I donāt really like wading into debates, but I see a lot of misconceptions here that need clearing up.
Hereās the thing. If parents refuse to allow their child to be vaccinated for a preventable illness, then the responsibility lies with them if their child catches an illness as a result of that action. They chose to against medical recommendations. Until a child is old enough to choose to vaccinate themselves, they unfortunately have no say in the matter as they likely canāt run off to get themselves vaccinated. The fact that itās sexually transmitted doesnāt lessen the fact that parents could have chosen to protect their kid against an illness, and actively chose not to. Whatever their reasons were, they were almost certainly misguided even if they were well-intended.
Iām not here to debate abstaining from sex; thatās a personal decision on an individual basis, and as far as Iām concerned nobody has any right to tell other adults to have sex, or not to have sex. There isnāt the same culture of āno sex before marriageā in the UK as there is in the US, so this hasnāt really been as much of an issue here in the UK to the same extent.Ā Even in the US, only 3% of people āwait til marriageā. Thatās a relatively tiny proportion of people compared to the number who might therefore be exposed to HPV.
So, yes, in reality you should assume that almost everyone is having sex before marriage, and plan health strategies in order to protect those people.Ā I donāt understand the assertion that because itās āonlyā transmitted sexually, HPV is not important to protect against, when the vast majority of young people have sex. It is absolutely important to protect against, because almost all people will be risking exposure at some point. There is no cure once youāve been infected with HPV, and no current way to stop it continuing to cancer in some unlucky individuals.
But putting that aside, we donāt base health policy on religion. You canāt base healthcare initiatives on āidealā behaviour, because people donāt just do what others tell them to do. People do all sorts of things which lead to difficult consequences. Our job in medicine is to work with human nature and with the reality as best as we can.
The reason people vaccinate against HPV at a young age isnāt because doctors believe all the 13 year olds out there are having sex; research suggests that in the UK at least, the most common age range young people lost their virginity wasbetween ages 16-18 (our age of consent is 16).Ā But you donāt give a vaccination AFTER you think most people will be exposed to it; itās most effective if you can vaccinate children before the vast majority needed.Ā Nobody is advocating that children should be having sex, but itās absolutely important to protect the ones that are; if a child is being abused or taken advantage of, having transmissible diseases to add to their problems doesnāt help.
Weāre not just talking about very young kids; the aim is to protect teenagers of an age where they are making their own choices. I agree that for most teenagers, empowering them to understand the risks associated with sex, and encouraging them to wait until they are truly ready is important; it isnāt something youngsters should be falling into lightly or through peer pressure. But In reality, no matter what we do as a society, and no matter how well you try to guide them, some youngsters are going to have sex, and the only reasonable and sensible thing you can do to stop some of them getting cancer is to vaccinate them all beforehand. Thereās a whole other discussion to be had about how we can empower children to understand their body, understand their owndership of it, and assert their right to choose for themselves what happens to it, and the roles that sex education plays in keeping them safe. Thatās beyond the scope of this discussion.
However well-intentioned the advice above may be, itāsĀ entirely misguided. Absolutely donāt wait until your children are having sex to say āwell, if you wonāt stop, then you might as well have the vaccineā ; by that point your kids could very easily have been exposed to the virus, rendering vaccination potentially pointless.Ā This is why in the UK catch -up vaccinations only went up to certain ages when they introduced the vaccine; by a certain age, they had worked out that so many youngsters would have already been exposed to the virus, making it ineffective to vaccinate people at that age because it would save less people. Personally, I think they could have extended it further to save more lives, but it proves the point that thereās such a thing as vaccinating a population too late.
Arguably, the most responsible thing would be for any parent to realise that despite what they might teach their kids, their kids will make their own decisions, and sometimes their own mistakes. And that if they can take the steps now to minimise the impact those decisions or mistakes could have on their children, then perhaps that is the wisest path.
I donāt want my future kids having unprotected sex at that age because I donāt think most are ready for it, but I certainly donāt want them to get cervical cancer and potentially die 10 years later because I was too prissy to vaccinate them at 13 because the idea that they might one day eventually be sexual beings in their own right freaked me out as a parent. Iād want to arm them with everything I could. We donāt say that wearing seatbelts encourages reckless driving, why should this be any different? Being a parent is stressful enough, think of it as one more worst case scenario that can be removed from that list.
It doesnāt even need to come across as condoning sex before marriage, if thatās what parents are worried about. Itās not hard to explain in a child-friendly way; something like āThere are some illnesses that are passed on when people who love each other and are married make love, and this vaccine protects against one of those, so when you are a grownup you will be safeā. Though Iād like to point out that we only vaccinate against rubella because if someone catches it when they are pregnant, it can harm the foetus. And nobody seems to mind that.
Itās also misguided for anyone to suggest that getting vaccinated against the pathogen will make youngsters run out and have more sex; if the idea of getting HIV and having a baby donāt frighten people off having unprotected sexĀ (and apparently, for many people, they donāt, or nobody would have unprotected sex), one more illness isnāt going to scare them off any more. People have been having sex, since the dawn of time, despite being ostracised or facing death penalties; whilst individual people may be very good at making a decision and sticking to it, as a group most decide to take part in an activity that is normal, pleasurable and which they feel a strong biological urge to do. Most people have sex. And we have to work to protect the people who do.
Itās also dangerous to say that cervical cancer is ārareā it really isnāt, and it disproportionally affects young women. More than half of the cervical cancer cases in the UK each year are diagnosed in women under the age of 45.Ā Incidence rates for cervical cancer in the UK are highest in females aged 25 to 29. It represented 2% of new cancer cases in the UK.Ā Worldwide, more than 527,000 women were diagnosed with cervical cancer in 2012. But most importantly, almost all cases are preventable.
