The Moral Justification for a Compulsory Human Papillomavirus

Vaccination Program
YES (Summary)
The Moral Justification for a
Compulsory HPV Vaccination
Program
The polio hysteria of the 1950s
is used to show an example of why it
should be mandated to be vaccinated
for HPV.
It was determined that
retrospectively
the
decision
to
implement a compulsory vaccination
program for polio was an effective,
legal, and ethical solution used by the
public health authority.
The polio
vaccine was effective at reducing the
incidence rate for polio.
It was
determined to be 80% to 90%
effective
in
preventing
paralytic
poliomyelitis, and 60% to 70%
effective in overall prevention of the
disease.
This history is what the
argument
for
compulsory
HPV
vaccination stands on. It is thought to
be ethically permissible based on the
harm principle proposed by John
Stuart Mill, which states that The only
purpose for which power can be
rightfully exercised over any member
of a civilized community, against his
will, is to prevent harm to others.
In order to determine if the HPV
Vaccination
should
be
made
compulsory, those involved in public
health need to determine whether this
action is justified.
Does it reduce
harm to individuals and society, and
does
this
action
produce
consequences that are at least as
good as, if not better than alternative
ways of preventing HPV.
Joseph E Balog sites that young
people are more sexually active,

therefore, increasing their risk, and the

risk of others contracting STIs. This
includes HPV, which can lead to
cervical cancer. The CDC estimates
that 3.2 million adolescent girls have
STIs, and of these, about 18% are
infected with HPV.
Evidence shows that abstinence
programs,
and
parental
communication on sexual subjects is
ineffective, and shows a need for
public health intervention.
Balog
states that a compulsory or voluntary
vaccination program could greatly
improve disease prevention.
He
advocates that it is wrong to assume
that ideals will override reality when it
comes to risky sexual behaviors.
Should the rights of the child or
the parent prevail? The right of the
child to be protected before they are
exposed should override the respect
for the parents social belief system.
The HPV vaccine should be
provided to everyone in need.
A
compulsory vaccination program will
be the best way to serve those at the
greatest risk, and in the most need of
health care.
Scientists
opposing
the
compulsory program recognize that
the HPV vaccine being mandated can
provide a highly effective means of
protection from cervical cancer. They
also caution against making it
mandatory before there is more
information
about
the
vaccines
relative value.
In the U.S., it is common for
mandatory
vaccines
for
school
entrance. The difference with the HPV
vaccine is the association with sexual

behavior, which raises moral, social,

and scientific concerns among society.
Although, prevention measures should
not be withheld for these reasons, but
made available.
There is also some opposition
because of the low rate of morbidity
and mortality with cervical cancer.
There also isnt enough information
yet for the safety and efficacy of the
vaccine.
The vaccine is not a
replacement
for
cervical
cancer
screenings, but is valuable to use in
combination with them. Combining
the 80% efficacy of screening and the
70% rate of reduction by HPV
vaccination would achieve an even
greater good for society.
No (Summary)
Assessing Mandatory HPV
Vaccination: Who should Call the
Shots?
Why Mandating HPV is Premature
Long-Term
Safety
and
Effectiveness of the Vaccine is
Unknown Although the goal of
clinical trials is to gain safety and
effectiveness data that can be given
to the general population, such trials
cannot reveal all possible adverse
events related to a product. It takes
time to determine if there are longterm effects of a vaccine. If after
being
publicly
available,
it
is
determined to be dangerous, it could
be pulled from the market. So far, the
short-term trials have not shown any
serious adverse side effects. There is
also no clear data on the length of
time the vaccine will be effective
Historical
Justifications
for
Mandated Vaccination Are Not Met
HPV is different in several respects
from the vaccines that first led to

state-mandated vaccination. By the

1900s the majority of states had
enacted
compulsory
smallpox
vaccination laws.
Although, not
initially tied to school attendance,
when the rate of infection was going
up in school age children, it was
decided that it would be mandatory
for students attending school. The
smallpox laws of the 19th century laid
the
foundation
for
modern
immunization statutes.
In 1977 the federal government
launched the Childhood Immunization
Initiative
in
response
to
the
transmission of measles in the 1960s
and 1970s. Currently all states require
DTaP, polio, and measles in order to
enter kindergarten. HPV is different
from the vaccines that have previously
been mandated. With the exception of
tetanus, the mandated vaccines fall
within the public health necessity
principle. This basically states that
these vaccines protect from highly
contagious diseases that have a high
morbidity and mortality rate shortly
after exposure. Tetanus is required
because of the inevitability of children
playing and getting scratches.
HPV in contrast does not satisfy the
same principles. It is not a public
health necessity.
HPV is not
immediately life threatening.
If
cervical cancer is developed, it will not
manifest for years, if not decades.
Most women arent ever exposed to
the cancer causing strains of HPV, that
occurrence is actually quite low in the
U.S. Therefore, making it mandatory
for school attendance is only to coerce
compliance, not to avoid a public
health emergency.
In the Absence of Historical
Justification, the Government Risks

Public Backlash by Mandating HPV

Vaccination People tend to be weary
of the government. There are already
those that oppose the mandated
vaccines that are already in place.
Since diseases such as polio and
measles have largely disappeared, the
strong motivation to vaccinate is
abating as well. There is an alarming
number of parents opting out of
vaccination in general.

The
success
of
childhood
vaccination programs make it an easy
target to just add another one to.
However, that overstretches the
original justification for mandated
vaccinations.
Although
HPV
vaccination is beneficial to public
health, it is not contracted by sitting in
close proximity in classroom. It should
be evaluated and determined by
parents, not forced upon them.

By attempting to mandate a
vaccine that is in essence for a
disease that is contracted by ones
choices, the government is over
reaching its police powers authority.
Since it is transmitted sexually, not all
children are at an equal risk for
contracting the disease.
A parent
should be allowed to weigh the
benefits and risk for their own
children. According to one poll 61% of
parents prefer vaccination, 72% are
open to receiving information about it,
and only 45% just want it to be done
in the adolescent vaccination routine.
Educating about the value of the
vaccine might be the most effective
way, without risking parental backlash.

Does the Compulsory HPV

Program Meet the Justifications of
Other Mandated Vaccines?

By mandating the vaccine, and

having opt-out caveats, it risks
changing the options for our other
vaccination programs, and risks a rise
in transmission of these serious
diseases.

Although there is definite value

in getting the HPV vaccination, I dont
think it should be mandated. Joseph
Balog talks about the hysteria
centered on polio in the 1950s.
Retrospectively, implementing that
vaccine was successful.
The
elimination of poliomyelitis has been
called one of the 10 great public
health achievements of the twentieth
century in the United States.
I dont see an epidemic of HPV.
Although I understand that the ideal
would be to prevent a disease before it
hits
epidemic
proportions,
this
vaccination is better off being chosen
by the parents rather than forced on
them. It hasnt been available long
enough to determine any long-term
side effects. It is also not contracted
by being around somebody who has it.
My daughter wont get HPV by sitting
in her math class.
There also seems to be a
precedence
for
mandatory
vaccinations. For example, smallpox is
highly
contagious
with
a
high
morbidity and mortality rate shortly
after exposure. It was so scary that
the mandatory vaccination was almost
always held up in court. In the 1960s

and 1970s the transmission of

measles
led
to
the
Childhood
Immunization Initiative. The diseases
that are mandated for vaccination are
more susceptible to children because
of the close proximity they are in at
school.
HPV does not meet that
criteria.
Having said that, I am not
diminishing the value in receiving the
HPV vaccine. I have four daughters,
three of which are in the age range for
receiving this vaccine. I am carefully
evaluating the risks and deciding what
would be best for my girls. I have
personal and religious beliefs that lead
me to teach my children abstinence
until marriage, however I am not nave
enough to think that bad things (like
rape) cant happen, or that my
children
wont
make
decisions
contrary to what they were raised
with.
This is all information I am
considering while I determine what is
best for my family. I appreciate the
chance I have to make an informed

decision, and not be forced

something I dont understand.

into

What Societal Implications Might

There Be if the HPV Vaccine Were
to Remain Optional.
I think by not mandating the
vaccine, the government is leaving
some control to parents. Living in a
society that more and more feels like
our choices are being taken away, this
is a positive thing. Allowing me as a
parent to research and make an
informed decision is a right that I
respect. On the other side, there will
be parents that choose not to
vaccinate.
Some will educate
themselves, others will not.
It is
difficult to determine what the right
answer is. I however stand by the HPV
vaccine remaining optional, while
understanding the value of receiving
it.