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对12至13岁的年轻人强制接种人乳头瘤病毒疫苗是否符合伦理道德?

Is it ethical for immunisations against human papillomavirus to be mandatory in young people aged 12-13 years old?

作者信息

Gjika Frenki

机构信息

The University of Buckingham, UK.

出版信息

Future Healthc J. 2024 Oct 25;11(4):100204. doi: 10.1016/j.fhj.2024.100204. eCollection 2024 Dec.

Abstract

The discussion surrounding the ethics of mandatory HPV vaccination for young adolescents aged 12-13 is complex. The human papillomavirus (HPV) is a prevalent sexually transmitted infection with certain strains linked to cervical and other types of cancers. While screening and behavioural interventions play important roles in prevention, vaccination has been shown to provide superior protection, thus reducing the incidence of HPV-related diseases by up to 90%. The effectiveness of the HPV vaccine, particularly Gardasil9, has led to discussions about making vaccination mandatory to improve public health outcomes. However, this raises ethical concerns about parental rights, individual autonomy and the implications of mandating vaccination in the context of sexual behaviour. This paper explores the ethical implications of a mandatory HPV vaccination programme, focusing on the ethical concerns of parental rights, gender equity and socioeconomic disparities. Additionally, the paper considers barriers to vaccination uptake and emphasises the importance of education and informed consent. It will be further discussed that while mandatory vaccination could lead to substantial public health benefits, it must be balanced by respecting individual freedoms and be accompanied by education campaigns. Ultimately, the ethical justification for mandatory HPV vaccination lies in its potential to prevent significant harm and promote health equity across populations.

摘要

围绕12至13岁青少年强制接种人乳头瘤病毒(HPV)疫苗的伦理讨论十分复杂。人乳头瘤病毒(HPV)是一种常见的性传播感染,某些毒株与宫颈癌和其他类型的癌症有关。虽然筛查和行为干预在预防中发挥着重要作用,但疫苗接种已被证明能提供更好的保护,从而将HPV相关疾病的发病率降低多达90%。HPV疫苗,特别是九价重组人乳头瘤病毒疫苗(佳达修9)的有效性引发了关于强制接种以改善公共卫生结果的讨论。然而,这引发了关于父母权利、个人自主权以及在性行为背景下强制接种疫苗的影响等伦理问题。本文探讨了强制HPV疫苗接种计划的伦理影响,重点关注父母权利、性别平等和社会经济差异等伦理问题。此外,本文还考虑了疫苗接种率的障碍,并强调了教育和知情同意的重要性。还将进一步讨论,虽然强制接种疫苗可能会带来巨大的公共卫生益处,但必须在尊重个人自由的基础上加以平衡,并辅以教育宣传活动。最终,强制接种HPV疫苗的伦理依据在于其预防重大伤害和促进人群健康公平的潜力。

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本文引用的文献

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Mandatory HPV vaccination and political debate.人乳头瘤病毒强制接种疫苗与政治辩论。
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The cost-effectiveness of male HPV vaccination in the United States.美国男性 HPV 疫苗接种的成本效益。
Vaccine. 2011 Oct 26;29(46):8443-50. doi: 10.1016/j.vaccine.2011.07.096. Epub 2011 Aug 2.

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