HPV Vaccines in Teens

The Human Papilloma Virus (HPV) is a sexually transmitted disease that can be contracted by any individual who is sexually active. The HPV vaccines are given to teens to prevent them from diseases caused by the virus. The Centre for Disease Control and Prevention (CDC) advocates for the vaccination of females of 9-26 and males of 11-21 years (Liddon et al, 2012). The virus may cause vaginal and cervical cancers for women and penile cancer for the males if left untreated. The HPV infection also causes genital warts, throat and anal cancers which are diseases common to both the males and females. The vaccine is known to have a higher immune response in pre-teens as compared to older teens thus the need to vaccinate youngsters from the age of 11 or 12 years (Liddon et al, 2012). It is important to note that the Human Papilloma Virus vaccine cannot be administered to a pregnant individual.

The Human Papilloma Virus vaccine has a great impact on the health care policies since its one of the major goals of the urgent actions required to prevent cancer (Kahn et al, 2005). In order to achieve this goal, the healthcare policies must support the maximum availability and access to the vaccination services. This can be achieved by ensuring that the vaccines are timely availed in healthcare centers where adolescents seek medical services and should be appropriate enough to cater for the whole HPV vaccination series without much cost implication. The health care system must formulate policies that facilitate a reduction of missed clinical chances in physicians’ offices thus increasing the consumption of the Human Papilloma Virus Vaccines (Hughes, 2002). The healthcare policies adopted must ensure that every individual can access the vaccines whether they are privately insured or covered by public programs.

The politics surrounding the use of the Human Papilloma Virus vaccines by teens is somewhat controversial. The issue is opposed by religious conservatives while some states make it mandatory. Those who have negative sentiments about the vaccine argue that it gives teens the green light to be sexually active and would want a determination establishing whether the right to take vaccines lies with the state, parents or the individual. Additionally, conservatives’ state that mandating the use of HPV vaccines compromises the campaign on abstinence based mode of prevention. There are ethical and policy issues that arise from laws mandating the use of vaccines. The people arguing on religious grounds believe that the use of the vaccines promotes promiscuity among teens thus encouraging immoral behavior (Olshen et al, 2005). The conservatives’ argument is based on the premise that sex should only take place in marriage which they perceive as the ideal scenario.

 However, abstinence messages don’t seem to work and most teens are known to begin sexual activities at a young age even after receiving information on the need to abstain. The medical fraternity argues that the efficacy of the vaccines should highly be considered since it works a great deal in preventing the terminal illnesses that result from infection of Human Papilloma Virus amongst individuals such as cervical cancer for females which is known to result in a large number of deaths annually (Nobbenhuis et al, 1999). The extent of parental autonomy and place of political advocacy in preventive health may determine the acceptability of compulsory vaccines. The issue of Human Papilloma Virus vaccines in teens can be said to be at the formulation stage of the policy making process. The policy requiring mandatory uptake of the HPV vaccines has neither been adopted nor implemented due to the challenges facing it arising from controversies surrounding the use of Gardasil. However, it is imperative to note that individual persons take the vaccine at their own will so as to prevent them from the long term effects of untreated Human Papilloma Virus.

Sociocultural Issues in Human Papillomavirus Vaccine;

The Human Papillomavirus vaccines are widely recognized for their role in promoting advanced healthcare for women universally. However, the uptake of the vaccines is not equitable due to various challenges some of which are sociocultural. Women who are faced with socio-economic marginalization from both developing and developed countries suffer from the burden of cervical cancer, a disease caused by untreated HPV. The vaccines are not equitably accessible to every woman thus the large number of cervical cancer patients across the world.

 Sociocultural practices in various societies may hinder the uptake of HPV vaccines. For instance, members of a society whose culture does not allow them to seek medical attention in hospitals are not likely to take the vaccines thus resulting in terminal illnesses in case one is infected by the virus. Cultural issues arise from tradition and values inculcated in individuals based on certain beliefs and different cultures have their own way of treating diseases such as the use of herbs. 

The family unit is also a social factor that may hinder or influence the consumption of HPV vaccines (Olshen et al, 2005). Teens whose parents are religious conservatives’ would probably not take the vaccine due to the influence the parents have on them. On the other hand, teenagers whose parents are medical practitioners or those who are knowledgeable may influence their children to take the vaccine because they clearly understand that administering it does not in any way give a go ahead to sexual activity. Additionally, the influence from peers may drive an individual to either take the vaccines or fail to depend on what members of the peer group believe about them. For example, peers who are well informed about the importance of taking the vaccine may influence a member by virtue of the knowledge they have of the Human Papillomavirus while the vice versa is also true.

Ethical issues in Human Papillomavirus Vaccine;

The medical benefits arising from universal vaccination against Human Papilloma Virus provide an appropriate basis for its acceptability. Nonetheless, there are ethical problems that pose a hindrance in the uptake of the vaccine. The side effect of administering the vaccine is one of the ethical issues arising in HPV vaccine. Since the licensing of the vaccine in 2006, there have been no major negative side effects reported from any country that adopted the vaccine (Paavonen et al, 2009). It is only said to cause mild dizziness and fainting in the worst case scenario. Physicians recommend that individuals on whom the vaccine is administered should lie down for about 15 minutes to avoid any harm in the event one faints though they are not common (Paavonen et al, 2009). An opposing argument premised on the side effects can, therefore, not be used to rule against universal vaccination in teens since the benefits are far more reaching than the effects.

 The decision of whether or not individuals who abstain from sex is an ethical issue as well. The age limit for vaccination which is 9 to 14 years has a very minimal probability of having sexually active teens. It is, however, not guaranteed that the individual will abstain throughout their lifespan and may contract the virus even in marriage if the partner did not practice abstinence. It is therefore important to take the vaccine since an individual will be able to prevent infection in such a scenario. The presumption that Human Papilloma Virus vaccination gives teens the green light to engage in sexual relations is not at all factual. The vaccine is administered at teenage age since it has a high efficacy during that period as compared to older adolescent age. In this regard, the universal vaccination of teens against the virus is highly justified. However, the vaccination should be done hand in hand with campaigns advocating for delaying sexual activeness while at the same time creating awareness of the negative effects of the virus. People must be notified of the dangers they are exposed to as a result of failing to take the HPV vaccine.

Legal and Historical Issues in Human Papilloma Virus vaccine;

State laws pose requirements of vaccination during school admission. The Human Papilloma Virus vaccine elicits varied responses in different legislatures. Since the licensing of Gardasil, various states have established legislation to inform the general public about the HPV vaccine and other states have enacted the law. States such as New Hampshire offer the vaccine to girls of 11-18 years with no cost implication to the user (Sauvageau et al, 2007). However, laws that require mandatory uptake of the vaccine are controversial because of the moral issues raised by religious conservatives’. When the Center for Disease Control and Prevention (CDC) gave approval for the use of HPV vaccine by women, the then Governor of Texas Rick Perry gave an executive order requiring mandatory uptake of the vaccine by all girls in sixth grade (Paavonen, et al, 2009).  He argued that vaccinating the girls before infection was responsible health that provided the ability to minimize the number of cervical cancer patients. Nonetheless, the order was overruled by the Texas legislature.

Financial/economic issues Human Papilloma Virus vaccine;

The financial perspective of the HPV vaccine is premised on its price and cost effectiveness. The vaccine series is composed of three doses each retailing at $120 making the total cost $360 (Liddon et al, 2012). The financial burden associated with the uptake of the HPV vaccine is, therefore, not bearable by all citizens especially the low-income earners. It is critical to note that mandating the vaccine imposes economic constraints on the citizenry since they may have to forego various necessities in order to purchase the vaccine. The state should establish favorable modes of easing the financial constraints by, for instance, enacting laws that mandate insurance providers to cover the vaccine, provide exemption clauses based on the financial capability of individuals. Such laws could help in providing the vaccine to economically marginalized societies at a subsidized fee or at no cost at all if possible, thereby ensuring that all citizens are able to access and receive the vaccine. 

Those opposed to the compulsory uptake of the HPV vaccine allege that it is not cost effective on the premise that not all Human Papilloma Virus infections result in cervical cancer. Additionally, they maintain that most HPV infections clear on their own and therefore do not understand the need for such expensive vaccines. However, analyses carried out are in favor of the cost effectiveness of the vaccines as opposed to that of treating the virus. It is estimated that the annual cost of treating the HPV infections and their resultant diseases is $5 billion in the United States of America (Liddon et al, 2012).

Policy options for Human Papilloma Virus

The following are policy solutions available for the HPV.

Policy Option one: Focus on creating awareness about HPV

The opposition leveled against HPV vaccines is as a result of lack of knowledge about the infection amongst most people. The citizenry has scanty information about the causes and long term effects of the virus if left untreated (Fawcett & Russell, 2001). Creating awareness through educative campaigns provides the ability for people to make informed decisions regarding the uptake of the HPV vaccine. This campaign may impact a positive partial change towards the adoption of the vaccine. Among other objectives of the awareness campaign, it must clearly outline the possible terminal illnesses that are caused by untreated HPV, the cost implication on the family’s finances and the cost effectiveness of taking the vaccine before getting into contact with the virus as opposed to treating the infection. 

The theoretical underpinning for this option arises from the arguments of those opposed to mandating the vaccine with a specific interest on those that allege that most HPV infections clear on their own and that cervical cancer among women is not rampant (Fawcett & Russell, 2001). Awareness creation is a health advocacy which requires the use of factual statistics in order to pass the intended message across to all people. The awareness campaign should be led by health practitioners in collaboration with schools and churches. The church, in particular, must use factual evidence in order to clearly inform the religious conservatives’. Though the process of informing the public may be tedious and costly, it has far more reaching benefits such as reducing the amount spent in treating HPV related illnesses and minimizing the number of deaths caused by those diseases.

Policy option two: Focus on providing the vaccines at no cost

This policy solution aims to achieve radical change towards the use of HPV vaccine since most people fail to get the vaccine due to its high cost. Its theoretical underpinnings arise from the assertion that the vaccines are not cost effective because not everyone is exposed to the risk of contracting the infection especially those that adhere to abstinence prevention messages (Riedesel et al, 2005). Eliminating the financial burden incurred by the consumers is a health advocacy which ensures equitable access to all the population. 

This solution should be led by the state government in collaboration with the vaccine manufacturer and health practitioners. Involving the vaccine provider allows the government to negotiate and acquire the vaccine at discounted prices which then makes it possible for the state to offer it at no cost to the public. This option is cost effective to the government since increased uptake of the vaccine minimizes the number of infections thus reducing the amounts spent by the state in treating infections by a large margin.

Policy option three: Invalidating laws that mandate vaccination

This policy solution may achieve little or no change since most people are against the laws that make the use of HPV vaccines mandatory. The option’s theoretical underpinning is premised on the argument that the state does not possess the right to decide whether or not an individual should take the vaccine (Olshen et al, 2005). Parents assert that the decision should be theirs to make based on their religious, medical and philosophical grounds. This policy solution should be led by legislatures and other interested parties and may not have much cost implication. Basically, the option allows people to decide on their own whether or not to take the vaccine thus making it an individual right. The disadvantage of this option is that the state may spend a large amount of its revenue in providing treatment for HPV related illnesses.

The policy options outlined above can seamlessly be collaborated to build a consensus that addresses the issue of Human Papilloma Virus. The policy solutions can be implemented simultaneously without any backlash from the population thus achieving the ultimate goal of increasing the number of people taking the vaccine series without any missed clinical opportunities.

References

Hughes, J. P., Garnett, G. P., & Koutsky, L. (2002). The theoretical population-level impact of aprophylactic human papilloma virus vaccine. Epidemiology, 13(6), 631-639.

Kahn, J. A., Zimet, G. D., Bernstein, D. I., Riedesel, J. M., Lan, D., Huang, B., & Rosenthal, S. L. (2005). Pediatricians’ intention to administer human papillomavirus vaccine: the role of practice characteristics, knowledge, and attitudes. Journal of Adolescent Health, 37(6), 502-510.

Fawcett, J., & Russell, G. (2001). A conceptual model of nursing and health policy. Policy, Politics, & Nursing Practice, 2(2), 108-116.

Liddon, N. C., Leichliter, J. S., & Markowitz, L. E. (2012). Human papillomavirus vaccine and  sexual behavior among adolescent and young women. American journal of preventive medicine, 42(1), 44-52.

Nobbenhuis, M. A., Walboomers, J. M., Helmerhorst, T. J., Rozendaal, L., Remmink, A. J., Risse, E. K., … & Meijer, C. J. (1999). Relation of human papilloma virus status to cervical lesions and consequences for cervical-cancer screening: a prospective study. The Lancet, 354(9172), 20-25.

Olshen, E., Woods, E. R., Austin, S. B., Luskin, M., & Bauchner, H. (2005). Parental acceptance of the human papillomavirus vaccine. Journal of Adolescent Health, 37(3), 248-251.

Paavonen, J., Naud, P., Salmerón, J., Wheeler, C. M., Chow, S. N., Apter, D., … & Hedrick, J. (2009). Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis of a double-blind, randomised study in young women. The Lancet, 374(9686), 301-314.

Riedesel, J. M., Rosenthal, S. L., Zimet, G. D., Bernstein, D. I., Huang, B., Lan, D., & Kahn, JA. (2005). Attitudes about human papillomavirus vaccine among family physicians. Journal of pediatric and adolescent gynecology, 18(6), 391-398.

Sauvageau, C., Duval, B., Gilca, V., Lavoie, F., & Ouakki, M. (2007). Human papilloma virus vaccine and cervical cancer screening acceptability among adults in Quebec, Canada. BMC Public Health, 7(1), 304.