強制接種HPV疫苗與相關政策辯論【全球瞭望】
Mandatory HPV Vaccination and Political Debate
在2006年人類乳突病毒疫苗陸續獲得美國食品藥物管理署核可上市後,對於是否應該透過立法來強制接種人類乳突病毒疫苗,美國社會有相當激烈的政策辯論。保守宗教團體除了認為政府的強制措施,將鼓勵青少年提早進行性行為、侵害家長的親權行使外,甚至由於疫苗藥廠的強力立法遊說與對政治人物的獻金,使得公眾對於立法者的公正性、疫苗的有效安全性產生質疑。另一方面,許多醫學與公衛專業團體基於實證數據,相信該疫苗能有效預防人類乳突病毒病毒的感染。但同一時間,該政策所引發的性別平等、醫療成本等問題,更讓疫苗政策的利弊得失變得複雜。本文認為,政府應該投入經費來推動人類乳突病毒疫苗接種,並將其列為性行為傳染病預防政策的一環。假使自願疫苗接種政策不成功,政府應考慮以強制接種的方式來推動。但如何透過衛生教育與社會遊說來獲得社會信任,也須將其一併納入考量。
When the U.S. Food and Drug Administration (FDA) approved a human papillomavirus (HPV) vaccine in 2006, American society had a fierce political debate about whether to enact a compulsory vaccination law as a public health intervention. It was not only the conservative religious groups strongly opposed the mandate, arguing it would condone premarital sex and undermine parental rights, but also the public had doubts about lawmakers’ objectivity as well as the safety and effectiveness of the vaccine, due to the lobbying and political donation from the vaccine manufacturer. On the other hand, numerous medical and public health organizations endorse HPV vaccination for young women, believing the clinical trial evidence has shown that the vaccine is almost 100% effective in preventing infections associated with HPV types included in the vaccine. However, the vaccine implementation aroused debates about gender equity and health care cost and made the situation more complicate. This article argues that governments should commit sufficient funding to increase HPV vaccination rates as part of a comprehensive sexually transmitted infection prevention package. If voluntary vaccination proves unsuccessful, governments should consider compulsory vaccination laws seriously, but how to retrieve public trust through health education campaign and social marketing should also take into consideration.
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