Medical ethics principles underscore advocating for human papillomavirus vaccine

Abstract

Studies have consistently shown that vaccination rates against human papillomavirus (HPV) lag far behind other adolescent vaccinations recommended at the same age, resulting in exposing adolescents to unnecessary future risk of infection, and genital and head and neck cancers. Studies also have demonstrated that a major barrier to vaccination is lack of a strong provider recommendation. Factors that providers offer for failing to give a strong recommendation range from perception that the child is not at risk or the need to explain that the vaccine is not mandated (lack of equity and justice) or respect for parental autonomy. We look at the issue through a different lens, and reframe the above viewpoint by describing how failing to make a strong recommendation means the provider is not meeting the four principles of medical ethics (justice, beneficence, non-maleficence and autonomy).

The adoption of the HPV vaccine school-entry requirement in Puerto Rico: How practical lessons can inform future vaccine policies

“…The HPV vaccine has proven to be a safe and effective tool to prevent HPV-related cancers (e.g., cervical, vulvar, anal, penile, oropharyngeal); yet, in 2020, only about 59 % of adolescents were up-to-date in receiving their vaccination series ( Pingali et al, 2021 ). Factors such as vaccine hesitancy caused by myths and misinformation surrounding the HPV vaccine ( Rositch et al, 2022 ), lack of strong provider recommendation ( Healy et al, 2022 ), and an absence of political will ( Abiola et al, 2013 , Barraza et al, 2016 ) have resulted, in part, in a limited number of states/territories (i.e., Virginia, Rhode Island, Washington DC, Puerto Rico, and Hawaii) adopting HPV vaccine school-entry requirements ( Barraza et al, 2016 , Colón-López et al, 2021b , State of Hawaii Department of Health, 2020 , Vázquez-Otero et al, 2021a ).…”

An ethics of HPV vaccination: beyond principlism

“…Healy et al rightly raise the question of the role of medical ethics in the face of an absence of vaccination or insufficient vaccination coverage against human papillomavirus (HPV), as such vaccination can prevent almost 90% of infection-related cancers. 1 Given this high percentage, and its significance in terms of public health, an ethical responsibility could be evoked in terms of lost time, but also in terms of the resulting human and economic costs of this disease and its treatment. 2 According to the authors, the recommendations in force may bear the major responsibility for this failure, as they have resulted in parents being insufficiently well informed of the need to get their children vaccinated against this virus.…”