Abstract
Recently, scholarly studies revealed that a single-dose immunization against Human Papilloma Virus (HPV) vaccine might be as effective as three doses. The purpose of this paper is to examine the recent studies relative to single-dose HPV vaccines. Existing guidelines recommend three doses of the HPV vaccine over a 12-month period to be administered between the ages of 9-26 years of age. Details about the need for mandatory implementation of the HPV vaccine for all adolescents are also provided. The research findings suggest one dose of the HPV vaccine could be a reliable alternative to the current 3-vaccine series. Also, the single-dose option for the HPV vaccine are discussed and tested to ensure the effectiveness of a single dose. The HPV vaccine will prevent the negative consequences associated with the virus. The vaccine is important because it is a prevention measure against HPV which places one at risk for cancer. One of the adverse outcomes of HPV contraction is cervical cancer which is often fatal. At this time, the vaccine is not considered mandatory in New Jersey. This vaccine is recommended for the New Jersey citizens, meaning that they are not obliged to be vaccinated but can choose it as an option.
Legislative Issues in Healthcare
The Human Papillomavirus (HPV) is a significant cause of morbidity and mortality worldwide. Scientific research has documented evidence of cervical cancer and genital warts as the result of the virus (“How many cancers are linked with HPV each year?”, 2019). Recently, researchers have conducted studies that demonstrate the effectiveness of a single dose of HPV vaccine immunization schedule. These changes should be considered by the state of New Jersey in addition to policies that would mandate the HPV vaccines that are now recommended. However, efforts to mandate this vaccine for school-aged children has been met with mixed emotions. This paper serves to provide information about the HPV single-dose vaccine option and current efforts to mandate the vaccine.
Current Public Health Issue of HPV
There is no effective treatment for human papillomavirus that would ensure the absence of the disease. Instead, doctors and professionals can provide protection against HPV prevent HPV infection in 90% of the. The administration of the HPV vaccine depends on a person’s age, diagnosis, and the presence of lesions of the virus. The Advisory Committee on Immunization Practices (ACIP) regulates and specific schedules for immunization through the lifespan (“Human Papillomavirus,” 2019). The current recommendation is that children receive the initial dose of the vaccine at the 11 or 12 years of age, however, some children may receive their first dose as early as 9 years-of-age (Persichilli, 2019). The ACIP recommends two doses of vaccine prior to the 15th birthday. For adolescents and adults, who initiated treatment after the age of 15 or who have a weakened immune system, a 3-dose schedule is recommended (Persichilli, 2019).
Recently, the ACIP approved several new recommendations for HPV immunization including a “catch-up” dose for males until the age of 26 years (instead of 21 years), and vaccination of individuals aged 27 to 45 years of age based on “shared clinical decision-making.” (Human Papillomavirus, 2019). Over the past year, the committee has also discussed the possibility of revising the dosage number from three doses to one dose as a result of the new research findings on the effectiveness of one treatment for HPV prevention (“Human Papillomavirus,” 2019). In a study by Meites et al. (2019), the researchers report that the current coverage with more than one dose of vaccine was 65.5%, meaning that more than fifty percent of people aged 13 to 17 years in the US received the vaccine, which resulted in significant declines of HPV lesions (Meites et al., 2019). Therefore, since the vaccine proves to be effective, based on the results of the discussed study, it is possible that ACIP might revise its recommendations regarding HPV vaccination soon.
Political Influences and Health Development Opportunities
The legislative changes may significantly influence the healthcare sphere and regulatory movements. One can assume that the government will continue to play a role in compliance with the quality and efficiency of the HPV vaccine. Researchers also suggest that political authorities, agents, and health care workers have power in the healthcare service delivery that can result in both positive and negative effects for individuals that require assistance (Gore & Parker, 2019).
When considering HPV, the Centers for Disease Control and Prevention (CDC), establishes guidelines that regulate getting mandatory three doses of the HPV vaccine (CDC, 2020). However, Bacalar (2020) indicated that that only half of the adolescents received all the required doses to be protected against HPV. Therefore, it can be assumed that there might be changes to health policies with respect to the for HPV to make the vaccination a mandatory procedure (Bacalar, 2020).
Overall, there are multiple health policy development opportunities in a medical environment that can be opted for in the future. Health policy analysis and evidence-based document provision, as well as learning from experience, discussed by scholars, can contribute to the development of solutions to address the challenges of the HPV vaccine (Pillai, 2016). In-depth medical assessment methods, scientific-based healthcare services, and consistent policies are seen to be promising opportunities for health policy development.
Advocacy of Authorities on the Issue
The issue of HPV among professionals, authorities, and healthcare specialists is often debated. As HPV might cause various types of cancer, authorities view HPV vaccination as an effective method to prevent such consequences (“HPV vaccine: State legislation and statutes S 1163,” 2018). However, school vaccination regulation in the US depends on the individual choice of states, which presents a problem. Some professionals who advocate vaccination, do not support providing it at schools because of medication costs, parental refusal, and safety. While others have objections against the required immunization for a disease (“HPV vaccine: State legislation and statutes S 1163,” 2018). Parents believe that children who receive the HPV are giving tacit approval their children to engage in sexual activities. Educating the parents that there is no cure to HPV, but there is a prevention measure that can prevent cancer, in the future, may provide them with a better understanding of the long-term benefits of the vaccine. If all the states in the country mandate the HPV vaccine must also address the issue of financing the vaccination for all individuals. It is believed that funding of this mandated vaccine must involve collaboration among government-based insurances, for example, CHIP and Medicaid. The planned financing must include uninsured youth, as well as challenges that necesitate coverage by insurance plans (“HPV vaccine: State legislation and statutes A 1847,” 2018). Funding issues have caused further debate on whether or not the vaccine should be mandatory for the population.
The Centers for Disease Control and Prevention (CDC) reported the Federal Vaccines for Children (FVC) program ensures that all states in the US have access to the HPV vaccine (HPV vaccine: State legislation and statutes S 1163, 2018). Also, in 2019, some states discussed the option of introducing bills that would obligate parents to begin the HPV vaccine series before entry to school starts, which means that the legislators may revise the initial age at which the vaccine can be administered. However, these bills are not enacted yet, and the deliberation continues among the legislatures (“States seek to increase HPV vaccine,” 2019). In New Jersey, the new law (A 1847) was recently introduced, and required HPV vaccination become mandatory for children from six to twelfth grades (“States seek to increase HPV vaccine,” 2019). Thus, the discussion on immunization continues to be a controversial topic for states and regulatory committees.
Current HPV Vaccine Research
There are emerging studies that may disrupt the current system of HPV vaccination established by authorities. Some studies report that one dose of HPV vaccine versus three doses might produce the same results against HPV-related issues (Bacalar, 2020). Researchers in the US who studied women aged 18 to 26 years, discovered that one dose of the vaccine might provide enough protection against HPV (Sonawane et al., 2019). Scholars revealed that, based on the evidence, there was no substantial difference in the level of HPV prevalence of those women who received one dose or three doses (Sonawane et al., 2019). Other studies that the regulatory committees relied on upon suggest that three doses of the HPV vaccine demonstrated significant efficacy against various types of HPV related illnesses (Meites et al., 2019). Overall, the evidence on the effectiveness of three doses persists because there insufficient studies validate its efficacy.
Scholars continue to engage in the further development of the HPV vaccination and discussing the possibility of getting one dose of medication instead of three (Brotherton et al., 2019). A scientist from Australia based the one-dose vaccine on the results of a human clinical trial. The data supported one dose of the “quadrivalent HPV vaccine” as a sufficient substitute for two or three doses when targeting cervical diseases (Brotherton et al., 2019, p. 8). Researchers also revealed data from two cities each located in Quebec and Mexico demonstrated successful implementation of two doses usage and omitting the last dose or using it only when urgently needed (Brotherton et al., 2019). While others are focused on finding a therapeutic vaccine that would be focused on cancer prevention among women who already had HPV previously (Hancock, Hellner, and Dorrell, 2018).
Finally, there are both pros and cons of three versus 1-dose of the vaccine. On the one hand, three doses improve the efficacy of the vaccine against HPV infection, whereas side effects might be a drawback of multiple doses of the vaccine (“Human Papillomavirus (HPV) vaccine,” 2019). On the other hand, one dose may be as effective as three doses, implying substantial cost savings for states that consider making the HPV vaccine mandatory for the population (Safaeian, Sampson, & Pan, 2018). The findings by Brotherton et al. (2019) suggest that one dose could have almost the same effectiveness as three doses when preventing high-grade disease in high coverage settings. This points to the possibility that one vaccination could be a viable strategy when working toward eliminating the adverse effects of HPV. However, the one-dose option requires further research prior to being integrated into current healthcare practices.
Pushback from Anti Vaxxers
One one hand, the prevention of HPV is essential and can save lives, while on the other, it is against the civil liberties to impose the requirement of mandatory vaccination on people, providing an ongoing debate about this issue and ways to resolve it. The reason why this vaccine was met with push back is that there are beliefs and fears that vaccinations are dangerous and can cause severe health damage, especially when administered to children. Despite the fact that HPV can cause cancer and the CDC’s recommendations, some people choose to avoid the vaccinations (“HPV vaccine: State legislation and statutes S 1163,” 2018).
As Smith (2019) points out, “the safe, heavily researched HPV vaccine remains tragically under-used — and anti-vaccine movies and conferences could make it more so if we’re not careful” (para. 1). The anti-vaxxers movement has gained a significant following in the United States over the years, although the main issue with this community remains unresolved – they often rely on misinformation and overlook research and other evidence that support the safety of HPV vaccine. Smith (2019) also points out that authoritative figures, such as Robert F. Kennedy, Jr., the son of Robert F. Kennedy, are supporters of the anti-vax movements. This gives more credibility to the movement itself and the claims made by its supporters, which further spreads misinformation. Kenedy has recently published an article with 25 reasons why people should avoid the HPV vaccine (Smith, 2019). Moreover, the community has already prepared a documentary that specifically targets HPV vaccination and why people should not do it. Therefore, the HPV vaccine faces a lot of push back from the anti-vax community.
One aspect that guides the anti-vax movement in their goal of discrediting the HPV vaccine is the question of morality and ethics regarding the mandatory administration of the vaccine. The issue of civil rights and the right of parents to choose whether their child receives a vaccine or not becomes a center of discussion for HPV prevention. As Smith (2019) points out, the anti-vax movement no longer claims that vaccines are harmful because they can cause Autism. They focus on other aspects, such as civil liberties, and the right of parents to discuss sex with their children when they decide and not when the child gets vaccinated. Therefore, the members of the anti-vax movement promote the argument that this vaccine will force the people to have discussions about sex with their children at an early age, even if the former want to postpone the discussion.
Conclusion
In conclusion, recent studies regarding HPV may alter the view of regulatory organizations about the HPV vaccination recommendations. The states may reconsider their healthcare policy based on current evidence that improve safety and quality and decrease the costs. Reliable data on HPV vaccination is essential to persuade organizations to change the strategy for HPV immunization mandates. However, it is imperative to ensure that the challenges of financing are addressed because they represent the key limitations for making the vaccine mandatory for the population.
References
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