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Potential Barriers to HPV Immunization: From Public Health to Personal Choice

Published online by Cambridge University Press:  06 January 2021

Gregory D. Zimet
Gregory D. Zimet*
Affiliation:
Duke University, Section of Adolescent Medicine, Indiana University School of Medicine
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Extract

Of the over 100 types of human papillomavirus (HPV), more than 40 can be sexually transmitted. Genital HPV infection is very common, with a point prevalence among women worldwide of approximately 10 percent. In most cases, HPV infection is either cleared or becomes undetectable and causes no disease; however, persistent HPV infection is causally related to all cervical cancers and genital warts. In addition, a large proportion of other cancers, such as vaginal, vulvar, anal, and penile cancers as well as many cancers of the head and neck, are associated with HPV infection. Moreover, recurrent respiratory papillomatosis (RRP) is a potentially serious disease caused by HPV types typically responsible for genital warts. RRP can lead to severe airways obstructions and may require repeated surgical interventions. HPV types are typically divided into high-risk types, most often associated with cancers, and low-risk types, typically associated with warts. High-risk types 16 and 18 are responsible for approximately 70 percent of cervical cancers worldwide, whereas low-risk types 6 and 11 are responsible for approximately 90 percent of genital warts.

Type
Article
Information
American Journal of Law & Medicine , Volume 35 , Issue 2-3 , June 2009 , pp. 389 - 399
Copyright
Copyright © American Society of Law, Medicine and Ethics and Boston University 2009

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References

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18 Id. at K57.

19 Id.

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23 Id.

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27 See generally Gillian Haber et al., Editorial, The HPV Vaccine Mandate Controversy, 20 J. Pediatric & Adolesc. Gynecology 325 (2007).

28 Nati’l Conf. State Leg., supra note 26.

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30 See id. at 1101.

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32 See Loretta Brabin et al., Uptake of the First Two Doses of Human Papillomavirus Vaccine by Adolescent Schoolgirls in Manchester: Prospective Cohort Study, 336 Brit. Med. J. 1056, 1056 (2008) (finding that 1930 out of 1989 girls received the second dose).

33 S. Garland, Address at the Plenary Session I of the European Research Organisation on Genital Infection and Neoplasia (EUROGIN) 2008 International Conference: Introduction and Acceptance of HPV Vaccines: Australian Perspective (Nov. 13, 2008).

34 See Department of Vaccines and Biologicals, World Health Organization (WHO), Report of the Meeting on Future Directions for Rotavirus Vaccine Research in Developing Countries 8 (2000), available at http://www.who.int/vaccinesdocuments/DocsPDF00/www531.pdf.

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36 Id.

37 Anna Koulova et al., Country Recommendations on the Inclusion of HPV Vaccines in National Immunization Programmes Among High-income Countries, June 2006-January 2008, 26 Vaccine 6529, 6530 (2008).

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41 Id.

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43 Irwin, supra note 38.

44 Andrus et al., supra note 40, at K88.

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53 Garland, supra note 33.

54 Stan L. Block et al., Comparison of the Immunogenicity and Reactogenicity of a Prophylactic Quadrivalent Human Papillomavirus (Types 6, 11, 16, and 18) L1 Virus-like Particle Vaccine in Male and Female Adolescents and Young Adult Women, 118 Pediatrics 2135, 2143-44 (2006).

55 A. Giuliano, Address at Scientific Sessions of the EUROGIN 2008 Int’l Conference: Burden of HPV in Males: Design of an Efficacy Trial of a Prophylactic HPV6/11/16/18 Vaccine Among Men Aged 16-26 Years (Nov. 15, 2008); J. Palefsky, Address at Plenary Session I of the EUROGIN 2008 Int’l Conference: Efficacy in Other Populations: Males, HIV (Nov. 13, 2008).

56 Jane J. Kim et al., Modeling Cervical Cancer Prevention in Developed Countries, 26 Vaccine (Supp.) K76, K85 (2008).

57 Id.

58 See Al V. Taira et al., Evaluating Human Papillomavirus Vaccination Programs, 10 Emerging Infectious Diseases 1915, 1920, 1922 (2004).

59 Amanda F. Dempsey & Laura A. Koutsky, Editorial, National Burden of Genital Warts: A First Step in Defining the Problem, 35 Sexually Transmitted Diseases 361, 361 (2008); Lacey, supra note 5, at S3/37; S Woodhall et al., Estimation of the Impact of Genital Warts on Health-related Quality of Life, 84 Sexually Transmitted Infections 161, 161 (2008). For demographic-related statistics on genital warts in the United States, see generally Thu-Ha Dinh et al., Genital Warts Among 18- to 59-year-olds in the United States, National Health and Nutrition Examination Survey, 1999-2004, 35 Sexually Transmitted Diseases 357 (2008).

60 Anna R. Giuliano & Daniel Salmon, The Case for a Gender-neutral (Universal) Human Papillomavirus Vaccination Policy in the United States: Point, 17 Cancer Epidemiology, Biomarkers & Prevention 805 (2008); Anne Szarewski, HPV Vaccines: Peering Through the Fog, 34 J. Fam. Planning & Reproductive Health Care 207, 208 (2008).

61 Id.

62 Interview with Anne Szarewski, Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, in London, United Kingdom (Nov. 14, 2008).