[Extraordinary aspects of patient information before vaccination against human papillomavirus.]

Some cases of obligatory patient information before vaccination against human papillomavirus (ongoing infection, anti-vaccination standpoint) raise ethical dilemmas and might require a different approach from basic guidelines in clinical practice.

Overviewing the special aspects of competing patient rights concerning human papillomavirus vaccination and finding a balance between them also taking into account the domestic virus genotype prevalence.

We collected and compared the relevant sections of health law, instructions for use and recommendations of professional associations and authorities. Vaccination of adult women is conferred with recent representative prevalence data of human papillomavirus genotypes.

Virus screening before vaccination is not necessary from the medical viewpoint of professional bodies. In our study, 14.1% of 25-29, 8.2% of 30-34, 8.9% of 35-39, 5.2% of 40-44, 5.4% of 45-49, 5.2% of 50-54, 3.1% of 55-59, and 3.2% of 60-65-year-old women carried one or more genotypes targeted by the nonavalent vaccine. For them, the protection by the vaccine would be different. The patients have the right to comprehensive and individualised information about the potential benefits and risks of accepting or declining the suggested intervention.

Not safety reasons or indication of the vaccine raise the question of infection status, as everyone benefits from it, but patient information obligation does. It is more important to be protected by the vaccine before starting sexual engagement eventually in a concealed relationship than the direct consent of the parent because denial of the consent might be irreversibly disadvantageous to the minor.

Although virus screening before vaccination is not necessary, obligation of providing individual patient information about vaccine efficacy can justify offering the test depending on age and sexual activity. A minor above the age of 16 has the right to appoint another major for the consent to the vaccination instead of the legal representative (parent). Orv Hetil. 2023; 164(45): 1795-1802.