A mother’s attitude towards cervical cancer screening influences decisions to vaccinate daughters against the cancer claims this – not entirely surprising – headline in a BBC news report on Monday, which is based on new research in the European Journal of Cancer.
The research found that uptake of HPV vaccination among girls aged 12-13 years whose mothers had never been screened for cervical cancer was 58%. Among those whose mothers had been screened for cervical cancer in the past five years, the uptake was almost 84%.
Therefore, the researchers suggest that a mother’s attitudes and behaviour with respect to her own cervical screening attendance, or to preventive programmes in general, are important determinants in her decision to vaccinate her daughter, particularly at younger ages. In-depth interviews are planned to find out what influences a mother’s decision to give consent for her daughter to be vaccinated and whether socio-economic factors play a part.
The HPV vaccination programme in the UK to teenage girls has been the subject of a number of CMF articles and blogs. A CMF file explored the issue back in 2008 as did a longer article by Peter Saunders in EN in 2006. I posted a blog on a UN drive to ask governments to fund the vaccination of every girl in the world against HPV.
At one level this latest research is encouraging as it reflects the important role that mothers (and, we would hope, fathers) still have over their daughters’ life choices. It highlights a useful, and perhaps unexpected, outcome from the introduction of the HPV programme: it seems to have encouraged parents to discuss the vaccine and – crucially – the reasons for taking it (or not), with their daughters, and shows that many mothers are able to influence their decision-making.
This was certainly true from my own personal experience, as detailed in a previous blog. When my daughter was told that all her class was to be given the vaccination against the HPV virus, assuming they consented to it, we discussed it in some depth. We found ourselves challenged by some of the dilemmas it highlighted, not least sex, cancer, death, screening and consent and for our daughter, the extra factor of peer pressure. It still sometimes comes up as a topic for discussion and consideration and provides a great launch pad for talking about sex and relationships.
One of the conclusions from the new research is that: ‘It shows there is a link within families and that targeting both mothers and daughters may have an influence on uptake of prevention programmes’
So while the researchers are highlighting the (unsurprising) link within families their primary concern is that the uptake of the vaccine from youngsters is still not high enough and there are concerns that cervical cancer rates will consequently increase.
This is a genuine concern. We know that cervical cancer is a terrible disease that claims thousands of lives worldwide, not just in the UK, therefore a vaccine that helps prevent it is surely to be welcomed. To deny it would be selfish, foolish, ungracious and lacking mercy. Indeed, many innocent victims of non-consensual sex and marital unfaithfulness could be helped.
Yet on the other hand, there is still little long-term research on the effects of the vaccine, nor on how long the vaccine lasts. It may ‘only’ prevent 70% of cervical cancer overall and could increase complacency, risk taking and promiscuity amongst adolescents who consider themselves protected. An editorial in the New England Journal of Medicine in 2008 stated that: ‘more long-term studies were called for before large-scale vaccination programmes could be recommended. Unfortunately no longer-term results from such studies have been published since then.’
As with all previous reporting of this issue, it again notably fails to mention any broader ethical dilemmas associated with the national vaccine programme for teenage girls. In fact, it is assumed that the programme is not only highly successful but an unqualified ‘good’.
Most concerning of all, however, is that the context in which the HPV vaccine is promoted utterly fails to promote sexual abstinence and faithfulness. There is no addressing by promoters of the vaccine of the need to change sexual behaviour, by advocating a preventative approach. For most teenage girls, the major factors contributing to promiscuity include exposure to ‘sex-without-consequence’ and pornography through magazines, TV, film and internet, and a lack of warnings about the real results of sexual immorality.
It is not just the links between mothers and daughters that promoters of the vaccine should be thinking about. If the primary cause of cervical cancer continues to be downplayed and widely ignored the outcome will surely be an increase in the disease rather than cure?
So, whilst thinking about the important links between mothers and daughters, promoters of the vaccine would do well to also consider promoting abstinence before, and faithfulness within, marriage, or at least long-term relationships.
As Christians we have a responsibility to promote premarital abstinence and marital faithfulness. As parents, we will have to carefully weigh up the issues ourselves, in discussion with our child(ren), whether or not we consent to them being vaccinated, to protect them from theirs or others’ sexual immorality.