Every year three thousand seven hundred women succumb to cervical cancer, which is caused by the HPV. Since Gardasil is effective against this virus it is mandatory to administer it. In addition to protecting the present day young women it also affords protection to the females of the subsequent generation. Its manufacturer, Merck has been hectically lobbying in order to make its administration mandatory in all the states of the Union. Protection for women and girls from the Human Pappiloma Virus was provided by Gardasil.
It has been surmised that twenty million US males and females are afflicted by genital HPV, by the Centers for Disease Control and prevention. Moreover, it has been estimated that annually, around six million people acquire this viral infection. Vaccination for females between the eleven to twenty six years has been recommended by the Advisory Committee on Immunization practices and the American Academy of Pediatrics, moreover, this vaccine can be administered even to females who are nine years old.
The best time to administer this vaccine is prior to the commencement of sexual activity by the patient, nevertheless, even females who are sexually active benefit from such medication (Snow, March 2007). It is incorrect to abstain from administering this vaccine to children, merely on the basis of the fact that HPV is transmitted sexually. For instance, the administering of medication that has enabled infants to be protected against the Hepatitis B virus indicates that public health campaigns are fully capable of preventing diseases without engendering moral depravity.
The fact remains that the proliferation of HPV is independent of risky sexual behavior, because eighty percent of the women are exposed to this virus due its common occurrence. In the year 2001, there were twelve thousand nine hundred new instances of invasive cervical cancer in the US (Wright, 1998), whereas in the year 2006, the corresponding number was nine thousand seven hundred and ten (Zimmerman, Februrary 2007) HPV Infection affects the genitals including on the skin of the penis, the vulva or the exterior of the vagina, the anus, the inner linings of the vagina, the cervix and the rectum.
In many instances significant symptoms are not exhibited and the infection gets cured of its own accord (Genital HPV Infection – CDC Fact Sheet, 2004). Gardasil has to be administered in three doses and it costs nearly US$360, this makes it unaffordable for most of the people in the world. Further, negative effects had been observed during its experimental stage. Thus some people consider it ill advised, hasty and careless to use this vaccine at this juncture.
Rick Perry, the Governor of Texas has promulgated an executive order to be implemented by September 2008, which makes it mandatory for every girl joining the sixth grade to be immunized. This order induced opposition from several Republicans who opined that it would meddle with parental rights and could bring about opposition to the vaccine (Executive Order RP65, 2007). Merck’s Gardasil affords protection from four types of HPV that are responsible for seventy percent of cervical cancer and ninety percent of genital warts.
The Advisory Committee on Immunization Practices or ACIP recommended the administration of Gardasil to girls between the ages of 11 and 12 years, and to all females between the ages of 13 to 26 years (Edlin, 2007). Lynn Nishida, manager, clinical pharmacy services for Portland, of the Oregon based Regence stated that in addition to being the first HPV vaccine that had been approved by the FDA it indicated a change in strategy from mere treatment of disease to prevention of the disease. This had the capacity to drastically curtail the damage caused by HPV based diseases (Edlin, 2007).
The American Academy of Pediatrics’ Committee and the Advisory Committee on Immunization Practices had recommended the usage of the HPV vaccine for girls between the ages of 11 to 12 years. Girls and women between the ages of 13 to 26 years old who had received or completed the three dose vaccine series could also be administered the vaccine. The FDA approved of the vaccine for females between the ages of nine to twenty – six years. Furthermore, a working group on HPV prevention recommended that any sexually active person could be made a recipient of this vaccine (Pichichero, 2007).
The compulsory use of HPV vaccination is not due to any moral considerations, and it is imperative to obtain the public’s trust in this endeavour. Efforts to implement legislation that would make it mandatory to undergo HPV vaccination have served to reduce public confidence. Moreover, it is imperative to specify the compensation to be made to recipients of this vaccine if they are afflicted with serious adverse effects in the future. Ethics require the state to specify adequate compensation if it makes such vaccination compulsory and if the recipient suffers at a later date due to the vaccine (Gostin & DeAngelis, May 2, 2007).
The opponents of vaccination for HPV have raised several questions regarding the feasibility of such treatment. First, won’t the administration of such vaccination promote early sexuality? Second, at a cost of US$360 isn’t the vaccination unaffordable? Third, since, the HPV is not a highly infectious and airborne, is it justified to administer vaccine to prevent it? Fourth, as the vaccine produced by Merck proves to be ineffective after five years, is it justified to administer it?
Fifth, the majority of the patients who had been administered this vaccine suffered from moderate to severe pain at the site of the vaccination, is the use of this vaccine that has such painful side effects correct? Sixth, is it safe to use this vaccine in the absence of conclusive proof that the vaccine would not cause auto – immune and neurological problems such as seizures over a period of time? Seventh, is it justified to use this vaccine, even after it is common knowledge that it could cause pelvic inflammatory disease, appendicitis and gastroenteritis?
Eighth, is it not highly irregular to use this vaccine in the absence of adequate clinical examinations? Ninth, is it safe to use this vaccine when it had not been tested on girls less than sixteen years of age? Tenth, does not this vaccine promote promiscuity? In the US there exist mandatory vaccinations for infectious diseases like measles, German measles and mumps. Moreover, administering the tetanus vaccine is mandatory as it prevents infections that could arise from injuries. These vaccines, as per the statistics, are successful in almost totally immunizing the population against these infections.
However, HPV vaccine cannot compare with these vaccines as it is effective only against four of the known HPV infections. Moreover, it is only half as effective due to the fact that men are not administered this vaccine and consequently continue to carry the infection. This does not develop herd immunity as in the case of mumps and measles (de Soto, 2007). However, the administration of this vaccine is mandatory, because it protects to a great extent, women from fatal diseases like cervical cancer and it would be a grave injustice to abstain from administering this vaccine, merely on the assumption of moral grounds.
References Berenson, A. (2005, April 24). Evidence in Vioxx Suits Shows Intervention by Merck Officials. Retrieved June 29, 2007, from New York Times : http://www. biopsychiatry. com/bigpharma/vioxx. html de Soto, J. (2007, April). Should HPV vaccination be mandatory? Journal of Family Practice , pp. Vol. 56 Issue 4, p267-268, 2p; (AN 24893917). Edlin, M. (2007, May 1). Plans choose coverage for HPV vaccine, ponder routine mandate .
Retrieved June 29, 2007, from Managed Healthcare Executive: http://www. managedhealthcareexecutive. com/mhe/article/articleDetail. jsp?id=409185&sk=&date=&&pageID=1 Executive Order RP65. (2007, February 2). Relating to the immunization of young women from the cancer-causing Human Papillomavirus . Austin , Texas , USA: Rick Perry, Governor of the State of Texas. Food and Drug Administration. (2006, May 18).
FDA Background Document for Vaccines and Related Biological Products Advisory Committee. Genital HPV Infection – CDC Fact Sheet. (2004, May). Retrieved June 29, 2007, from Centers for Disease Control and Prevention: http://www. cdc. gov/std/HPV/STDFact-HPV. htm Gostin, L. O. , & DeAngelis, C. D.
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