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Srdjan Kamenko

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When it comes to vaccine intervention for disease control, should personal liberty go before the benefit to society?

This question is extremely important when one considers current news on the Human Papillomavirus vaccine. The main vaccine, Gardasil, has been widely used on women ages 9-26 since its introduction in 2006. The vaccine first made waves in 2007 when Texas governor Rick Perry issued an executive order to mandate the vaccine for all young women in Texas. Even though it was met with much opposition and ultimately failed, the question still remained: should we have a mandatory HPV vaccine for all women? The two sides of the argument clash, each bringing significant evidence to bear on the issue. Mathematical models indicate that with a vaccine as effective as this one (about 100%), mandating the vaccine will stamp out the virus types targeted by the vaccine. HPV is the most common STI with 45% of college age women currently infected. Freeing society of such a dangerous virus, the number one cause of cervical cancer, is a highlight of the pro-mandate argument. The opposition suggests that personal liberty is at stake, and that parents should have the choice to vaccinate their children if they believe the vaccine is worth it for them. What do you think? Is it reasonable to limit personal liberty for the good of the community in the face of a spreading killer virus?

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  • Mar 7 2012: I am also torn on this issue. I think that if 35% of young women were infected with a disease that wasn't sexually transmitted, most people would want a vaccine mandated. However, this disease is transmitted by a life style choice. HPV affects a large percentage of the population because a large percentage of the population is sexually active with more than one partner. For the part of the population that isn't sexually active, even into adulthood, it seems unfair to mandate that they receive a vaccine that might be against their moral values. If we mandate a vaccine to the entire population including those that do not engage in the 'risky' behavior, where is the line drawn? About 34% of American adults are obese, which is a large amount of the population. Does that mean if a cure for obesity-related illnesses, like diabetes, were found that all Americans should be required to get the vaccine? A disease that is the direct result of a behavior is different from a disease that is spread by droplet or indirect contact. However, with HPV it only takes one time to contract the disease, making it different from obesity which is why I am torn. Ideally, people should be educated about HPV and make an educated choice if they want to get themselves vaccinated.
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      Mar 7 2012: You pose a great point: why should someone be forced to take the vaccine if they are not going to participate in sexual activities with more than one partner? This is one of the big points for the opposition. Because this virus is not something that can simply be coughed on you but has to instead be contracted by means of sexual activity, it limits who the susceptible populations are, i.e. the sexually active. However, with a virus as prominent as this one, we can imagine a situation in which a person who has been abstinent their entire lives until they chose to settle down with a partner, might contract the virus from that partner who has had sexual relationships with multiple people. Participating in sexual intercourse with that one person in, in effect, like having sexual intercourse with all their previous partners as far as the virus is concerned. It might be good for that person to protect themselves against possibly getting the virus one day down the road. Again, I totally agree that people need to be educating first before making any sort of decision on the issue. Maybe we should start with an opt-out vaccination? What do you think?
      • Mar 8 2012: I like the idea of an opt-out vaccination. If doctors were required to educate adults, especially parents, about the disease and the vaccine, then the public could make educated, personal choices. A mandate with the option to opt out is a fair government response to a disease such as this. The fact that someone can contract this from one isolated sexual encounter makes this disease a risk to almost the entire US population, so people should be educated and the vaccine made available. I am usually for freedom of choice and the government not making personal decisions, such as medical decisions, for the citizens. Because this disease is spread through direct sexual contact, and not in a faster more aggressive fashion, people should be given the choice to be vaccinated. Even if getting the vaccine seems like a no brainer, the fact that there is a choice is important to me.
        • Mar 8 2012: I agree as well I think that education of HPV is more important right now than mandating that everyone receive the vaccination. The choice to then decide whether or not you will get the vaccine becomes something that you have control over and are aware of. The fact is that people need to know what HPV can do to you and that once you get it there is no cure. Regular papsmears (which everyone should be doing) are then necessary to make sure that it does not develop into cancer. They also need to know that it actually takes a quite a bit of time to contract the virus and have it develop into cancer, so as long as they stay in control of the situation they can prevent the cancer themselves. Safe sex should also be promoted with this education even though you might still receive it from genital genital contact that is uncovered it would still be beneficial. Ultimately people deserve a choice in the matter just like they choose to have multiple partners.
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          Mar 8 2012: I fully agree with education being the most important part and not mandating the vaccination. To me it is a no brainer to get the vaccine, but in terms of fully eliminating cervical cancer, the vaccine is not sufficient. It will decrease it in great numbers but not remove it completely because although HPV is the main causes of cervical cancer, it is not the only one. Therefore, only those who fear the disease and worry about their future health should get the vaccine. Those that do not worry or see the benefit of the vaccine will be the ones who will most likely obtain HPV and bare the consequences. Yea, of course inaction can affect others, but everyone can protect against it in other ways and also detect the disease by doing annual exams. For this, I really believe it is a personal decision that can only be made when educated about the virus, associated diseases, and the vaccine benefits.

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