When the initial HPV (human papillomavirus) vaccine was released in 2006, it was met with a large public outcry in the United States from concerned parents, pediatricians, and politicians. Their claim was that vaccinating pre-adolescent boys and girls would encourage riskier adolescent sexual behavior.
It was thought that the vaccine would give young adults a false sense of protective security and thus encourage them to engage in higher risk sexual activities (sex without a condom, increased number of partners, etc.). Researchers immediately began structuring studies that would investigate the claim, and several studies were started across the country.
The research findings were that there was no evidence to suggest a link between riskier adolescent sexual behaviors among vaccinated teens. Despite the clinical evidence, the idea of mandatory HPV vaccination has sparked considerable controversy across the country. The predominant reasons cited for opposition from adults were that it was not necessary for their child or that their child was not sexually active. Doctors have also raised concerns about discussing sexual activity and behavior with preteen patients.
Abstinence remains the predominantly taught form of sex education in the United States. HPV is predominantly transmitted through sexual contact, which means that vaccinating preteen girls means recognizing the potential for sexual activity in preteens and young teens at the legislative level. For many parents, politicians, and doctors, this creates uncomfortable emotional responses and has led to a push within the United States to postpone the recommended age for vaccination until sometime in the teens.
The concept of mandatory HPV vaccines is not revolutionary: Western European countries, the United Kingdom, Canada, and Australia have since incorporated HPV vaccines into mandatory school vaccination programs. The HPV vaccine is unique in that it is one of the few known drugs that directly reduces the risk of specific cancers.
In the early 1900s, cervical cancer was the leading cause of cancer-related death in American women. With the introduction of regular Pap tests and an understanding of the HPV virus, cervical cancer today affects approximately 12,000 women a year and results in approximately 4,000 deaths a year.
Worldwide, the problem of cervical cancer is very different. It is the second most common cause of cancer-related death among women, disproportionately affecting women during their childbearing years. Unfortunately, more than 80% of all cervical cancer cases occur in the developing world and more than 300,000 women die each year and thousands of others are financially, socially and emotionally affected.
For the first time in human history, we have the opportunity to reduce the risk of a specific type of cancer for our children and youth. As healthcare providers and citizens of the world, it is our responsibility to work to minimize barriers to access to these types of vaccines.