A missed shot: The failure of HPV vaccination state re...( In an article appearing in the curre...),Health

In an article appearing in the current issue of Clinical Pharmacology & Therapeutics, experts from the University of Pennsylvania Center for Bioethics and Johns Hopkins Berman Institute of Bioethics review the controversy surrounding the human papillomavirus (HPV) vaccine debate, and its effects on ethical and public health issues.

The arrival of Gardasil was a major achievement for cervical cancer prevention efforts worldwide, says Jason Schwartz, MBE, Researcher, Penns Center for Bioethics and Department of History & Sociology of Science, and lead author. Much of the initial enthusiasm for the vaccine was lost amid the controversy surrounding state proposals that would require teenage girls to be vaccinated in order to attend school. The events of the past year reveal important lessons regarding ways to introduce new vaccines successfully and in an ethically responsible manner."

In the months leading up to the June 2006 approval of Gardasil, there was unprecedented media coverage and support from even socially-conservative groups. However, this support for the vaccine began to slow in September 2006 following the introduction of a bill in the Michigan state legislature that would require the vaccination of girls attending public schools. Additional states also were quick to propose similar legislation. In response to the legislation, numerous groups expressed their opposition by arguing that it was either too soon to consider an HPV requirement, or that the sexual transmission of the virus did not warrant requiring the vaccine in schools.

The opposition grew when the governor of Texas issued an executive order requiring HPV vaccination for all girls entering the sixth grade. Critics of state HPV requirements called attention to how these policies violated obligations to respect parental autonomy. However, many critics often overlooked opt-out provisions, implying that the proposals made vaccination compulsory.

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