Taking Sides: HPV YES: 1. Joseph E. Balog is arguing for a mandatory program for the HPV vaccine.

He would like to see the program implemented because he feels that it would do us, as a society, good in terms of preventing the HPV disease and cutting down the risk of contracting cervical cancer from the disease. 2. Beneficence- A party fighting to create a vaccination program to reduce the risk of HPV among young people. Malevolence- A party fighting against the medicine that could reduce the risk of HPV or just choosing not to provide the medication at all. Autonomy- They are not trying to take away the parents rights to making decisions for their children, but rather making sure that that the vaccination is made available to all. Justice- Making the vaccine equal to everyone, regardless of their age, race, religion or any social factor would only be fair. 3. If the vaccine is effective, having a mandatory vaccination program could lead to eradication of that disease. A vaccination program would be best for those who may not be able to provide/afford the best healthcare. Creating a mandatory program for vaccination would be more effective than abstinence programs and communication. 4. Trying to prevent sexual activity in teen age youth through abstinence programs or sexual education is completely unrealistic and not effective. Parents discussing and communication with their children about sexual issues is also not effective. Because we know the vaccine would be effective, it would be better to make it mandatory instead of assuming the programs or communication are working. 5. An effective screening for cervical cancer already exists, but combining that with the vaccine would reduce the rates even more and would be a valuable tool in fighting a type of cancer. No imminent harm exists, but there are already some mandatory vaccine programs in place for diseases that have low imminent threats. It is not right to withhold treatments that prevent disease and/or death. 6. Regarding his opinion on autonomy, parents who are against this vaccine, or vaccinations altogether, would feel as if the authors proposal for this vaccine is infringing on their rights as parents to decide the best solution for their children. Young people are faced with the chance of contracting STDs or cancers are in need of this vaccine just as much as children who faced Polio, but some would argue against this believing that these two diseases cannot compare and they have two completely different outcomes.

NO: 7. The authors of this article are arguing against mandating the HPV vaccine mostly because they feel there is not enough evidence showing the effectiveness and safety of the vaccine. HPV is not a disease that they feel has proven it needs a mandatory program yet. 8. A. Long Term Safety and Effectiveness of Vaccine is Unknown- Although the vaccine was clinically tested with women and girls before it was released, you cannot possibly see all of the adverse consequences that could occur in the future. This vaccine is fairly new. Enough time has not gone by to see if its immunity will hold up for a long period, or if the dosage interval is the most effective. B. Historical Justifications for Mandated Vaccination Are Not Met- HPV is not like other diseases that require vaccinations. It does not risk whole populations like polio, small pox or Hepatitis. It is not immediately life threatening. C. In the Absence of Historical Justification, the Government Risks Public Backlash by Mandating HPV Vaccination- The fear is that mandating this vaccine will push people away from getting vaccines altogether. They could feel that the government is trying to control their rights as parents to make the best choices for their children. 9. Vaccines have a protective effect not only for the person who received the vaccine, but also for society as a whole. Many of the vaccines we have today have fit into the public health necessity principle and are considered justified. Cost for the government, medical staff and public is a consequence that should be considered before mandating vaccinations. 10. Providing information and education about the vaccine to the public could increase interest in the vaccine and also decrease the chance that people would reject it. The opt-out provision could potentially have an effect on other mandatory vaccine programs. 11. The authors are not saying no to the use of the vaccine for teenage girls and they are not disputing that it appears to provide protection against cervical cancer. They are only arguing against making the vaccine mandatory. 12. If people could use the opt-out option, it could help with the pressure the public may feel from the vaccine program. However, this may cause problems with other vaccine programs. People may feel that they can opt-out of other vaccine programs and not get vaccinated for diseases that are life threatening and put the public at risk. 13. I believe the NO argument was the most evidence based because their argument was more history based. I dont believe that any of the authors were biased. They both argued their sides well.

14. I feel that the NO argument is the most correct. Before I read the article I thought I would be for the YES side, because I felt that if a vaccine could help prevent cancer then why would you not want that? However, after reading both arguments, my opinion has somewhat shifted. In the no argument, the authors state that pushing the HPV vaccine may lead people to push back against vaccines altogether. I personally am not okay with that since HPV is not a disease I would consider crucial to vaccinate against. Diseases like measles, Hepatitis, rubella and mumps are much more common and contagious and pose a significant threat to the public. I think it is important that we maintain the current mandatory vaccinations for those diseases. I do think that educating is the best. If more people are educated about the vaccine and do not feel pressured to get it, then more people may decide that it is a good idea and they will get the vaccine on their own. 15. The HPV vaccine obviously will not be effective for boys in terms of cervical cancer. I think even more people would be against making it mandatory for boys for that reason. It would almost seem pointless. For the virus itself it could help them as well. However, making the vaccine mandatory for boys will have the exact same effect that it is having for the girls. The public does not like being told or forced to do certain things. 16. I DO believe the flu shot should be mandatory. Health officials have told us that the flu is potentially dangerous to all ages, no matter if you have great health or not. It could affect everyone. I think for the most part people are willing to go and get a flu shot. There are a certain few who still have the radical opinions that the flu shot actually causes the flu and that any shot you receive causes autism in children. It is not mandatory, but is strongly recommended. I think that people are willing to get one for that reason and they want to be protected against something that is so widespread. I think the herd immunity theory can apply here. Quite a few people receive flu vaccines. That vaccine could protect not only them, but others around them.

Reflection: As far as the feelings toward vaccinations, I have always known that people have different opinions about them. Some believe that they are a necessity and others do not, whether its because of religious beliefs, political beliefs or because they believe it causes autism. I was, however, surprised to learn about the opt-out policy. I did not know this existed. I assumed that people had to have a really good reason to opt out of vaccinations because some diseases do pose such a great threat to the public. I would hope that opting out does not become a popular trend and people just decide that they do not need these vaccinations. I have noticed as I have read the book and articles, including this one, that I pay more attention to these stories regarding health and disease. Ive increased my knowledge regarding health subjects and I also try to think outside the box when it comes to debates like this.