Running head: Mandatory Human Papillomavirus (HPV) Vaccine for Children

Mandatory Human Papillomavirus (HPV) Vaccine for Children

A Review of the Literature

name

Excelsior College

Author Note

This paper was prepared for EC Success Seminar, taught

by Professor Rebecca Labombard

Mandatory Human Papillomavirus (HPV) Vaccine for Children 2

Abstract

In recent years, medical experts, parent, teachers and lawmakers have raised the issue of

mandatory human papillomavirus vaccine for school- age children. While some agree that a

proactive approach should be taken to reduce the risk of various cancers and genital warts in the

future; others feel it is the right of the parents to decide if a child should receive a vaccine and

not be forced to vaccinate their child. This literature review will examine the reasoning as to why

children who are attending public school should receive the vaccine.
Mandatory Human Papillomavirus (HPV) Vaccine for Children 3

Mandatory Human Papillomavirus (HPV) Vaccine for Children

An Introduction

The United States Department of Health and Human Services should dedicate a portion of

its budget to the human papillomavirus (HPV) vaccine. The human papillomavirus vaccine can

fight against several types of cancer such as cervical, vulvar, vaginal, penile, anal, and

oropharyngeal. The human papillomavirus vaccine should be mandatory, in order for children

ages 11-12 to attend school in the U.S. The HPV vaccine is an important tool to prevent future

generations from contracting these deadly diseases.

“The Human papillomavirus (HPV) is one of the most common sexually transmitted

infections (STI) and has been identified as the leading cause of cervical cancer in the United

States”. (Smith et al. 2014) Studies have shown as recent as 2008, that 14 million Americans are

infected with the virus. Based on research estimates over half of the newly infected cases occur

between youths, ages 15 to 24 years. The average age of a first sexual intercourse is age 17. The

research states, “Oral sex with heavy petting where skin comes into contact can spread the virus.

This transmission can occur long before the youth has sexual intercourse”. (Smith et al., 2014)

States are looking for ways to mandate the vaccine, “September 2006, Michigan proposed

the first legislation of its kind, mandating vaccination of all girls with Gardasil, the new human

papillomavirus (HPV) vaccine, before they could enter the sixth grade.” (Roll, 2007) The bill

was defeated by the State House of Representatives. Based on Michigan’s effort, other states

have sought to make the human papillomavirus vaccine mandatory for adolescents.

One strategy to assist in the implementation of the vaccine is to pass laws that force a

parent to vaccine their child before they can enroll in school. However, there is not enough

support in the public to pass such a law. By, mandating the vaccine a large number of the
Mandatory Human Papillomavirus (HPV) Vaccine for Children 4

population could avoid contracting certain cancers and genital warts. Such effects have a

potential to reduce health inequalities caused by HPV. Research states, “despite potential public

health benefits, HPV vaccination mandates were proposed and advocated for prior to

establishing widespread support for the HPV vaccine”. (Smith et al. 2014)

The Case for Mandatory Vaccine Administration

“HPV vaccination mandates have resulted in political, religious, and ethical opposition.”

(Smith et al. 2014) Creating a mandatory vaccine requirement that would prevent a child from

entering school seems to some that the government may be over stepping their reach. One

argument it’s the parents’ decision to determine if their child should have a vaccine when he or

she is not sexually active.

Human papillomavirus vaccination is a controversial topic that is often polarizing. The

protective nature of the vaccine against several types of cancer has encouraged multiple states to

attempt passing HPV vaccination mandates that require school-aged children to obtain the

vaccine prior to enrollment. (Smith et al. 2014) The intent of this legislation is to protect the

child; this decision has not come without controversy from parents, lawmakers, and the religious

community.

However, the human papillomavirus is a credible threat and a serious stance must be taken

to prevent the exposure of cancers to the future population. Research states “two strains of HPV

cause 70 percent of cervical cancer cases. Two other strains of HPV are associated with 90

percent of genital warts cases”. (Javitt et al. 2008) Furthermore, research states, “approximately

twenty million men and women in the United States are currently infected with genital HPV, and

approximately 6.2 million individuals will acquire a new genital HPV infection each year, The

incidence of HPV is highest among sexually active adolescent girls and young adult women aged
Mandatory Human Papillomavirus (HPV) Vaccine for Children 5

fifteen to nineteen. In addition, by age fifty at least eighty percent of women will have acquired

an HPV infection.” (Roll, 2007)

Gardasil is a vaccine created to prevent the HPV virus. Research states it is “one of the

most expensive vaccines ever developed. Each dose in the three-dose series costs $120, totaling

$360 for the complete vaccine package”. (Walter, 2013) The vaccine is costly, however, when

compared to cancer treatments, such as surgery, chemotherapy, and medication; the vaccine is

more cost effective. The United States Federal Government should provide free vaccinations

through their Medicaid program. Financial assistance would allow families who cannot pay for

the vaccine or without health insurance to ensure their children have protection against possible

cancers developing in the future. Research supports this position that “a cost-effective vaccine

has low cost, high efficacy and results in a situation in which the upfront expenditure for

vaccination is entirely offset by costs averted through disease prevention”. (Walter, 2013)

A group of healthcare professionals, the Advisory Committee on Immunization Practices

(ACIP) is charged with creating recommendation regarding vaccine administration. The ACIP

recommends “routine initial HPV vaccination at age 11 or 12 years for girls, with additional

vaccination cycles between the ages of 13 and 26 years”. (Smith et al. 2014)

Conclusion

Transmission of HPV occurs through sexual contact, unlike another virus that transmits

through air or blood borne pathogens. Studies have shown that the HPV vaccine can protect

against cancers. The HPV strains 16 and 18 are known to cause cancers of the vulvar, vaginal,

penile, cervical, and oropharyngeal; by mandating the vaccine these cancers can be avoided.

While critics believe mandatory HPV vaccine is the government playing “big brother”.

Additional, education should be given to parents so they can gain a greater understanding of how
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the HPV vaccine works and the benefits associated with the vaccine. Parents should become

comfortable talking to their children about sex. Research states, “HPV can be transmitted

through genital contact and, because most HPV infections are asymptomatic, infected individuals

may be unaware of their status and thereby unknowingly infect their sexual partners.

Furthermore, condoms may not be effective in preventing HPV transmission because the virus

may be present on the skin beyond the area covered by the condom. Once contracted, there is no

cure for HPV”. (Walter, 2013)

Mandating adolescents receive the HPV vaccine to attend school will ensure parents

protect their children against the deadly diseases associated with this virus. Thus providing lower

medical costs in the future and saving lives.

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References

Javitt, G., Berkowitz, D., & Gostin, L. (2008). Assessing mandatory HPV vaccination: Who

should call the shot?. Journal Of Law, Medicine & Ethics, 36(2), 384-395.

Roll, C. A. (2007). The Human Papillomavirus Vaccine: Should It Be Mandatory Or Voluntary?.

Journal Of Health Care Law & Policy, 10(2), 421-444.

Smith, Matthew Lee, Kelly L. Wilson, Jairus C. Pulczinski, and Marcia G. Ory. (2014) Support

for HPV Vaccination Mandates for Both Females and Males. American Journal of Health

Behavior, 38(6), 831-38.

Walter, C. S. (2013). Ethical, Legal, And Economic Considerations Related To The Mandatory

Administration Of The Human Papillomavirus Vaccine. Notre Dame Journal of Law,

Ethics & Public Policy, 27(2), 611.