Panama HPV Vaccination Program Stirs Debate Over Public Health Education

Main Category: Cervical Cancer / HPV Vaccine
Also Included In: Public Health
Article Date: 25 Mar 2009 - 6:00 PDT

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PRI's "The World" on Friday examined how Panama's campaign to vaccinate all girls against human papillomavirus at age 10 is raising new concerns among some public health experts over how much information the government should disclose about such programs. The vaccine, which requires a three-dose regimen, protects against certain sexually transmitted forms of HPV that cause many cervical cancers, according to "The World." Panama is the first country to make the vaccine mandatory and offer it at no cost, spending $5 million annually on the program. "The World" reports that parents have broadly welcomed the vaccination program, unlike in the U.S., where there has been some objection to vaccinating young girls on the grounds that it could encourage sexual activity.

Jose Cedeno of Planned Parenthood Panama said that the reason there has been no objection among parents of young girls is that government officials have not told parents that the vaccine protects against a sexually transmitted virus. According to "The World," the message that the inoculation is "just a 'cancer vaccine' is central to how the government promotes the program on TV and radio." Cedeno said that because there is no national sex education program in Panama, the government is missing out on an opportunity to educate the public. He noted that the vaccine does not protect against all cancer-causing strains of HPV, adding that girls need to learn how to protect themselves. However, some members of the public health community support Panama's approach. Newton Osbourne, a prominent gynecologist in Panama, said, "I think it's a good thing because if they tie it to sexual activity, it's going to bring up all kinds of controversy that I don't think is going to be all that relevant to the main issue -- we want to prevent women from getting cancer."

Rosario Turner, Panama's minister of health, said that cervical cancer is the second leading cause of death among women in the country and that women's health is a top priority for the government. According to "The World," many women in Panama do not routinely get Pap smears, making the vaccine the most effective way to protect women against HPV. Turner said that in the first few months of the program, 19,000 girls were vaccinated, including many girls from small villages. Turner acknowledged that the health department has downplayed the relationship between HPV and sexual activity. She said, "I saw the outcry over the HPV vaccine abroad and tried to avoid it by focusing only on cancer." Parents in Panama "can be sensitive about discussing sexuality," "The World" reports. For example, when the government attempted to introduce comprehensive sex education in schools last fall, "a huge debate ultimately crushed the effort," according to "The World" (Weise, "The World," PRI, 3/20).

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