# Should schools require the new HPV vaccine? **URL:** \ **Category:** Great Debates\ **Created:** [November 24, 2006, 8:40pm UTC](https://boards.straightdope.com/t/should-schools-require-the-new-hpv-vaccine/381678 "2006-11-24T20:40:02Z")\ **Posts on this page:** 10\ **Page:** 1
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [November 24, 2006, 8:40pm UTC](https://boards.straightdope.com/t/should-schools-require-the-new-hpv-vaccine/381678/1 "2006-11-24T20:40:02Z")
In June, Merck was approved to sell Gardasil, a vaccine that can potentially prevent up to 70% of all cervical cancers. From [here](http://www.nytimes.com/2006/06/30/health/30vaccine.html?ex=1309320000&en=73611cb06d9b311d&ei=5090) > [@](#): > > A federal vaccine advisory panel voted unanimously yesterday [June 29] to recommend that all girls and women ages 11 to 26 receive a new vaccine that prevents most cases of cervical cancer. School-aged girls who are not yet sexually active are the major target of this vaccine, since they would be the most protected from future HPV infections. From [here](http://www.fda.gov/bbs/topics/NEWS/2006/NEW01385.html) > [@](#): > > HPV is the most common sexually-transmitted infection in the United States. The Centers for Disease Control and Prevention estimates that about 6.2 million Americans become infected with genital HPV each year and that over half of all sexually active men and women become infected at some time in their lives. On average, there are 9,710 new cases of cervical cancer and 3,700 deaths attributed to it in the United States each year. Worldwide, cervical cancer is the second most common cancer in women; and is estimated to cause over 470,000 new cases and 233,000 deaths each year. So, this isn’t a rare disease. We’re not talking about saving one life. From [here](http://www.nytimes.com/2006/06/30/health/30vaccine.html?ex=1309320000&en=73611cb06d9b311d&ei=5090) > [@](#): > > States and school districts have the power to decide whether to mandate vaccinations, but such decisions are usually not made until at least a year after a vaccine is introduced. Schools can decide to require this vaccine. Conservative groups are opposed, claiming that the vaccine will only serve to destigmatize early sexual behavior. From [here](http://www.nytimes.com/2006/06/30/health/30vaccine.html?ex=1309320000&en=73611cb06d9b311d&ei=5090) > [@](#): > > “You can’t catch the virus, you have to go out and get it with sexual behavior,” said Linda Klepacki of Focus on the Family, a conservative Christian group based in Colorado Springs. “We can prevent it by having the best public health method, and that’s not having sex before marriage.” This ignores the possibility of rape or molestation, and it also ignores the apparent facts about abstinence programs–that they don’t work to prevent sexual activity. (Cites will be furnished on request.) From [here](http://www.webmd.com/content/article/123/115100.htm) > [@](#): > > 1. How effective is Gardasil? > > Studies have shown 100% effectiveness in protecting against infection with HPV-16 and HPV-18 strains in people who had not been previously exposed to the virus. So, considering this is a transmittable disease, a health risk for women (and men, who can develop genital warts from the same infections), and the prime years for vaccination are school years, should schools mandate this vaccine? I lean strongly toward yes. The vaccine is expensive, but programs can be put in place to help defray the costs. The vaccine can save lives, and parents shouldn’t be allowed to prevent life-saving medical intervention. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [November 24, 2006, 8:46pm UTC](https://boards.straightdope.com/t/should-schools-require-the-new-hpv-vaccine/381678/2 "2006-11-24T20:46:46Z")
No. I don’t believe any vaccines at all should be mandatory, as that goes against the concept of informed consent, which I heartily support. In addition, I don’t think HPV is a school related issue the way one could argue mumps or measles could spread quickly throughout the school by casual contact. Am I getting my daughter vaccinated? Hell, yes. But I don’t think any medical decision should be mandatory. I might be persuaded otherwise if we instituted national health care. ---
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [November 24, 2006, 8:49pm UTC](https://boards.straightdope.com/t/should-schools-require-the-new-hpv-vaccine/381678/3 "2006-11-24T20:49:18Z")
I also lean strongly toward yes. The federal endorsement makes a big difference, and if schools are able to tell parents that their children need to be vaccinated for other illnesses, which I think they are, they should require this, too. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [November 24, 2006, 8:57pm UTC](https://boards.straightdope.com/t/should-schools-require-the-new-hpv-vaccine/381678/4 "2006-11-24T20:57:01Z")
The precedence has been set with Hepatitis B vaccines, which already are required. But I think that requiring that vaccine was a mistake that needs not to be repeated. I love this vaccine and do advise it for my patients, but requiring a vaccine, IMHO, requires either an imminent risk to the child, or a substantial health benefit to the entire public good, such as that engendered by herd immunity. For example, pertussis vaccines only work by having a critical mass of the population immunized and the brnrfit of vaccination is immediately realized by the child. This one, as promoted, does not require herd immunity. A non-compliant individual is, to an extremely large extent, only placing herself at risk. The behaviors that put her at risk are mainly volutarily chosen and most of the behavior will occur after adulthood and the right to take on responsibility for ones own choices. This vaccine does not meet the burden needed to limit people’s freedoms to make stupid decisions and when you limit freedoms without good cause you inevitably cause a backlah that overall hurts your cause. ---
**Author:** ![Autumn\_Almanac](https://avatars.discourse-cdn.com/v4/letter/a/d26b3c/32.png) [@Autumn\_Almanac](https://boards.straightdope.com/u/Autumn_Almanac)\ **Post date:** [November 24, 2006, 9:10pm UTC](https://boards.straightdope.com/t/should-schools-require-the-new-hpv-vaccine/381678/5 "2006-11-24T21:10:27Z")
[QUOTE=DSeidI love this vaccine and do advise it for my patients, but requiring a vaccine, IMHO, requires either an imminent risk to the child, or a substantial health benefit to the entire public good, such as that engendered by herd immunity. … This vaccine does not meet the burden needed to limit people’s freedoms to make stupid decisions and when you limit freedoms without good cause you inevitably cause a backlah that overall hurts your cause.[/QUOTE] Agree 100%. It reminds me of the controversy over Deaf culture from another thread. It may be a no-brainer to most people that deafness is a disability that should be treated medically and cured if possible; but if some people don’t see it that way, and they’re only hurting themselves, who are we to _force_ them to the light? ---
**Author:** ![Ethilrist](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ethilrist/32/4604_2.png) [@Ethilrist](https://boards.straightdope.com/u/Ethilrist)\ **Post date:** [November 24, 2006, 9:27pm UTC](https://boards.straightdope.com/t/should-schools-require-the-new-hpv-vaccine/381678/6 "2006-11-24T21:27:32Z")
> [@](#): > > Schools can decide to require this vaccine. Conservative groups are opposed, claiming that the vaccine will only serve to destigmatize early sexual behavior. Do these people really think there are a significant number (say, about 233,000 per year) of teenaged girls who think “You know, I’d really like to have sex, but hey, I could catch HPV, so I won’t”? That’s kind of scary. ---
**Author:** ![Marley23](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@Marley23](https://boards.straightdope.com/u/Marley23)\ **Post date:** [November 24, 2006, 9:37pm UTC](https://boards.straightdope.com/t/should-schools-require-the-new-hpv-vaccine/381678/7 "2006-11-24T21:37:09Z")
[QUOTE=DSeid] A non-compliant individual is, to an extremely large extent, only placing herself at risk. The behaviors that put her at risk are mainly volutarily chosen and most of the behavior will occur after adulthood and the right to take on responsibility for ones own choices. [/QUOTE] Or rather, non-compliant parents are placing only their child at risk. ---
**Author:** ![DSeid](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dseid/32/20194_2.png) [@DSeid](https://boards.straightdope.com/u/DSeid)\ **Post date:** [November 24, 2006, 10:23pm UTC](https://boards.straightdope.com/t/should-schools-require-the-new-hpv-vaccine/381678/8 "2006-11-24T22:23:08Z")
True. Their child at risk up to a point that they are considered an adult and can make their own choice for the amount of exposure they will have up til then. Funny thing though. I have a fair number of Christian Conservatives among the moms in my practice. They are as eager for their girls to get this as anyone else has been. The sales pitch is easy: 50% of adults harbor this virus without even knowing it. Even a woman who is sexually active only within the confines of mariage to a single man has a significant chance of exposure. Hepatitis B, which most of them had never seen or much heard of, their babies having sex someday in the future … that met up with resistance. And resentment that it was mandated, resentment that fueled an antivaccine backlash that we are only now recovering from. A disease that many adult women, including Christian Conservatives, have known people to suffer from, the concept that their now pubescent (and sometimes rebellious) girls may have sex in the future and have preventable consequences from it … this is an easier sell. And if I can’t sell it, then shame on me. A hijack: how about for the boys? They gain no direct benefit but herd immunity would increase the benefit of the vaccine. Should there be a male indication for the vaccine? ---
**Author:** ![wonky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wonky/32/393_2.png) [@wonky](https://boards.straightdope.com/u/wonky)\ **Post date:** [November 24, 2006, 11:24pm UTC](https://boards.straightdope.com/t/should-schools-require-the-new-hpv-vaccine/381678/9 "2006-11-24T23:24:50Z")
[QUOTE=DSeid] A hijack: how about for the boys? They gain no direct benefit but herd immunity would increase the benefit of the vaccine. Should there be a male indication for the vaccine? [/QUOTE] They are studying the use in boys to prevent some genital warts. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [November 24, 2006, 11:57pm UTC](https://boards.straightdope.com/t/should-schools-require-the-new-hpv-vaccine/381678/10 "2006-11-24T23:57:37Z")
I have mixed feelings about this. There is definitely a strong medical indication for young girls to receive the HPV vaccine. We’ve made great strides in lowering cervical cancer incidence with Pap tests\* and this is a logical extension of routine cytologic screening, with potential significant health care cost saving (considering the $$$ spent on following up cytologic abnormalities, including colposcopy, biopsy and other procedures). I am also concerned about a hostile climate among certain segments of the public towards vaccines in general (i.e. the phony vaccine-autism link and other scaremongering) as well as battling the “pro-family” lobby. I’m not sure mandating the HPV vaccine right off the bat in grade school is worth the uproar. What _would_ be highly worthwhile is government-sponsored programs to provide the vaccine at reduced cost on a wide basis. \*only a dozen more to look at this evening and I can go home.