PoPulationand Public HealtH etHics

Case discussion in response to
scHool baseD HPv vaccination For
girls in ontario
Laura Shanner, Ph.D.
John Dossetor Health Ethics Centre, University of Alberta
Edmonton AB
lsHanneR@ualBeRta.Ca
Introduction
Ontario’s HPV vaccine program raises more ethical issues than can be considered
fully here. Fundamental justification for vaccination programs and
competing visions of fair allocation are complicated by issues of socio-economic
and gender justice in both the impact of HPV infection and marketing
strategies for such a vaccine. Further, any topic involving adolescent sexuality
typically challenges social, personal political, and ethical norms, making
HPV a focus for broad, multi-layered discussion.
Infectious diseases make all of us stakeholders, although those most at risk
and/or most severely affected — in this case, marginalized and low-income
women — might be considered primary stakeholders regarding both the risks
of illness and the risks of stigma, side effects and coercion in the use of a vaccine.
Because the HPV vaccine is targeted to minors, parents should be the
primary decision makers. Taxpayers and the governments that represent them,
as well as third-party insurers, are stakeholders regarding health-care costs
for both prevention and treatment of HPV-related illnesses. The manufacturer
has an unambiguous financial stake in increasing the sales of the product.
Foundations of public health ethics
The ethical justification for vaccination programs may focus either on autonomous
choices regarding risk exposure and self-protection, as reflected
School Based HPV Vaccination for Girls in Ontario
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