The HPV (human papillomavirus) vaccine and its implementation are hotly debated topics in general and the controversy has by no means escaped the Orthodox Jewish community. For us here at Stern College, this issue is not an insignificant one: for some, this is one of the first independent medical decisions which we are given the opportunity to make, and is something we can all ponder as far as what our attitudes should be for the next generation.
The Stern College student body was lucky enough to be the recipient of a lecture (sponsored by the Biology Club and the Genetics Club) by Dr. Gideon Weitzman, the director of PUAH Institute, a Jerusalem center for reproductive health, on the topic of the HPV vaccine. Such a lecture was not only exciting and useful but also, perhaps, outright necessary. In an informal poll conducted on a small random sample of Stern College students, nearly half of students surveyed reported that they had not received the vaccine and nearly a quarter were still deciding if it was a viable option — and being well — informed is a vital part of making such decisions. But how well-informed are students? Of the polled students who made their own decisions about receiving the vaccine, almost half reported not knowing the scientific background when making their decisions, with that number split 50/50 over whether having known it would have changed their decisions had they known. When polled on whether they believed the HPV vaccine should be mandatory in schools, well over 50% of responders said that they did not feel they had enough information to indicate a position.
Dr. Weitzman began his lecture with the basics—the medical background of the HPV vaccine. HPV is often contracted as a sexually transmitted disease and is generally more likely to be contracted the more sexual partners a person has had. It is nearly impossible for monogamous people to contract it. It is in most cases completely benign and subclinical, merely causing warts and lesions which will completely disappear within several years. However, it can, in a minority of these sexually transmitted cases, then become the cause of over 90% of cervical and other genital cancers and more than five 5% of all cancers in general, earning the title of one of the most significant infectious causes of cancer. 5-10% of women infected by HPV can get precancerous lesions, which can be difficult to detect in advance and can take many years to develop.
It would seem, then, that the natural recourse is to vaccinate — this is one of the very few forms of cancer that we can very nearly prevent, and this vaccine has the potential to save numerous lives. And, indeed, Dr. Weitzman spoke strongly in favor of the safety and effectiveness of vaccination; while many remain fearful of side effects from a vaccine that some believe has not been around long enough that its long-term safety can be accurately gauged, actual recorded side effects have been minimal, particularly compared to the benefits of the vaccination. Since September 2009, of the forty-four reported deaths (of any cause) of women who had received the vaccine, exactly zero had their deaths correlated with receiving the vaccine itself.
From a health perspective, it is clear that the opportunity we have, the ability to actually vaccinate against 5% of cancers, is an extraordinarily valuable one and one not to be squandered. But many, particularly religious conservatives, raise the question: will giving this vaccine, for an illness which is contracted via sexual contact with multiple partners and which is nearly impossible to contract if a person is entirely monogamous, encourage promiscuity by removing a potential barrier? In particular, this vaccine is targeted at young teenagers so that they have received the vaccination long before they are at risk of contracting HPV. Will this potentially life saving vaccination overly condone teenage promiscuity?
For many Orthodox Jews, who know that they will be monogamous, is there a point in receiving the vaccination at all, given the practically nonexistent chance of contracting HPV in a mutually monogamous relationship? On this, Jews consider both the general ethical quandary and potential halachic issues.
On the backs of both the scientific and Jewish perspective then comes the question: how well is the Jewish community doing at raising awareness and sending messages about the HPV vaccine to its constituents? Only about 50% reported getting messages about the vaccine in the general media prior to being asked to make a decision about such an important vaccination. Typically, survey respondents received information about the vaccine from their medical professionals, with more than ¾ getting positive messages about it— and while this is, of course, a valuable resource, in only about 35% of cases did responders feel that their doctors had taken the fact that they were Orthodox Jews into account. Truthfully, it is not the role of the medical professional to factor in all of these seemingly disparate elements for us— as thinking people, it is our responsibility to remain well-informed about the issue and to use this knowledge to make proper judgment calls. The lecture from Dr. Weitzman was, therefore, a valuable first step to ensuring that such complex decisions as deciding whether to get the vaccine and whether they should be mandated by schools are made with full background of the details at play.