Posted: October 24th, 2022

The HPV Vaccine

The HPV Vaccine should be available to all Grade 7 students in the public school system without parental consent.
Without parental consent, the HPV vaccine should be made available to all Grade 7 students in the public school system.

Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the United States, according to Agrawal and Morain (2018). HPV can cause certain cancers and a variety of other health problems. Prophylactic HPV vaccination can help prevent infections and diseases caused by specific HPV types like 6, 11, 16, and 18. (Fisher et al.,2020). With the HPV vaccine now available in public schools, there may be an opportunity for health education. Because of the convenience and accessibility for parents and students, administering the HPV vaccine to all Grade 7 students in the public school system would be beneficial to increasing vaccine uptake.
There has long been debate about whether minors need consent to receive medical treatment such as vaccinations. According to Coughlin (2018), there is no legal age in Ontario to give medical consent. If the minor understands and comprehends the benefits, potential adverse reactions, and risks of not receiving the treatment, they can give consent. With these critical elements in place, the provider must assess the patient to ensure they are deemed capable of providing consent by demonstrating decision-making abilities and maturity (Coughlin, 2018).

Vaccine hesitancy remains a growing issue, with potential barriers including misinformation and/or a lack of information, optimism, and cultural beliefs (Agrawal & Morain, 2018). According to Grandhal et al. (2017), the parents who refused the vaccine believe that the risks outweigh the benefits. A parent’s beliefs have a strong influence on how a child makes decisions due to a lack of understanding, which leads to a lack of confidence in providing consent (Fisher et al., 2022)
It has been noted that parental consent for sexual and reproductive treatments can be counterproductive, which is why healthcare providers should respect a minor’s autonomy when appropriate (Fisher et al., 2022). According to Agrawal and Morain (2018), the lack of dialogue surrounding “sensitive topics” such as sexual health causes morbidity and mortality in adolescents, and thus parental consent can become a barrier to accessing treatments that affect both the population and the individual. There is a preconceived notion that allowing the parent to give consent for the minor undermines the individual’s right to autonomy (Fisher et al., 2022). This also creates an impediment to health education. Because of the lack of dialogue, allowing adults to make decisions limits the opportunity to inform minors about the HPV vaccine and involve them in decisions that affect their health and body.
Cervical cancer is the second most common cancer in women and the fifth leading cause of death; thus, research has shown that timely vaccination can reduce HPV-related diseases. Parents who have agreed to vaccinate their child have stated that they trust the recommendations of authorities and want to take preventative measures to protect their child from this disease. According to Fisher et al. (2022), young people can use their power to ensure they receive the HPV vaccine through willingness and advocacy, and thus a young person’s autonomy is important in decision-making. According to Karafillakis et al. (2021), a few subjects believed that the vaccine concerned their own body and that the final decision should be theirs. The subjects understood that by being proactive and consenting to the vaccine, they were protecting themselves and society.
Finally, without parental consent, the HPV vaccine should be offered to all Grade 7 students who are deemed capable of giving informed consent in the public school system. The HPV vaccination can be used as a vehicle to begin empowering students to make more autonomous health decisions. According to Karafillakis et al. (2021), allowing minors to participate in decision-making not only allows them to be autonomous and responsible, but it also allows them to be more informed and aware of their sexual health and body.

References
S. Agrawal and S. R. Morain Who makes the decisions? Adolescent self-consent for HPV vaccination: an ethical consideration. 531, Journal of Medical Ethics, 44(8). https://doi.org/10.1136/medethics-2017-104694
K. Coughlin From infancy to adolescence, medical decision-making in paediatrics. Paediatric Society of Canada https://cps.ca/en/documents/position/medical-decision-making-in-paediatrics-infancy-to-adolescence
H. Fisher, K. Evans, J. Ferrie, J. Yates, M. Roderick, and S. Audrey A qualitative study of young women’s autonomy and information needs in the school-based HPV vaccination program. BMC Public Health, 20, 1-10. https://doi.org/10.1186/s12889-020-09815-x
Grandahl, M., Tydén, T., Westerling, R., Nevéus, T., Rosenblad, A., Hedin, E., & Oscarsson, M. (2017). To Consent or Decline HPV Vaccination: A Pilot Study at the Start of the National School‐Based Vaccination Program in Sweden. The Journal of School Health, 87(1), 62–70. https://doi.org/10.1111/josh.12470
Karafillakis, E., Peretti-Watel, P., Verger, P., Chantler, T., & Larson, H. J. (2021). The role of maturity in adolescent decision-making around HPV vaccination in France. Vaccine, 39(40), 5741–5747. https://doi.org/10.1016/j.vaccine.2021.08.096

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