds. Anyone who is sexually active can get HPV and it is so common that 80 percent of people who has had sex before will get it at some point throughout their life. HPV can be spread by vaginal sex, anal sex, or oral sex with someone who has the virus. HPV can even be passed when an infected person has no signs or symptoms. Getting HPV does not mean that a person is engaging in high levels of promiscuity. A person can receive HPV even if they had only one sexual partner in their lifetime.
The symptoms of HPV can start to appear weeks or even years after an individual has had sex with an infected person. In most cases, your body’s immune system will detect and defeat the HPV infection without producing any symptoms. For people who are infected, there are over 100 different strands of HPV that can affect the genital area. The strand number and level of risk determines the symptoms that could be produced from the infection. Low risks types such as strands 6 and 11 produce about 90 percent of genital warts on individuals. High risk types of HPV can develop cancer such as cervical, vaginal, vulvar, penial, anal, head or neck, and oropharyngeal cancer. HPV high risk type strands 16 and 18 are what are responsible for 75 percent of cervical cancer in women. In women, the HPV virus most commonly cause cervical cancer and in men, throat cancer.
Out of all the effects of the Human papillomavirus one of the most common is cervical cancer in women. Cervical cancer is cancer that forms in the tissues of the cervix which is the organ that connects the vagina and uterus. There are five different stages of cervical cancer starting with Stage 0 called carcinoma in situ. This stage is where abnormal cells are found in the innermost lining of the cervix. These cells can become cancerous and spread to nearby tissue. Stage 1 is cancer only in the cervix. Stage 2 is when the cancer spreads beyond the cervix but not to the pelvic wall or lower third of the vagina. Stage 3 is the spread to the lower third of the vagina and the pelvic wall. This is when kidney problems may start to occur. Stage 4, the final stage, is the spread of the cancer to the bladder, rectum, and other parts of the body such as the liver, lungs, bones, or distant lymph nodes. The five year survival rate is the percent of women who survived at least five years after their diagnosis of cervical cancer. This percent varies by stage: Stage 0 is 93 percent, Stage 1 is 80-93 percent, Stage 2 is 58-63 percent, Stage 3 is 32-35 percent, and Stage 4 is 15-16 percent. According to the American Cancer Society in 2015 an estimated 12,400 new cases of invasive cervical cancer will be reported in women and 4,100 women will die.
HPV Vaccines
To help prevent from getting HPV there are some precautions you can take. First you can use condoms every time you have sex. This does not prevent the virus completely but it can help lower the risk of you getting it. For women, you can also get yearly pelvic exams and pap tests done by your gynecologist. The final precaution and most effective is to get vaccinated with the HPV vaccine.
For the prevention of HPV two different vaccines were produced, Gardasil and Cervarix. Produced by GlaxoSmithKline, Cervarix is an inactivated bivalent vaccine (HPV2) that protects females against HPV types 16 and 18. These are the types that most commonly cause cervical cancer. Gardasil, produced by Merck & Co, is an inactivated quadrivalent vaccine (HPV4) that protects males and females against HPV types 16, 18, 6, and 11. The recommended age for males and females to get the vaccine is between 11 and 12 years old because this is an age before they are actually exposed to the infection. However you can get the vaccine as early as age nine and as late as twenty-six years old. The vaccine comes in three dosages at 0, 1-2, and 6 months. Both vaccines are highly effective in preventing the infection types they target. Gardasil and Cervarix can prevent HPV types 16 and 18 up to eight years and can prevent nearly 100 percent of precancerous cells caused by types 16 and 18. Researchers have found that since the introduction of the HPV vaccine, infection rates have dropped nearly 50 percent.
Neither vaccine has been proven to have serious side effects but their side effects can range from mild to moderate. Cervarix can have side effects such as pain/swelling at the injection site of the shot, fever, headache, fatigue, nausea, vomiting, diarrhea, abdominal pain, and muscle or joint pain. Gardasil has side effects such as pain/swelling at the injection site of the shot, headache, and mild/moderate fever. Both vaccines also can cause fainting after injection that is why it is required to sit for fifteen minutes after the shot is given to you.
HPV Vaccine Statistics
About one-third (37.6%) of adolescent girls between the ages of 13 to 17 received all three vaccines in 2013. This percentage was only slightly higher than the percentages in 2012. Hispanics, Asians, and girls whose families live below the poverty line were more likely to receive all three doses compared to whites, African Americans, and girls whose families are above the poverty time
In between 2012-2013 there was a significant increase of HPV vaccination rates in four states: Illinois, South Carolina, New Mexico, and Mississippi. There are presently twenty-one states and D.C. that have laws that either require HPV vaccination for school entry, provide funding to cover the costs of the vaccines, or support public education about HPV and the vaccine. D.C. and Virginia require for the vaccination of girls entering into 6th grade, but parents have the option to opt out of the requirement due to medical, religious, or moral opposition. Over the years different states have also proposed different act and laws to either require the vaccination, educate it to the public, and fund the vaccine. For example in 2009-2010 Pennsylvania proposed an act that would require health insurance policies to provide coverage for the vaccination of the human papillomavirus.
Arguments for HPV Vaccination
• Importance of the HPV vaccine is one argument for it. As explained throughout this proposal, the vaccine prevents against the human papillomavirus strands that can cause cervical cancer for women and genital warts for both men and women. It also gives future protection to those who have not engaged in sexual activity yet in their life.
• Mandating the immunization for children of school age has been associated with a significant decrease in morbidity and mortality. The argument for adding the HPV vaccine to an immunization schedule for school children notes that such mandatory school vaccinations are optimal for rapid and widespread disease protection that is distributed among children regardless of race/ethnicity or socioeconomic status. Also many different professional groups have found that this is the most appropriate time to give the HPV vaccine and other vaccines such as meningitis.
• The vaccine has proven to be cost effective by protecting you from the economic burden of the infection.
• The Center for Disease Protection and Control reports that it is unlikely that sexual activity will increase among teens because of the vaccine. Fear of STI infection is not a primary reason for adolescents not to engage in sexual activity. National data from a study done on adolescent sexual behaviors (grades 9-12) shows that sexual activity decreased in a decade prior to 2002, as well as the decrease in the number of girls sexually active, and a decrease in their number of partners.
• The HPV vaccine issue motivates parents to be proactive in health decisions for their child. They must decide what will be better for their child in the long run because more than likely a parent will not know when there child will become sexually active in the future. By vaccinating them earlier, they are protecting their child’s future and taking the precautionary measures.
Opposing Arguments to the Vaccination
• Adolescents may not fully comprehend the purpose of the vaccine and may think it is a “protection” against other sexually transmitted diseases. This will promote premarital sex and give children tacit permission to engage in risky sexual behaviors.
• The target audience for this vaccination is one that should be taught consistent messages about abstinence being only 100 percent effective method for preventing STIs and unintended pregnancies. This vaccination could pressure children to engage in premarital sex. Some politicians worry that the HPV vaccine will convey misguided and erroneous messages when we should be sending a clear one. Previous representative of Virginia Jo Ann Davis stated: “We need to yell it to the top of the rooftops that these condoms we’re sending down to you don’t protect you …. [You] have a false sense of security. So I think we’re sending the wrong message when we use taxpayer dollars to give condoms out to these kids and we don’t tell them, ‘By the way, you’ll probably be dead at age 24 by cervical cancer. But we’re giving you condoms, so go do your thing.’ To me, abstinence is the only way.”
• Mandating this vaccine infringes on the decision making powers of parents and also may violate some families’ religious beliefs. This is oppositional to parental rights and religious choices regarding what is acceptable medical and sexual behavior for their own child.
• Circumstances of vaccine would contribute to existing health disparities rather than enhance overcoming them because there are still many unanswered questions regarding the vaccine such as all possible side effects of it.
Conclusion
Even though many individuals have opposing arguments about the HPV vaccine, one thing everyone can agree on is the seriousness of the human papillomavirus. The vaccine was made to protect both men and women from the serious effects of the illness such as cervical and throat cancer but also the easily treatable effects such as genital warts. The vaccine should be mandated for children ages 11-12 across the country as a source of protection to these individuals. Many believe that this will promote sexual activity in teenagers and take away the right of parents to make choices for their child but that is not what this vaccine is trying to do. It is trying to protect the people in our country from a virus that has been heavily spread throughout the years. Mandating this vaccine will help towards the cause of preventing this nationwide virus and towards protecting the people of our nation from a disease such as this one.