Ethical analysis of HPV vaccine policy options

Vaccines against human papillomavirus (HPV) may soon be licensed. In contrast to most vaccine-preventable diseases, which are transmitted by air or casual contact, HPV is primarily transmitted by sexual contact. An analysis that applies ethical theories, such as utilitarianism, rule of double effect, and principlism, is needed for policy considerations. These analyses reveal that HPV vaccination can be recommended universally, including at ages 11-12 years. However, given concerns for autonomy, justice, as not all persons are at risk, and non-maleficence, HPV vaccine should not be mandated for school entry. Economic justice indicates a need to provide vaccination for the disadvantaged.