Home Latest News Human Papilloma Virus Vaccine – Safety and Ethical Issues

Human Papilloma Virus Vaccine – Safety and Ethical Issues

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Recently, the Heath Services Unit at the University of the West Indies, St. Augustine Campus, announced that vaccination against Human Papilloma Virus (HPV) infection will be provided free of cost (costs approximately US$ 150) for students and UWI employees.

HPV infection has been aetiologically associated with the development of cervical cancer and hence this vaccine offers protection against not only viral infection and warts but also against cancer.

A series of e-mails clogged the Campus staff members’ inboxes, with varying opinions regarding the necessity, safety, and other ethical perspectives pertaining to the vaccination.

There were calls for promoting ‘abstinence’, ‘marital fidelity’, etc. and suddenly everyone s
byeemed to be promulgating conservative ideas of how all these ‘virtues’ and ‘moral values’ are better than vaccination.

However, the interesting feature was regarding the safety of vaccination, and some academicians claimed that “in their own research”, HPV vaccine is not safe to use. This blog is to debunk the misconceptions.

The book entitled “Adverse Effects of Vaccines: Evidence and Causality” by the National Academies Press (ISBN 978-0-309-21435-3) (2012), has clearly established the safety of the vaccine.

Currently, two vaccines are licensed in the United States to prevent diseases caused by HPV infection. The quadrivalent vaccine, Gardasil™ (Merck & Co., Inc.), was licensed in 2006 by the Food and Drug Administration (FDA) to protect girls and women age 9 through 26. In 2009, this was additionally approved for use in males aged 9–26 years to prevent warts and cancer, although it was not recommended for routine vaccination in this population. The bivalent vaccine, Cervarix™ (GlaxoSmithKline Biologicals), was licensed in 2009 by the FDA to protect girls and women age 10 through 25.

Both forms of the vaccine offer 80-90% protection against HPV infection and 70% protection against cancer.

According to a report by Center for Diseases Control (CDC) released in 2010, 44.3% of girls in the United States aged 13 to 17 had received at least an initial dose of either vaccine.

The Committee to Review the Adverse Effects of Vaccines established by the Institute of Medicine (IOM), in the United States did not find any causal relationship with the administration of the vaccine and development of neurological ailments such as acute disseminated encephalitis, transverse myelitis, multiple sclerosis, Guillain-Barré syndrome etc.

In addition, the Global Advisory Committee on Vaccine Safety established by the WHO, conducted a thorough scrutiny into the adverse effects of HPV vaccine with a particular focus on multiple sclerosis. The report released as recent as February 2014 asserts that with more than 175 million vaccines distributed worldwide, the Committee is reassured by the safety profile of the vaccine.

Finally, the ethical standpoint remains if it is advisable to have universal vaccination against HPV. Notwithstanding the cultural differences with respect to initiation age of sexual activity, number of sexual partners and other lifestyle perspectives, a recent article published in BMC Medical Ethics 2014, 15:29 (doi: 10.1186/1472-6939-15-29) concludes that “the universal vaccination against HPV in young women is acceptable from an ethical point of view, given the medical advantages it presents.”

In summary, the concerns raised by some academics of UWI St. Augustine against HPV vaccine may be unfounded with mounting scientific evidence reiterating its safety. However, it may be left to individuals if they wish to utilize the opportunity of having a vaccine against cancer free of cost.

Submitted by Prof. Seetharaman Hariharan

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