Madison Snarr

BIOL 1090
Clark Timmons

Taking Sides: Should Vaccination for HPV be Mandated for Teenage Girls?
HPV, the most common STI in the U.S., is linked to cancer of the cervix which leads to
274,000 deaths each year around the world. Millions of individuals are infected yearly in the
U.S. with HPV and there is no treatment for the infection. In 2006, a vaccine was introduced
that could protect against a whopping 70 percent of cervical cancers generally caused by
HPV.
A health science professor, Joseph E. Balog, argues for mandated vaccination in
regards to moral justification and health care rights. Balog delivers several excellent points
in regards to teens and young adults sexual relationships and the risk of exposure to STI's
and, for women, potentially cervical cancer. He argues that nearly 50 percent of teens will
engage in sexual intercourse before graduation and 75 percent of people will engage in
sexual intercourse before marriage (Balog, pg.23). Alongside this, Balog argues that
abstinence programs are ineffective (teens are going to have sex regardless) and that there
is a lack of parent to child sexual discussions. In other words, kids aren't learning about safe
sex yet are engaging in sexual activity. Health care should be available to all and Balog
believes it is the child's right over the parents say that should be of precedence. His final
argument states that vaccinations prevent harm and reduce diseases. Taking a vaccination
is a preventative means to reduce harm and disease and the combination of prevention
(HPV vaccine) alongside screening (detection of cervical cancer and STI's) is what is needed
for the best health care results.

The opposing argument, written by Gail Javitt, Lawrence O. Gostin (law

professors) and Deena Berkowitz (physician), justifies government backlash and
safety and effectiveness of a newer vaccine. They argue that the safety and

effectiveness of the vaccination long-term is not yet known and that the unknown
could eventually have adverse health effects. They also question how long this
vaccination might be effective and "completely protective" (Javitt, pg. 29). Their
second point is that the HPV vaccine doesn't meet the justifications for mandated
vaccination falling under the "public health necessity" (Javitt, pg. 30). The
mandated vaccinations that do meet this justification are for diseases that have
high levels of morbidity and mortality. Their final, and in my opinion most riveting,
argument is that mandating such a vaccine would produce government backlash
and potential financial burdens on the government as well as the public.
Both arguments make valid and excellent points taking into consideration the
public as well as overall benefits of the vaccination itself. Both sides taken into
consideration, how ethical would it be to mandate a vaccine for teen girls only that
would determine whether they can enter school or not? With rates of sexual activity
and STI's increasing among teens, what is the best preventative action?
As Balog pointed out, the influence of abstinence programs are most likely far
from effective and statistics alone prove that. Public school health classes teach
about sex and STI's but don't teach about safe sex. With the additive issue of lack
of parent-to-child talks about sex, teens have nowhere to turn for guidance on safe
sex and healthy role models. Without these two crucial methods for teaching teens
about safety, how could they be motivated to be cautious when engaging in sex?
And, if parents don't feel comfortable talking to their teens about sex, it is unlikely
that teen girls will feel comfortable asking for vaccinations.
While I think all the above evidence supports mandated vaccination, I am
persuaded by the opposing argument. I believe it is not ethical to mandate a

vaccine that would prohibit teen girls, and only girls, from entering school if not
vaccinated. As mentioned above, pointed out by Javitt, Berkowitz and Gostin, the
HPV vaccination does not fit into the public health necessity category. Other
mandated vaccines are for diseases that are potentially life-threatening and quickly
spread. While HPV is easily spread, it is spread due to voluntary choice to engage in
sexual activity.
I believe that there is a much bigger issue here: a lack of education about
safe sex, multiple sex partners and how STI's are commonly spread and the damage
that follows. In order for an HPV vaccination program to be effective, it needs to be
paired with the right education about sex and education about the vaccine. Sixth
grade classes have a mandatory "Maturation" class designed specifically for
females and males and the areas each gender needs to know about their bodies
maturing. I strongly believe this would be a great time to introduce the HPV
vaccination and possible benefits. Teen girl's physicians should also be encouraged
to talk about HPV vaccination giving the teen the education and power to decide on
their own, alongside the help of parental guidance should they wish it. Sex
education paired with HPV and vaccination education should be introduced early so
that teens have an advantage to make an educated decision before it's too late.
Health classes should speak openly about safe sex with emphasis on abstinence.
Abstinence education alone will not be enough of a preventative measure.
Giving teens the right education and empowering them to make the decision
for themselves is the most effective way to prevent STI's and cancer as well as
spare government backlash from a mandated vaccine not associated with high
morbidity and mortality rates. In order for teens to make safe and effective choices,

they need to feel empowered that they are capable of making those decisions on
their own with the right guidance provided by responsible adults.

Citations
Balog, Joseph E. "The Moral Justification for a Compulsory Human Papillomavirus Vaccination
Program." American Journal of Public Health 99.4 (2009): 616-22. Abstract. Taking
Sides Readings BIOL 109(2014): 22-26. Print.
Javitt, Gail, Deena Berkowitz, and Lawrence O. Gostin. "Assessing Mandatory HPV
Vaccination: Who Should Call the Shots?" The Journal of Law, Medicine & Ethics 36.2
(2008): 384-95. Abstract. Take Sides Readings BIOL 1090 (2014): 28-33. Print.