Narrative
In Scenario 6, a young female patient presents to the office for a general check-up. Her vaccinations are not up to date – she has not received the HPV vaccine, recommended for all adolescents of 11 to 12 years old by the Centers for Disease Control and Prevention ([CDC], 2016). However, her caretakers express their concerns; they believe that this vaccine could encourage the girl to engage in early sexual activity. In this case, the dialogue should be built around potential outcomes of receiving or not receiving the vaccine.
First of all, I would confirm that the CDC (2016) highly advises vaccination for all adolescents in order to prevent the infection before a person is exposed to it in any way. Second, I would present the reasons for administering the vaccine – the prevention of cervical, oral, anal, vaginal, and other types of cancer as well as genital warts (Ball, Dains, Flynn, Solomon, & Stewart, 2015). I would present evidence that the vaccine is safe, and its side effects are minimal, including some instances of fever, swelling, and redness (Sullivan, 2019). I would also note that the HPV vaccine is very useful in preventing serious conditions. I would collect such information as patient’s allergies, especially concerning latex and yeast, and her current state of health.
To address the ethical concerns, I would educate the family of the patient about vaccinating schedules and their necessity. HPV vaccination is administered to adolescents not only due to some people’s early sexual activity, but also because of their immune system’s specificities (Navarro-Illana, Aznar, & Díez-Domingo, 2014). Young patients may benefit from receiving the vaccine early, even if they do not have sex for several years after. It may also be appropriate to mention that the young girl is likely to have marital sex in the future, and her early vaccination will protect her. One cannot know for sure whether their partner never had contacts with HPV-infected persons, and marital sex is not a guarantee of never encountering a virus.
Explanation
Family’s education is necessary to ensure that they are aware of the consequences that a refusal to vaccinate can bring. Parents of the child should see that vaccination does not change patients’ behavior (Cook, Venkataramani, Kim, Tamimi, & Holmes, 2018). Moreover, it is vital to point out that early vaccination has many long-term positive effects on the child’s immune system (Navarro-Illana et al., 2014).
While these steps may not assure the caretakers, they may inform them and the child for future decisions. Moreover, these discussions should be carefully documented to avoid liability since the refusal of parents on religious grounds goes against the recommendations of the CDC (Sullivan, 2019). While one cannot override the parents’ decision, one may continue to bring up this subject in the following meetings.
Regarding the actual medical information needed to distribute the vaccine, the patient’s allergies and present health are the essential aspects. An allergic reaction to latex is a precaution for all immunizations as prefilled syringes may contain this material (CDC, 2016). A yeast allergy is a contraindication – such persons cannot receive the HPV vaccine since it is produced in Saccharomyces cerevisiae (CDC, 2016). Otherwise, the patient should be generally healthy during the vaccination process; some light illnesses (mild infection or fever) are permissible. This data, paired with the history of previous vaccination and consent, should be enough to administer the vaccine in this case.
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.
Centers for Disease Control and Prevention. (2016). HPV vaccine recommendations. Web.
Cook, E. E., Venkataramani, A. S., Kim, J. J., Tamimi, R. M., & Holmes, M. D. (2018). Legislation to increase uptake of HPV vaccination and adolescent sexual behaviors. Pediatrics, 142(3), e20180458.
Navarro-Illana, P., Aznar, J., & Díez-Domingo, J. (2014). Ethical considerations of universal vaccination against human papilloma virus. BMC Medical Ethics, 15, 29.
Sullivan, D. D. (2019). Guide to clinical documentation (3rd ed.). Philadelphia, PA: F. A. Davis.