Minor Teens Shouldn't Need Permission to Get the HPV Vaccine

Arthur L. Caplan, PhD


August 16, 2019

This transcript has been edited for clarity.

Hi. I'm Art Caplan. I'm at the Division of Medical Ethics at the NYU School of Medicine.

I heard about a case recently of a young man (I believe he was 17) who went to his doctor and said, "My parents don't approve of the HPV vaccine" — the vaccine that prevents cervical cancer, oral cancers, anal cancers, and genital warts.

He said, "They are anti-vaccine and they don't want me to get it. Would you give it to me?"

That raises a number of very interesting questions and challenges. Normally, parents have to give permission, both ethically and legally, to a minor child getting medical care. That's not a solid line because there are some exceptions. For example, a woman who's pregnant does not need to go to her parents to get medical care or to seek out an abortion if she's 16 or 17 years old.

Reproductive issues allow young people under the age of consent to use medical services — contraception, for example — without parental permission. We have carved out a special area where teenagers can get medical care and treatment without permission of their parents, and they swirl around reproduction.

Interestingly enough, though, so does the HPV vaccine. That virus is transmitted sexually. Boys can be carriers; they can also get both oral and anal cancers. Women, obviously, can get the cancer through sexual transmission.

The question about whether you should give the teenager the vaccine is perhaps better addressed by saying we ought to consider the HPV vaccine as part of reproductive health; therefore, we should extend the same rights to teenagers as we do for other reproductive health services.

In the case of the physician, I'm not sure what state he or she was in. I'm not sure whether anybody would recognize the HPV vaccine under this particular area of reproductive health services. I probably would have given the vaccine. It's an ethical choice and I would have taken my chances with the parents.

I think it would be better if we got states to include the HPV vaccine as part of their exemptions that don't require parental permission. Many states are considering making these changes. The American Medical Association has announced that it supports making this change, and I fully support the change as well.

This is a way of preventing cancer that's acquired through sexual contact. We've got the vaccine, it's safe, and it's effective. Recent studies show no problems with the safety of the vaccine. In Australia, England, and even Rwanda, huge reductions have taken place when HPV vaccination has been pursued aggressively.

We should be doing that too. If this teenager is smart enough and savvy enough to want to protect himself and his partners, I think that ought to be honored.

I'm Art Caplan at the Division of Medical Ethics at the NYU School of Medicine. Thank you for watching.

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