Yes, no, maybe?

States can’t make up their minds over mandating the HPV vaccine

Even after longstanding debate over whether an HPV vaccine should be mandatory, states still can’t make up their minds.

What began with Texas’ mandate to have an HPV vaccine required for sixth-grade girls attending public school (with some exceptions) has become an argument about the morality of requiring vaccinations for children for an STD and infringing on the rights of personal choice.

The verdict will be based on whether the benefits to the public’s health outweigh the costs. Other considerations include the practical implications of where the resources to afford vaccination come from, the safety of the vaccines and whether it is an infringement on one’s rights to have the decision whether to vaccinate or not taken away from them.

States can’t make up their minds over mandating the HPV vaccine

Even after longstanding debate over whether an HPV vaccine should be mandatory, states still can’t make up their minds.

What began with Texas’ mandate to have an HPV vaccine required for sixth-grade girls attending public school (with some exceptions) has become an argument about the morality of requiring vaccinations for children for an STD and infringing on the rights of personal choice.

The verdict will be based on whether the benefits to the public’s health outweigh the costs. Other considerations include the practical implications of where the resources to afford vaccination come from, the safety of the vaccines and whether it is an infringement on one’s rights to have the decision whether to vaccinate or not taken away from them.

What often happens in decisions related to public health is that propaganda rises to the surface and the truth of the matter is confused with hearsay. Fear is reinforced on both sides: Proponents to believe the public’s health is in danger, and opponents to think children’s lives are put at stake. Oddly, they are both advocating for the same idea. The decision regarding what should be mandated is which side’s fears are supported by facts.

There is, of course, the simple fact that most people don’t trust pharmaceutical companies. Many believe that these companies will do anything to make an extra dollar, even at the expense of the consumer. Despite the thorough testing that drugs and vaccines go through before they’re used on the public, distrust in the corporations themselves can lead people to distrust their products as well.

This can also result from debunked (but still popularized) studies. For example, there are no reputable studies that show that vaccinations cause autism, but people still peddle it. And others still believe it. Attempts to dissuade people from believing these since debunked studies are generally met with more expressions of distrust in the companies themselves.

Vaccinations are in place to do more than stir fear. They are there to protect the public against health concerns. Mark Bajorek, consulting physician at PSU, said mandating vaccination means that the risk of getting the disease and the impact on the general public justifies pushing for stringent guidelines.

“With people dying from the measles, that justifies that type of rule,” Bajorek said. “Certainly, when smallpox and polio were very prevalent, making sure that students are vaccinated before being in contact with large groups of students makes sense.”

It is easy to forget the importance of some of these vaccinations because we take having them for granted. “They almost seem like these mythical monsters instead of these real problems,” Bajorek said. Before vaccinations, people were dying from easily prevented illnesses, such as the mumps or chicken pox.

Mandating a vaccine suggests that concern for public health outweighs the concern over whether people can make the decision to vaccinate themselves. This is especially prevalent in vaccinating children. Because they don’t have the right to choose for themselves, the burden falls on the parent(s) or the state.

Much of the controversy surrounding HPV comes from the assumption that children are having sex. The vaccines have only a short window of effectiveness; one lasts four years, and the other lasts six. Possibilities for long-term prevention aren’t well known. The vaccine is available to 9–26 year olds, making those 11–17 years old the most vaccinated.

This bothers some, as it assumes children and teenagers may be having sex. But combating HPV starts with children. People need to be guarded against it before they are exposed to it. Children and teenagers are commonly infected because while it is assumed that they’re not having sex they often are. Vaccinating them ensures the highest number of people is protected prior to possible exposure.

The debate over whether it should be mandatory is not a debate over whether individual children are having sex or whether their parents are the best judges of that. It’s about whether the benefits of vaccinating everyone’s children outweigh the disadvantages.

Part of the group forgotten in legislation is males: Both men and women contract and transmit HPV. It has been related to cervical cancer, vaginal and vulvar cancers in women; penile cancer in men; and genital warts, anal and oropharyngeal cancers (cancers of the back of throat) in both. If HPV is a threat to the general public, then both girls and boys must be vaccinated.

According to the 2011 CDC, HPV affects 20 million people in the United States alone, a number that is growing by six million people a year. Roughly 50 percent of sexually active people will contract it at some point in their lifetime. It accounts for almost all cases of cervical cancer, the second leading cause of cancer fatalities in women worldwide.

Nearly 70 percent of cervical cancer cases and 90 percent of genital warts cases are linked to the strains with FDA-approved vaccinations. The Gardasil vaccination, which most young girls are encouraged to receive, also protects against most genital warts, anal, vaginal and vulvar cancers.

HPV is a preventable epidemic. It is not killing people at a drastic rate. Most people who contract it never develop symptoms or health problems and in 90 percent of cases the body’s immune system naturally eradicates HPV within two years.

However, not vaccinating for the virus doesn’t leave a necessarily viable option for those who are sexually active. It assumes that people who do have sex guard themselves against STDs and that their partners do as well (an assumption that is taken lightly because HPV can still be spread by sexual contact not covered by a condom).

With almost negligible side effects and since the decision revolves around children in particular, the decision to protect children should not be determined by their parents. It’s better to have children vaccinated and wind up not needing it than to see them become sick or die of preventable causes.