Ethical dilemmas and great expectations for human papilloma virus vaccination.

When the first preventive HPV vaccine became available in 2006, it drew both enthusiasm and multiple ethical problems. In the case of HPV vaccination, there is a clear conflict between the scientific data that claim a definitive advantage for preventing HPV infection in the exposed population and the ethical and moral issues resulting from a compulsory program. Despite the evident success of routine and compulsory vaccination in young women, there is increasing concern about safety, efficacy, and equity of the vaccine and to close the knowledge "gaps" about HPV infection and consequent health outcomes. Some of these fears are expressed particularly in conservative groups that link these arguments to those of religious and moral issues contending that HPV vaccination is an indirect license for liberal sexual activity in youths, resulting in promiscuity and/or less participation in cervical cancer screening. It has been well demonstrated that HPV infection can lead to harm through the induction of premalignant and cancerous lesions. Therefore, any proven method for preventing infection, such as HPV vaccines, should be used in persons at risk. These policies, however, should be strictly linked to cervical cancer screening programs.