1.5.2.5 Vaccination in situations of risky behaviour

A relatively new vaccination is vaccination against Human Papillomavirus (HPV), which has been part of the National Vaccination Programme in the Netherlands since 2009. Several variants of HPV exist: types 16 and 18 are the most common and dangerous viruses. They can cause cervical cancer in women. The HPV vaccine currently offered to girls in the Netherlands in the year of their 13th birthday therefore protects against these types 16 and 18.

An interesting issue is how natural it is to take advantage of this HPV vaccination. The risk of HPV infection occurs in people who are sexually active with alternating partners. The increase in cervical cancer in the population in the last 40 years is therefore attributed to the changed, “freer” sexual behaviour during this period. Infection with HPV is in principle avoidable through a monogamous lifestyle. A similar moral dilemma arises with the increasingly common PrEP use, especially among gay people. While this medication reduces the risk of HIV infection, at the same time it almost always aims to allow unlimited sexual intercourse with a reduced risk of HIV transmission. This, however, is a reprehensible intention. The objective of prophylactic acts is not to make immoral acts less risky and thereby facilitate them.

Decisive in ethical terms is the purpose with which vaccination takes place. If it is to protect against diseases to which one does not expose oneself through freely chosen behaviour, then vaccination is a good thing. This applies, for example, to a man who has led a promiscuous life for some time, but later makes the conscious choice of a monogamous marriage. A woman can protect herself against AIDS through vaccination when her husband may be a carrier of HIV. Similarly, medics at increased risk of HIV infection can take advantage of a prophylactic medication directed against it.