Qualms about HPV Vaccination
Here are a few data points about negative attitudes towards HPV vaccination:
A 2010 survey of 2000
parents in British Columbia found
so Gardasil was somehow less well accepted than the vaccine for another
sexually transmitted disease.
Main reasons for NOT having daughter receive HPV vaccine (n = 697):
- 65% reported their daughter had received first dose of Gardasil
- 88% reported their daughter had received the vaccine for Hepatitis B
- 209 (30.0%) Safety of the vaccine
- 110 (15.8%) Prefer to wait until daughter is older
- 87 (12.5%) Not enough information to make an informed decision
- 50 (7.2%) Vaccine is too new
- 37 (5.3%) Daughter not at risk of cervical cancer
- 18 (2.6%) I do not believe in vaccines, HPV no different
- 17 (2.4%) My physician advised me not to have daughter receive it
- 14 (2.0%) Daughter is too young
- 13 (1.9%) More research needed
- 13 (1.9%) Daughter is not sexually active
- 12 (1.7%) Vaccine is a ploy by pharmaceutical company
- 11 (1.5%) Consent will encourage sexual activity
- 10 (1.4%) Will educate daughter on abstinence and safe sex
- 10 (1.4%) Too many needles
- 86 (12.3%) Other
- A 2005 study of Seattle parents
found that providing detailed written information about HPV risks and the vaccine had no
effect on parents' decision whether to vaccinate their children.
Core vs. Non-Core Reasons
People who decline vaccination may have several reasons of varying
strengths, i.e. some of their objections may go away once they
know more, while others may be so strong that no amount of additional
knowledge can change them.
Here are a few of what seem to the most frequent core, or very strongly
held, reasons some people object to HPV vaccination.
Conservative Attitudes towards Sex
As a sexually transmitted virus, HPV seems to push some peoples' buttons.
A 2003 survey of
found 50% believe it is a sin for unmarried teens to have
7% feel that sex education should not be taught at all in schools,
and 7% feel that girls really will wait until 18 or marriage to have sex.
These attitudes may have evolved over the aeons to protect against disease;
see this excerpt
"Evolution, Culture, and the Human Mind"
These people are likely to be uncomfortable with children, especially girls,
being vaccinated against HPV.
Here's an example blog post:
In all the commercials I have seen for this GARDASIL and
HPV, never once have I heard or seen them talk about abstinence as
the number 1 prevention technique against HPV and cervical cancer.
Instead, the "One Less" campaign is about getting an unnecessary
vaccine, which won't give you 100% protection, so all these so-called
strong, responsible women can still go around having promiscuous
i.e. people who do not expect their children to be having sex may believe
that their children are not at risk for HPV, and therefore do not need the
Here's an example post from a Christian anti-abortion/sexual sin site:
Giving this vaccine to girls...
suggests to our daughters that we expect them to be sexually active
and that we condone such behavior. (The detrimental affects of
communicating such values to our children is an important component to the
STD epidemic as well as the high number of pregnancies outside of marriage
and the occurrence of abortion.)
i.e., people who believe that premarital sex is a sin may not welcome
premarital sex being made safer.
Mistrust of Medical/Scientific Establishment
Trust is a fragile thing. A safe, effective, and ethical vaccine
can quickly become unpopular if enough people claim it is unsafe.
And searching the web for gardasil and depopulation, nazi, or gestapo finds
a disturbing number of hits, so there is already quite a bit of distrust out there.
A wave of public concern about vaccines in the late 1970s and early 1980s
led to the creation of the current systems for ensuring vaccine safety
the CDC's page,
History of Vaccine Safety).
"Could it happen here? Vaccine risk controversies and the specter of
(Health Aff., 2005) describes the fall and rise of trust in the MMR vaccine in England over the last decade, which might have some lessons for today.
2011 NIH talk about vaccine education has some tips about how and
how not to try to educate people about vaccine safety.
His book, "Deadly
Choices: How the Anti-Vaccine Movement Threatens Us All",
may also be of interest.
Failure to correctly understand risks
Skeptical Mothering writes,
people aren't really experienced with comparing really small probabilities.
Vaccine information sheets say something like "very small chance of injury
or death", but that sounds scarier than the average person's
personal knowledge of the disease the vaccine is supposed to prevent,
so unsurprisingly many people decline the vaccination.
This is an innate human feature, so it's "core" in that sense,
but it might be more amenable to education than the other reasons listed above.
Incompatible Belief Systems
are non-evidence-based belief systems which reject mainstream science
and/or medicine. People who subscribe to these belief systems
may bring up numerous objections to vaccination, but even if all
of these objections are disproven, they will continue to object
to vaccination simply because it's based on conventional medicine.
There are many web sites that oppose vaccination and endorse naturopathy and homeopathy. For instance:
The National Vaccine Information Center,
a nonprofit organization, was formed in 1982 during a
national wave of anxiety about the safety of the whole-cell DTP vaccine.
Their page about HPV
contains anecdotal accounts of vaccine reactions, links to press coverage
of the issue, and some links to government resources.
Sane Vax Inc was formed in 2010 during the current wave of anxiety about
HPV vaccines. Its position is that Gardasil is unsafe, and should be
removed from the market.
Mike Adams produces
videos claiming that HPV does not cause cervical cancer.
His web site, Natural News, is frequently updated with non-mainstream
news stories, and sells many alternative medicine
products, as well as his motivational book, "The 7 Priciples
of Mindful Wealth".
He doesn't seem to like skeptics.
The web sites of both NVIC and Sane Vax feature pictures and stories
of girls who are said to have been injured by vaccination.
Mistrust of Government
Some people believe the government should not be involved in
healthcare. These people are likely to view public vaccination
campaigns with suspicion, and may welcome reports that government-funded
HPV vaccination is unsafe.
Several organizations encourage people to oppose government-funded
or government-mandated HPV vaccination. For instance:
was formed in 1994, and claims to be a conservative, non-partisan organization.
As a mostly political organization, science and medicine are not
their main fields of interest, but they have taken an interest in Gardasil.
Curiously, they sued the government
for HPV-related records already publicly available from
VAERS, and filed press
releases touting their efforts.
See Henry Bauer and HPV.
Some people try to draw conclusions from insufficient data. For instance,
page points to the ATHENA study and says
The authors reported that in a sub group of 12,852 young women, the HPV
vaccine reduced HPV-16 infections only 0.6% in vaccinated women vs.
Even that little quote contains three errors:
only about 1100 vaccinated women were in the study, not 12,852;
the vaccine reduced HPV-16 infections from 8.7% to 8.1%, which is more
accurately described as an 8% drop, not a 0.6% drop;
and the data not statistically significant.
Also, the study was not designed to test whether the HPV vaccine
worked, so it did not control for the age at vaccination.
Studies of vaccine refusal:
There are several blogs that critique the anti-vaccine movement from a
scientific point of view:
There are others; try searching for gardasil on The Skepticator.
Other pages/sites/books that touch on the subject:
- A case study: the HPV vaccine disaster (Science of Science Communication Course, Session 1)
- A taxonomy of
reasoning flaws in the anti-vaccine movement. [pubmed 17292515, text]
"Cultural Perspectives on Vaccination"
"History of Anti-vaccination Movements"
at History of Vaccines
- RH Reality Check's HPV topic page
Epidemic of Fear: How Panicked Parents Skipping Shots Endangers Us All",
Amy Wallace, Wired October 2009
- InformationIsBeautiful - graphical presentation of HPV vaccine safety data
- The National Network for Immunization Information provides
comprehensive science-based information about vaccines, including a list
of the vaccination requirements for each US state.
Hospital of Philadelphia's Vaccine Education Center
- The Vaccine Wars - Frontline documentary on the subject
Medical Association Position Paper on HPV Immunization, 2007; the CMA
finds Gardasil safe, effective, and ethical, but opposes any school mandate
- Gardasil: What About the Boys?
(in "Science in Service of the Pro-Life Movement", 2011)
bioethical perspectives on Ontario's HPV vaccination (in "Open
HPV Vaccine--Not For "Little Girls"? (in CatholicMom)
Copyright 2011, 2012, 2013 Dan Kegel
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