HPV vaccine and adolescents' sexual activityBMJ 2006; 332 doi: https://doi.org/10.1136/bmj.332.7550.1106 (Published 11 May 2006) Cite this as: BMJ 2006;332:1106
All rapid responses
I am disappointed that Lo's editorial on the HPV vaccine engendered
so little discussion.
HPV vaccine is safe and effctive as determined by FDA and has the
long term potential to prevent about 9,000 cases of cervical cancer per
year in the US, (over 3500 deaths per year). Why was its approval so
opposed and why is it not being strongly promoted as a routine and
sensible addition to childhood immunizations?
The editorial mentions several factors (increased sexual activity,
repercussions from disaffected groups etc) described as ethical concerns,
which I, in contrast, would characterize as illogical accommodations with
fundamentalists and not the bailiwick of physicians.
For example, decades ago, Rubella immmunization was approved for use
in adolescents despite the fact that it was intended to prevent disease
and severe sequelae in only a subset of females who would become pregnant.
Did the discussions about the vaccine center around whether it would lead
to promiscuity and sexual behaviour in youngsters before their appointed
When various erectile dysfuntion medicines were approved did the
press pontificate about removing this naturally occurring control on male
heterosexual promiscuity? The terrible cost in increased adultery, the
spectre of elderly males becoming sexually active after their appointed
Do we in Europe really think that initiation of heterosexual activity
and promiscuity are limited "naturally" by the fear of cervical cancer?
The much more substantial risk of unwanted pregnancy and common STDs (HIV,
gonorhea, chlamydia) does not prevent patients of all ages from engaging
in unprotected sex.
But these are red herrings: a doctor's duty of care is to a patient.
What benefits our female patients most is to be protected at an early age
from future cervical cancer, no matter what their family, religious
institution, school, or government thinks.
Medicine and science in the US are being subverted to serve disguised
religious goals with the encouragement and support of the administration.
Scientists should be vigilant in identifying and challenging the export
of specious arguments from the US.
Competing interests: No competing interests