Catholic Medical Association on HPV vaccine

When we think cancer, most of us think cancer not something you can "catch."  Actually, there is a virus, the human papilloma virus or HPV that is the leading cause of cervical cancer.  And you guessed it, HPV is a sexually transmitted virus.  It is estimated that over 6 million people contract HPV and close to 10,000 women are diagnosed with cervical cancer every year in the U.S.  The annual pap smear is the first line of defense against HPV and cervical cancer.

But now there is a vaccine called Gardasil for HPV and there is much debate about whether or not to vaccinate girls against HPV.  Some say that vaccinating girls against a sexually transmitted virus would promote promiscuity.  I am of the mind that while my girls may not be sexually promiscous, their future husband just may be.  So, I will likely vaccinate my girls.

Dr. Beverly at LifeEthics.org has a great summary of the statements about the HPV vaccine from various organizations, including the Catholic Medical Association which states:

1.  Is Use of the HPV Vaccine Ethical?

There is no ethical objection to the HPV vaccine either as a strategy against disease or in its production. Patients and parents must have the opportunity to give informed consent to its administration.

Ethics

The fact that HPV is spread primarily by sexual contact does not render vaccination against it unethical. Healing and preventing diseases, no matter what their source, are acts of mercy and a moral good. Prevention of HPV infection is distinct from, and should not be construed as encouraging, the behavior by which HPV is spread.

Production

Gardasil ® is composed of recombinant type-specific capsid proteins that are expressed in yeast and that aggregate spontaneously intovirus-like particles. Its production does not involve cell lines derived from tissues of intentionally aborted babies as do other common vaccines such as those against hepatitis A, (some) rabies, rubella, varicella, and zoster.

Informed Consent

Generally accepted principles of informed consent include disclosure(of benefits, risks, and alternatives),understanding andvoluntariness. (Regarding voluntariness, see the discussion of mandates for the HPV vaccine, below.) In addition to the basic facts summarized in the manufacturers prescribing information, physicians should ensure that patients and parents understand that: Although Gardasil ® covers HPV 16 and 18, which account for 70% of cervical cancers, 11 other high risk strains of HPV exist that cause cancer; The duration of efficacy of the vaccine is not yet known. Booster injections may be required for sustained immunity; There are effective alternatives for preventing cervical cancer. For example, as a result of routine Pap smears over the past 50 years, the age-adjusted incidence of cervical cancer in U.S. women declined from 14.8/100,000 in 1975 to .1/100,000 in 2003; and during that time,the age-adjusted mortality from cervical cancer declined from 5.6/100,000 to 2.5/100,000.

2.  Should the HPV Vaccine Be Mandated?

Public health officials and legislators across the country are discussing whether the HPV vaccine should be required for attendance at school by girls 9 years of age. Indeed, in some areas, public officials have been faced with intense lobbying efforts to mandate the use of this vaccine.The CMA opposes mandating the use of HPV vaccine, as well as direct or indirect efforts to pressure parents or minors to accept it. 

In summary, the CMA thinks that the HPV vaccine is ethical.  Just because HPV is sexually transmitted does not mean a vaccine against it is unethical.  The CMA also states that certain conditions need to be met, including that the vaccine is not mandatory and that parents and minors are properly informed about risks and efficacy.