Ethical Issues in Health Prevention Group PPT
Human Papillomavirus Vaccine
USU, FNP 590 Health Promotion, Education, and Disease Prevention Across the Lifespan
Our Group 2 presentation is on the Human Papilloma Virus Vaccine. We will talk about what the HPV virus is, how you contact the virus and can prevent getting the virus, some information about the vaccine which includes some pros/cons and the issues and controversy surrounding it.
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HPV is a group of approximately 150 related viruses that can lead up to 6 different types of cancers later on in life.
HPV is the most common sexually transmitted infection.
HPV appears as skin or mucous membrane growths on the vagina, cervix, rectum, anus, penis, and scrotum.
What is Human Papilloma Virus (HPV)?
HPV is spread from skin to skin sexual contact with someone who has the virus.
HPV is the most common STD. Most people do not know they have it unless they feel or see the skin irritation and see their physician for diagnosis but the lesions usually go away on their own.
How do you get HPV?
The best way to prevent contracting HPV is to avoid sexual contact with someone who has the virus.
The HPV vaccine significantly reduces your chances of contracting the virus.
Prevention of HPV
HPV vaccination
-The vaccine is recommended for children at age 11-12 years old.
-Most children only require two doses of the vaccine when vaccinated before age 15.
-Studies suggest that the protection provided by the HPV vaccine is long lasting. Data from patients followed for 10 years substantiates protection has remained high in those individuals. There has been no evidence of the protection decreasing over time.
-Over 120 million doses of the HPV vaccine have been distributed since the vaccine was licensed, and data continue to show the vaccine is safe and effective.
-HPV infections, genital warts, and cervical pre-cancers have dropped significantly since the vaccine has been in use in the United States.
-Studies indicate there have been reductions of HPV cases due to vaccines:
* 86% among teenage girls
* 71% among adult young women
* 40% among women
The HPV vaccine is recommended for boys and girls at 11-12 years of age but can be given as young as 9 and up to 14 years of age and in 2 doses that are 6-12 months apart. If the vaccine is given after age 15 up through the age of 26, there are 3 doses required. The vaccine is not recommended for people over the age of 26 but can be a discussion with their doctor if they were never vaccinated at a younger age to discuss their risk for contracting HPV and the possible benefits to receiving the vaccine at this time.
It is recommended to receive the vaccine at the younger age prior to becoming sexually active.
The vaccine should not be given to people that have had a prior allergic reaction to vaccines or who are pregnant.
There are 3 different vaccines but the Gardasil 9 is the one given in the United States.
As healthcare providers, it is our job to educate the public on the importance in receiving this vaccine to drastically reduce the risk for developing cancers related to the virus. After 10 years of the vaccine use, there have been an 86 % reduction of HPV cases in teenage girls, 71% in young woman, and 40% is older woman.
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Vaccination
PROS
Science suggests vaccine is safe.
Some vaccines also protect against genital warts.
Three different vaccines to chose from.
The protection from the virus that this vaccine provides could last as long as 10 years or perhaps even life.
No need to receive booster shot for patients who have already been vaccinated for HPV.
Since 85% of people will get a HPV infection in their lifetime this vaccine will prevents against more than 6 types of cancers (ex. throat, cervical, and penile types).
CONS
Specific targeted age range girls 9-13. and boys starting at age 11
For success, the majority of population must be vaccinated creating an herd immunity.
Does not protect against other STD’s.
Does not protect against all HPV type cancers.
Vaccination Risks
Mild/Moderate
Muscle Pain
Nausea/vomit
Abdominal Pain
Diarrhea
Joint Pain
Headache
Slight Fever
Pain at Injection Site
Severe
Premature Menopause
Autoimmune Disorders
Neurological Disorders
Anaphylaxis
Death
Although HPV vaccines are not considered to be riskier than other vaccines, some side effects might deter some potential candidates from obtaining the vaccine. Such as: muscle pain, nausea/vomiting, abdominal pain, diarrhea, joint pain, headache, slight fever, and pain at the injection site. Other potential rare risks include autoimmune and neurological disorders, anaphylaxis and death. Some females who received the vaccine also stated having premature menopause.
7
Previous Reactions
Financial Costs
Infertility
Suspicious Parents
Sexual Relationships Misconceptions
HPV Vaccine - Current Issues
Candidates with previous reactions to compounds found in the vaccine should consult with the health provider and refrain from getting the vaccine. Ingredients include yeast, aluminum, L-histidine, polysorbate 80 and sodium borate.
As with many vaccines, the benefits often outweigh the risks for majority of potential candidates. With prevalence rates for HPV infection being higher among women younger than 25 years of age, family nurse practitioners and health providers benefit from staying up to date on barriers to successful implementation of the vaccine.
In low- and middle-income countries, financial barriers are a common obstacle to successful implementation of the vaccine. Females in these countries also have misconceptions about the vaccine. Some believe that the HPV vaccines may cause infertility and therefore refrain from getting the vaccine.
A study comprised of 29 HPV vaccination programs in low- and middle-income countries also reported that some families viewed vaccination as a permit or approval for young females to start having sexual relationships. Both lack of information and misinformation affected adequate implementation.
In some instances, even providing the vaccine free of charge had its consequences, some parents were even more suspicious when dealing with a free vaccine. The best course of action is for health providers to provide a welcoming atmosphere for patients and their family members. For open dialogue to be an integral part of informed decision making. Providing accurate information for potential candidates and answering parental concerns can help achieve safer vaccine implementation rates.
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People are skeptical the benefits outweigh the risks.
Parents withhold the vaccine due to concerns over the adverse reactions.
Parents believe that the vaccination would encourage young people to be sexually active.
The vaccine is not a therapeutic treatment for HPV-associated disease that may be present at time of vaccination.
Vaccine does not protect against strains of the virus that are not targeted by the vaccines.
Most published data on the vaccine is not provided by independent studies but by the vaccine companies themselves.
Controversy
Resources
Centers for Disease Control and Prevention. (2020, October 29). Six reasons to get vaccinated against hpv. https://www.cdc.gov/hpv/parents/vaccine/six-reasons.html
Edelman, C. L., & Kudzma, E. C. (2018). Health promotion: throughout the life span, (9th ed). Elsevier
Nicol, A. F., De Andrade, C., Russomano, F. B., Rodrigues, L., Oliveria, N.S., Provance jr, D. (2016). HPV vaccines: a controversial issue? Brazilian Journal of Medical and Biological Research. 49(5). 10.1590/1414-431X20155060
Scott, K., and Batty, M. L., (2015). HPV vaccine uptake among Canadian youth and the role of the nurse practitioner. J Community health. 41:197-205. DOI 10.1007/s10900-015-0069-2
Human Papillomavirus (HPV) Vaccines. (2019, September 9). https://www.cancer.gov/about-cancer/causes-prevention/risk/infections-agents/hpv-vaccine-fact-sheet.
Ladner, J., Besson, M. H., Audureau, E., Rodrigues, M., & Saba, J. (2016). Experiences and lessons learned from 29 HPV vaccination programs implemented in 19 low and middle-income countries, 2009-2014. BMC Health Services Research, 16, 1-10.
Shapiro, M. (2020, January 25). Pros & Cons of the HPV Vaccine. Htttps://medshadow.org/pros-cons-hpv-vaccine/.
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