The Guardian reports that some English schools are opting out of HPV vaccination programmes because their pupils, say the schools, “follow strict Christian principles” and “do not practise sex outside marriage”. As Bernard Lo wrote in the BMJ about the HPV vaccine: “The vaccine prevents cancer through preventing sexual transmission of HPV types that cause cervical cancer.”
The Guardian article continues:
The jab guards against two strains of the human papillomavirus (HPV) virus - 16 and 18 - which cause 70% of cases of cervical cancer. It is offered routinely to girls aged 12 to 13.
But an investigation by GP magazine found that 24 schools in 83 of England's 152 primary care trust (PCT) areas were opting out of the vaccination programme, many of them on religious grounds. The magazine found the majority of the schools opting out did not tell their local GPs, where the girls could be offered the vaccine.
The reasons were the typical responses that puts religious beliefs above the conclusions of science.
The reasons schools gave for not giving the jab included "not in keeping with the school ethos", "pupils follow strict Christian principles, marry within their own community and do not practise sex outside marriage" …
What does any of that have to do with preventing girls from getting cervical cancer? Not much. This is the result of bizarre equating of (1) protecting individuals from diseases associated with with sexual intercourse (like sexually transmitted HPV types) and (2) promoting so-called non-Christian ideas about sex: pre-marital, non-procreative, promiscuous, etc.
As Meghan O’Rourke put it, “Implicit in [their] argument is the assumption that good girls don't get cervical cancer; only ‘loose’ ones do—and they may get what they deserve.”
Now that everyone is aware of these schools' policies, work is being done to try solve it.
This is all tricky, since we want to balance individual freedom with social responsibility as a citizen. I have three points I want to put forward in this case and similar ones.
1. These people and their children aren’t living in isolation: There are other children and people they will interact with. Whether this spreads diseases, as happens when rejecting vaccines for spreadable diseases, or even bad ideas, others will also suffer and die. If these people weren’t part of a larger society, there might be more merit to their leaving them alone. If that’s what they want for their children and it won’t affect others who disagree, perhaps an argument can be made to let them be – despite suffering. But that is not the case here: they are embedded in a society where such policies aren’t focused purely on one group but all. Theirs is a selfish and arrogant attitude to have, when your distrust of science and evidence can cause unnecessary suffering to those who would not make the same choices as you (not vaccinating against spreadable diseases, a general distrust of science, etc.).
2. Future strain of resources: If someone does get cervical cancer or any number of diseases we want to vaccinate against, it will cost more to treat that patient. There will be a greater drain on resources than would’ve occurred if you’d simply vaccinated. However, this is interesting because…
3. If you distrust what medicine says here, then you shouldn’t use it anywhere: Are these people using aspirins? Did they go to hospitals to birth these children? Indeed, are they driving cars, flying planes? All of these are based on evidence, tested by smarter people and experts in the respective fields. Why do they reject what health professionals are saying now? What evidence do they have that the rest of us do not? Why should something as irrelevant as “possible promiscuity” trump something as vital as not dying from cancer? Furthermore, as was pointed out in the previous point, when they start having to treat the outcomes of not vaccinating, they surely are being hypocritical if they use medicine! They’ve just indicated they’re not interested in what medicine says – why are they trusting it now?
This doesn’t mean that doctors or health professionals are perfect or inscrutable. However, since I am not a doctor, I would trust what the evidence they present says. Doctors are not immune to quackery, of course, and managing health as a non-health professional is a constant dilemma. But in cases where there’s evidence versus mere religious or ideological assertion, we should always choose the former.
UPDATE: Steven Novella, at ScienceBasedMedicine.org, notes something related:
The Taliban has also announced recently that they will not allow the polio vaccine campaign in North Waziristan until the US stops its drone campaign. Estimates range from 280,000 to 350,000 affected children, who will not receive the oral polio vaccine because of the Taliban ban. They are essentially holding the public health, and world health, hostage as a political maneuver.
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