Human Papillomavirus Vaccine For Female Adolescents: Fill & Download for Free

Currently, science of cancer prevention is in its infancy, especially for non-infectious origin cancer (1, 2, 3). Since the question focuses on vaccines, answer's limited to cancer immuno- and not chemo-prevention, which is an entirely different field of study.Prophylaxis means prevention. A prophylactic cancer vaccine means inducing a sustained cancer-specific immune response in an individual who doesn't yet harbor it or at least hasn't yet been diagnosed with that specific cancer. Not as easy for cancers as it is for infectious diseases. Consider classical vaccines, i.e., vaccines against infectious diseases. Polio virus typically causes a debilitating paralytic disease. Its vaccine contains polio virus antigens formulated to drive a specific immune response against it. Vaccinate healthy, i.e., non-polio-infected, people, with this vaccine and they make an anti-polio immune response effective in preventing it from establishing a foot-hold. How to do the same with cancer? Do we know enough about the unique and yet universal features of each cancer to devise vaccines that stoke effective and long-lasting anti-cancer immune responses in as-yet non-cancerous individuals?Unique in that only cancer cells but not normal cells express them.Universal in that each individual with that cancer would express such antigens.Would such immune responses effectively prevent such cancers from ever establishing a foot-hold?Long-lasting because there's no predicting when after vaccination an individual might develop the cancer they were vaccinated against, could be months to years, a situation in striking contrast to communicable (infectious) diseases where such assessments are at least possible based on community incidence of such infections.Having thus defined the essence of a prophylactic cancer vaccine, at least three obvious problems present themselves.One, which cancer antigens would work as vaccines? Cancer antigens overlap much more with those of the body's own tissues compared to those from microbes. This increases risks that cancer vaccines could trigger autoimmunity so composition of a prophylactic cancer vaccine has a much higher safety burden compared to classic anti-infectious disease vaccines. Cancer-associated antigens overlap far more compared to cancer-specific ones meaning far higher autoimmune potential with the former. Problem is far more of the former and far fewer of the latter have been identified thus far.Two, who should get prophylactic cancer vaccines? Even if defined cancer-specific antigens for a particular cancer are identified, could such vaccines be given to everyone, similar to classical infectious disease vaccines?Since cancers aren't typically communicable like infectious diseases, there isn't a public health case for vaccinating everyone. Only carriers of rare cancer syndromes such as familial adenomatous polyposis coli (FAP) are almost certain to develop cancer if left untreated (4).OTOH, BRCA1/2 mutations induce defects in DNA repair with increased risks for tumors in breast, ovary, pancreas and prostate.However, since cancer risk isn't 100% concordant even in monozygotic twins, obviously environmental factors play a major role in cancer manifestation.Thus, for the vast majority of cancers, preventative cancer vaccine need exists for individuals at increased risk for specific cancers. How to identify such individuals? In general, precancer and cancer diagnosis need defined screening, diagnostic and prognostic biomarkers that can reliably screen and identify individuals at highest risk for specific cancers (2),screening biomarkers to identify those at highest risk (For precancers and early stage cancers)diagnostic biomarkers to identify lesions for invasive biopsy (For precancers, early stage cancers, and cancers).prognostic biomarkers to identify aggressive tumors that need to be treated (For cancers).Precancers and early stage cancers may shed unique DNA, RNA or biomolecules into circulation but their reliable detection is still far from reality. Circulating cancer biomarkers are most useful from convenience point of view. A rare example is ovarian cancer where unique cancer-specific mRNA isoforms were recently identified (5).Major obstacle is design and implementation of prospective studies to validate such biomarkers in the clinic.Two recent successes in such cancer biomarker discovery and validation for pre-cancer diagnosis areA highly sensitive stool DNA screening test validated for colorectal cancer (6).Two prospective multi-center trials (7) validated bronchial airway gene-expression alterations in cytologically normal bronchus epithelium of smokers with lung cancer (8) for early lung cancer detection.Thus, unlike communicable diseases, not so easy to define who should/shouldn't get prophylactic cancer vaccines. It will become feasible only with more such defined, confirmed genetic markers for specific cancers, i.e., a Pre-Cancer Genome Atlas (9). Such markers are the minimum building blocks necessary to be able to assemble prophylactic cancer vaccines. However, since a call to action for creating such an atlas has only occurred in 2016, clearly we're at the very beginning of this process.Three, can preventative anti-cancer immune responses be both immediately effective and capable of long-lasting memory to eliminate tumor recurrence far in the future?Based on these three most important considerations an ideal prophylactic cancer vaccine needs toDiscriminate between tumor and normal cells as unerringly as possible.Drive a strong and effective immune response capable of eliminating not just primary but also residual or micrometastatic tumor cells.Drive development of long-lasting immunological memory to help prevent tumor occurrence, even years post-vaccination.Have tolerable side effects and minimal or no toxicity, across genders and a broad age range.Prophylactic cancer vaccines are thus easier to envisage and develop for infectious origin cancers, cancers caused by viruses for example, since their design principles and public health argument for their usage are the same as those for classic anti-microbial vaccines.Immunoprevention for Infectious Origin Cancers: Solid Track RecordHepatitis B (HBV): The WHO estimates ~2 billion HBV infected worldwide with ~350 million chronic infections. Along with Hepatitis C virus (HCV), HBV accounts for ~85% of liver cancer (10). Most compelling data supporting the value of prophylactic cancer vaccines comes from Taiwan which began a nationwide HBV vaccination program in 1984 (11).It led to a >90% reduction in mortality rates from 1977-1980 to 2001-2004, confirming such prophylaxis prevents hepatocellular carcinoma (HCC).It reduced HCC incidence by >80%.Human papillomavirus (HPV): Cervarix and Gardasil, HPV vaccines against certain strains of HPV are currently among the most relevant examples of prophylactic cancer vaccines.Epidemiology shows that >99% of cervical cancers result from HPV infection and >70% of such cancers are associated with just two HPV strains, HPV types 16 and 18 (12).Medical and epidemiological argument for the HPV vaccine is based on estimates of annual country-specific cervical cancer rates. For example, between 2006 and 2010, an average of 33,160 annual HPV-associated cancer diagnosis in the US (20,589 or 62% women and 12,571 or 38% men) (13) and ~4000 deaths per year.Even with such clear and compelling public health need for HPV vaccines, unsubstantiated claims of adverse reactions (14) combined with moral policing concerns that getting such vaccines would increase promiscuity among young girls, i.e., sexual disinhibition, has left HPV vaccination rates far lower than that necessary to reduce HPV transmission and cervical cancer rates among women.Meantime since their approvals starting in 2006, >120 million doses of these vaccines have been distributed worldwide (15), and studies continue to pile up data showing both that these vaccines are safe (16, 17, 18, 19, 20) and that contrary to the moral police, greater knowledge associated with proactive HPV vaccination correlated positively with safer sexual behaviors (21, 22).As-yet unanswered questions with these HPV vaccines are the duration of protection they induce, whether boosters are necessary, and if so, how long after the primary jab and what doses.Immunoprevention for Non-Infectious Origin Cancers: Very Early StageColorectal cancer: A recent preventative non-infectious cancer vaccine trial for colorectal cancer was one of the first such (23).MUC1 is significantly over-expressed in colonic polyps with increased cellular abnormalities (24, 25).Consisting of a 100 amino acid peptide derived from the tumor-associated MUC1 antigen, this vaccine was adjuvanted with the TLR-3 agonist poly-LCIC (Oncovir) (23).People with recent history of advanced colorectal adenomas are at high risk of colorectal cancer. When injected in such patients, this vaccine drove strong MUC1-specific immunity, both cellular and antibody-based, in 43% of patients.A booster injection one year later drove increased circulating anti-MUC1 IgG antibody responses, meaning this vaccine was capable of inducing strong anti-MUC1 immunological memory.Patients without increased anti-MUC1 IgG antibody instead had high levels of circulating myeloid-derived suppressor cells (MDSCs), which are supposed to suppress effective anti-tumor immune responses. This means vaccines for non-infectious cancers need to be formulated with specific enhancers and/or modulators capable of decreasing cancer-associated immunosuppression.Vaccine was well-tolerated without any evidence of toxicity or autoimmunity.This 100 amino acid peptide vaccine was immunogenic in most HLA-DR and HLA-DQ haplotypes, negating the need to HLA type prior to vaccination or to only vaccinate individuals with specific HLA haplotypes.Ongoing trial is assessing efficacy of this vaccine in preventing adenoma recurrence (NCT02134925; Vaccine Therapy in Treating Patients With Newly Diagnosed Advanced Colon Polyps).Breast cancer: Currently in Phase I, STEMVAC's a preventative cancer vaccine clinical trial of a five-antigen (CD105, Yb-1, SOX-2, CDH3, MDM2) vaccine targeting breast cancer stem cells (NCT02157051; Vaccine Therapy in Treating Patients With HER2-Negative Stage III-IV Breast Cancer).Bibliography1. Meyskens, Frank L., et al. "Cancer prevention: obstacles, challenges and the road ahead." Journal of the National Cancer Institute 108.2 (2016): djv309. http://cache1.medsci.cn/webeditor/uploadfile/201511/20151110105155379.pdf2. Kensler, Thomas W., et al. "Transforming cancer prevention through precision medicine and immune-oncology." Cancer Prevention Research 9.1 (2016): 2-10. Transforming Cancer Prevention through Precision Medicine and Immune-oncology3. Maresso, Karen Colbert, et al. "Molecular cancer prevention: Current status and future directions." CA: a cancer journal for clinicians 65.5 (2015): 345-383. http://onlinelibrary.wiley.com/doi/10.3322/caac.21287/epdf4. Goss, Kathleen Heppner, and Joanna Groden. "Biology of the adenomatous polyposis coli tumor suppressor." Journal of Clinical Oncology 18.9 (2000): 1967-1979.5. Barrett, Christian L., et al. "Systematic transcriptome analysis reveals tumor-specific isoforms for ovarian cancer diagnosis and therapy." Proceedings of the National Academy of Sciences 112.23 (2015): E3050-E3057. http://www.pnas.org/content/112/23/E3050.full.pdf?sid=99cc97cb-528f-4544-9e5c-1d46569034406. Imperiale, Thomas F., et al. "Multitarget stool DNA testing for colorectal-cancer screening." New England Journal of Medicine 370.14 (2014): 1287-1297. https://www.wesleyobgyn.com/pdf/links/abog/2014_Multitarget_stool_DNA.pdf7. Silvestri, Gerard A., et al. "A bronchial genomic classifier for the diagnostic evaluation of lung cancer." New England Journal of Medicine 373.3 (2015): 243-251. http://www.nejm.org/doi/pdf/10.1056/NEJMoa15046018. Gustafson, Adam M., et al. "Airway PI3K pathway activation is an early and reversible event in lung cancer development." Science translational medicine 2.26 (2010): 26ra25-26ra25. http://www.bumc.bu.edu/pulmonary/files/2008/08/SciTransMed_2010.pdf9. Campbell, Joshua D., et al. "The Case for a Pre-Cancer Genome Atlas (PCGA)." Cancer Prevention Research 9.2 (2016): 119-124 The Case for a Pre-Cancer Genome Atlas (PCGA)10. Aly, Hamdy AA. "Cancer therapy and vaccination." Journal of immunological methods 382.1 (2012): 1-23).11. Chiang, Chun-Ju, et al. "Thirty-year outcomes of the national hepatitis B immunization program in Taiwan." JAMA 310.9 (2013): 974-976. http://website2.infomity.net/8292024/B%E5%9E%8B%E8%82%9D%E7%82%8E%E3%83%AF%E3%82%AF%E3%83%81%E3%83%B3%E3%81%AE%E5%8A%B9%E6%9E%9C%EF%BC%88%E5%8F%B0%E6%B9%BE%EF%BC%89.pdf12. Smith, Jennifer S., et al. "Human papillomavirus type distribution in invasive cervical cancer and high‐grade cervical lesions: A meta‐analysis update." International journal of cancer 121.3 (2007): 621-632. http://onlinelibrary.wiley.com/doi/10.1002/ijc.22527/epdf13. Markowitz, Lauri E., et al. "Human papillomavirus vaccination: recommendations of the Advisory Committee on Immunization Practices (ACIP)." MMWR Recomm Rep 63.RR-05 (2014): 1-30. http://origin.glb.cdc.gov/mmwr/pdf/rr/rr6305.pdf14. HPV Vaccine: The Science Behind The Controversy. NPR, September 19, 2011. HPV Vaccine: The Science Behind The Controversy15. Arnheim-Dahlström, Lisen, et al. "Autoimmune, neurological, and venous thromboembolic adverse events after immunisation of adolescent girls with quadrivalent human papillomavirus vaccine in Denmark and Sweden: cohort study." (2013): f5906. http://www.bmj.com/content/bmj/347/bmj.f5906.full.pdf16. Slade, Barbara A., et al. "Postlicensure safety surveillance for quadrivalent human papillomavirus recombinant vaccine." Jama 302.7 (2009): 750-757. http://archderm.jamanetwork.com/data/Journals/JAMA/4476/joc90070_750_757.pdf17. Haupt, Richard M., and Heather L. Sings. "The efficacy and safety of the quadrivalent human papillomavirus 6/11/16/18 vaccine gardasil." Journal of Adolescent Health 49.5 (2011): 467-475.18. Gee, Julianne, et al. "Monitoring the safety of quadrivalent human papillomavirus vaccine: findings from the Vaccine Safety Datalink." Vaccine 29.46 (2011): 8279-8284. https://www.researchgate.net/profile/James_Baggs/publication/51638735_Monitoring_the_safety_of_quadrivalent_human_papillomavirus_vaccine_Findings_from_the_Vaccine_Safety_Datalink/links/09e41512fbc123ac25000000.pdf19. Donegan, Katherine, et al. "Bivalent human papillomavirus vaccine and the risk of fatigue syndromes in girls in the UK." Vaccine 31.43 (2013): 4961-4967. http://www.pfizerpro.com.co/sites/g/files/g10013506/f/publicaciones/2013_31_43_Bivalent-human-papillomavirus-vaccine-and-the-risk-of-fatigue-syndromes-in-girls-in-the-UK_4961_4967.pdf20. Vichnin, Michelle, et al. "An overview of quadrivalent human papillomavirus vaccine safety: 2006 to 2015." The Pediatric infectious disease journal 34.9 (2015): 983-991. https://www.researchgate.net/profile/Rosybel_Drury/publication/281274070_Vichnin_et_al_PIDJ_2015_Complete_with_supplementary_material/links/55ddf3e008aeaa26af0f1f34.pdf21. Bednarczyk, Robert A., et al. "Sexual activity–related outcomes after human papillomavirus vaccination of 11-to 12-year-olds." Pediatrics 130.5 (2012): 798-805. http://pediatrics.aappublications.org/content/pediatrics/130/5/798.full.pdf22. Madhivanan, Purnima, et al. "Human Papillomavirus Vaccination and Sexual Disinhibition in Females: A Systematic Review." American Journal of Preventive Medicine (2016).23. Kimura, Takashi, et al. "MUC1 vaccine for individuals with advanced adenoma of the colon: a cancer immunoprevention feasibility study." Cancer Prevention Research 6.1 (2013): 18-26. A Cancer Immunoprevention Feasibility Study24. Ajioka, Y., H. Watanabe, and J. R. Jass. "MUC1 and MUC2 mucins in flat and polypoid colorectal adenomas." Journal of clinical pathology 50.5 (1997): 417-421. MUC1 and MUC2 mucins in flat and polypoid colorectal adenomas.25. Ho, Samuel B., et al. "Altered mucin core peptide immunoreactivity in the colon polyp-carcinoma sequence." Oncology research 8.2 (1995): 53-61.Thanks for the R2A, Huang ZheYu.

We should be highly skeptical of them.But let me back up.I'll get into why the science doesn't align with the reports you mentioned in a second. But first I want you to keep something in mind. Politicians are not scientists. The Advisory Committee on Immunization Practices (ACIP), on the other hand, is the panel of experts that decides what vaccines will be recommended for the routine schedule, and they do so based on all available scientific evidence that shows the vaccine to be safe, effective and necessary. If policy makers decide to require that all 7th graders have their meningitis vaccine, but not the HPV vaccine, it doesn't mean that the meningitis vaccine is more important or safer -- it means that the policy makers decided it was. Scientists should determine what vaccines should be recommended, not politicians.That being said, let's look at what the evidence says.The HPV vaccine is at least as safe, if not safer, than the other recommended vaccines in use today in the U.S. Is it 100% safe? Of course not. No medical intervention is. And anybody demanding (or offering) absolute guarantees doesn't understand medicine. Because like it or not, all medical interventions have risks. There will always be someone who is allergic to something or doesn't respond properly or who has something going on that we don't know about. Medicine is not one-fits-all, and so there will be risks for some people. The big question is: do the benefits outweigh those risks?And here is what we know about the risks associated with the HPV vaccine:As of Spring 2013, more than 56 million doses of HPV vaccine have been administered in the United States. HPV4 (brand name: Gardasil) accounts for 99% of those doses [1], so I'll focus on that particular vaccine.We have a number of ways to track vaccine safety after it comes out on the market. One of those is the Vaccine Adverse Event Reporting System (VAERS). Something important to note here: Anyone can report any reaction following a vaccine dose -- even if they aren't sure that the vaccine caused the adverse event.Number of serious and nonserious reports of adverse events after administration of quadrivalent human papillomavirus (HPV4) vaccine in females, by year — Vaccine Adverse Event Reporting System, United States, June 2006–March 2013** Total number of reports (serious and nonserious) = 21,194. In the Vaccine Adverse Event Reporting System, reports are classified as serious if the submitter reports one or more of the following: hospitalization, prolongation of an existing hospitalization, permanent disability, life-threatening illness, or death.-Human Papillomavirus Vaccination Coverage Among Adolescent Girls, 2007-2012, and Postlicensure Vaccine Safety Monitoring, 2006-2013 - United StatesWhat this graph says is that between June 2006 and March 2013, there were a total of 21,194 adverse events reported to VAERS following a dose of HPV4. Does this mean that the HPV vaccine caused those 21,194 events? No. All it means is that those events happened after the vaccine was given.This is where Jae Won Joh's point about correlation not equaling causation comes into play. If someone eats a peanut butter sandwich and then drives to work and gets into a car accident, does that mean that peanut butter sandwiches cause car crashes? Of course not. Just because something happens right after something else, it doesn't necessarily mean they had anything to do with each other.So when you see that "1,968 adverse cases have been presented to the Japanese government, detailing severe medical side effects" [3], you have to take it at face-value. Lots of people suffer from a wide range of medical issues every day. What's important to find out is: were those medical issues actually caused by the vaccine, or are they just coincidental? You can't get that from reports alone.These reporting systems are important, however, because they help scientists identify potential reactions that were too rare to spot during pre-licensing clinical trials. If we see enough reports of the same reaction, scientists do the research to see if those who received the vaccine have a greater risk of that happening than those who didn't.And that's what we did.The Vaccine Safety Datalink (VSD) analyzed specific adverse events -- like Guillain-Barre syndome (GBS), stroke, seizures and severe allergic reactions -- following more than 600,000 doses of HPV4. They then compared the rates of those events to a population that didn't receive the HPV4 vaccine. They found that none of these severe reactions were any more common in those who got the vaccine than those who didn't. [4]Other reports that the HPV vaccine has caused infertility (as the Japanese news articles have suggested), blood clots, autoimmune disorders or death have all been examined, too. And there is no evidence that the HPV vaccine caused any of those serious reports. [5, 6, 7, 8]What is probably caused by the vaccine are the same temporary side effects that we see with all vaccines in that age group:fainting (adolescents faint a lot during any medical procedure)dizzinessnauseafever (1 in 10 people will get a mild fever, 1 in 60 a moderate one)headachepain and redness a the injection siteThe worst that almost all people receiving the HPV vaccine can expect is feeling a little icky for a day or two.The vaccine is so safe partly because of how it is made. The HPV vaccine is a recombinant vaccine, which means that it's made by taking virus-like proteins that are manufactured using yeast cells [9]. We don't use the whole virus, like we do in some other more widely accepted vaccines. In fact, it's the same technology that we use to make the Hepatitis B vaccine, which is recommended for babies on the day they are born. If the HPV vaccine were given at a younger age with the majority of the other vaccines, I wonder if we would even be having this debate right now.Something else to note about that graph is that you'll see the number of reports have gone down despite vaccination coverage going up. Given that the vaccine hasn't changed, it's likely that the reports were caused more by fear and hype than the vaccine itself.So those are the risks, what are the benefits of the vaccine?Almost all adults will get HPV at some point in their lifetime -- often very shortly after their first sexual experience. But just because it's transmitted sexually doesn't mean that it only affects the sexually promiscuous. Penetration is not necessary. Anybody with fingers, a mouth and genitals can get and spread HPV. Even virgins can get HPV. And when 80%+ of people get it, it's normal. It's part of every day life, like the staph on our skin or cold sores. Very few people can say "that I/my child won't get HPV" and mean it. Almost everybody gets HPV.Thankfully, most people clear the infection with no problem. Some infections, however, can lead to a variety of cancers (see the table below). In fact HPV is estimated to cause 26,200 cancers every year in the United States [10], and 5% of all cancers worldwide [11].Source for table and graph: CDC - How Many Cancers Are Linked with HPV Each Year?Both HPV vaccines protect against the two-types of HPV that are most commonly associated with these cancers, and are credited for cutting the incidence of these HPV types in half. This is despite a really low coverage rate (less than half of all U.S. adolescents have received the full vaccination series) [12]. It's a highly effective vaccine. And while it's too early to have direct proof that it reduces cancer (that will take years), we know the vaccine reduces the HPV types that lead to most HPV-related cancers, as well as pre-cancerous lesions [13].And in exchange for reducing our risk of a variety of cancers, the vast, vast majority of us face only having fever or pain and swelling at the injection site.We have a vaccine against cancer. Let's have a large-scale conversation about that.Sources:[1] CDC - HPV Vaccine Safety - Vaccine Safety[2] Human Papillomavirus Vaccination Coverage Among Adolescent Girls, 2007-2012, and Postlicensure Vaccine Safety Monitoring, 2006-2013 - United States[3] Japan withdraws support for HPV vaccines due to infertility side effects - Live Free, Live Natural"[4] Findings from the Vaccine Safety Datalink[5] CDC - FAQ HPV Vaccine Safety - Vaccine Safety[6] http://www.cancercouncil.com.au/1060/cancer-information/cancer-risk-and-prevention/screening-and-early-detection/cervical-cancer-vaccine-fact-sheet/[7] The Childhood Immunization Schedule and Safety: Stakeholder Concerns, Scientific Evidence, and Future Studies[8] Autoimmune, neurological, and venous thromboembolic adverse events after immunisation of adolescent girls with quadrivalent human papillomavirus vaccine in Denmark and Sweden: cohort study | BMJ[9] Gardasil HPV Vaccine (recombinant human papillomavirus quadrivalent vaccine)[10] How Many Cancers Are Linked with HPV Each Year?[11] National Cancer Institute[12] Reduction in Human Papillomavirus (HPV) Prevalence Among Young Women Following HPV Vaccine Introduction in the United States, National Health and Nutrition Examination Surveys, 2003-2010[13] Early effect of the HPV vaccination programme on cervical abnormalities in Victoria, Australia: an ecological study

This question concerns religion and sex, two of the most conflict-laden issues in American culture.The HPV vaccine is a vaccination for a sexually transmitted disease. If an 11/12 year old doesn’t have HPV (which is the age at which the CDC recommends the shots be given[1]) then the only likely way they will contract it is through sexual contact[2].In addition, “religion is one of the major forces of control over sexuality, and many studies have observed an inverse relationship between religiosity and sexual permissiveness [3].”Those who hold religious values tend to:1) Condemn pre-marital sex [4]Many parents who hold religious values believe that their children aren’t at risk for HPV because they expect them to remain sexually abstinent until marriage.2) Hold sexist views towards women and their “purity” (i.e. their virginity) [5] [6]The HPV vaccine is sometimes touted as potentially a way of “encouraging young girls to engage in promiscuous behavior” [7]. These fears are heightened through media accounts and conservative organizations trying to promote their agenda. For example, “Tony Perkins, president of the conservative Family Research Council, is on record as saying that he wouldn’t have his teenage daughter vaccinated against HPV because doing so would send ‘the wrong message’ about the importance of abstinence”.3) Hold conservative political views (i.e. there is a correlation between strong religious values and conservatism)This study found that conservatives are less likely to vaccinate their children for HPV. Likewise, current research “suggests that parents who identify as liberals reported stronger intentions to vaccinate their sons . . . and that women or parents who reported being liberal or moderate, compared with conservative, expressed greater acceptance of the [HPV] vaccine[8]”The HPV vaccine has generated an exorbitant amount of media attention because of religious, conservative groups who oppose the use of the vaccination on the moral grounds and values explored above and have sought to make the vaccine into a controversial subject. In this study, participants were presented with two news stories with exactly the same content, yet with two different headings, one that mentioned controversy and one that did not. The study found that “those exposed to the message describing HPV vaccine policy as controversial were significantly less likely to support [a mandate] (22.8 percent) than those given the uniform support message (37.3 percent)” (see the graph below):In addition, this study found that “parents with frequent attendance at religious services were more likely than parents who do not attend services to have decided against [the HPV] vaccination[9].”Note: The source that you link in your question does not simply look at the relationship between religious values and the HPV vaccine, it also lobbies for the HPV vaccine to be made mandatory, without religious or philosophical exemptions available (for more on the implications of forcing vaccines see here and here). However, the campaign to make the HPV vaccine mandatory could potentially backfire:42 states have enacted laws governing the use of the HPV vaccine (such as allocating funds for its promotion and allowing minors to be vaccinated without parental consent) but only two states, Virginia and Rhode Island, mandate the HPV vaccine. Rhode Island mandates it for both sexes [10] and Virginia mandates it for females only[11]. However, both states make provisions for informed parental consent and allow opt-outs from the law.Since its introduction into the United States market in late 2006, 27 different states have attempted to pass legislation mandating the HPV vaccine and failed. As controversy grows and the push for mandates becomes stronger, vaccine uptake suffers. The Journal of the American Medical Association reported that “making the HPV vaccine mandatory contributes to long-standing parental concerns about the safety of school-based vaccinations. The use of compulsion, therefore, could have the unintended consequence of heightening parental and public apprehensions about childhood vaccinations” [12].In 2007, one year after the Food and Drug Administration approved the first HPV vaccine for public use, Texas became the first state to mandate the vaccine for all females aged 11 to 12 [13]. The law was passed through the executive order of Texas Governor Rick Perry, however, intense backlash soon followed due to parental concerns. Shortly thereafter, in May of 2007, the legislature swiftly overturned the law. Generating even more controversy, it was later reported throughout the media that “Perry's friend, former chief of staff Mike Toomey, spun through the revolving door to become a lobbyist for Merck [manufacturer of the HPV vaccine] in Texas, a position he held at the time of the HPV-related executive order” [14]. This created further public mistrust of governmental motives. As NPR explains, “Toomey’s career is emblematic of the revolving door between big business and the Texas government. Toomey was elected to the Texas House, left government to become a lobbyist, took a job as Perry's chief of staff, then left the governor's office to lobby for the drug company Merck.”Since the HPV vaccine got “a rapid, possibly premature push toward legislation to mandate its use — an effort that turned out to be largely promoted by the manufacturer of the HPV vaccine Gardasil, the pharmaceutical giant Merck” many parents became wary of the reasons motivating the mandates, undermining public trust and altering the public’s view of the necessity of the vaccination [15]. Studies have found that the more coercive the tactics used to force parents to vaccinate, the more parents resist. In regards to the HPV vaccine, “there was such an outcry for requirements, just days and weeks after [the vaccine] was introduced . . . that it backfired. Even if well intentioned, it wasn't the right time to talk about [legal] requirements.”Footnotes[1] HPV | Who Should Get Vaccine | Human Papillomavirus | CDC[2] STD Facts - Human papillomavirus (HPV)[3] https://www.andrews.edu/services/ipa/documents-scientificpublication/mcmillen_-_religious_orientation_and_sexual_attitudes_and_behaviors.pdf[4] The Relationship between Religious Attitude and Attitude toward Premarital Sex Relations[5] The Role of Religiosity in the Relationship Between Parents, Peers, and Adolescent Risky Sexual Behavior[6] The Damage Of Overvaluing Virginity[7] Social Warfare[8] http://www.sciencedirect.com/science/article/pii/S1049386713000066[9] HPV vaccine decision-making and acceptance: does religion play a role?[10] Department of Health[11] Five years after HPV vaccine law, state remains split[12] Controversy undermines support for state mandates on the human papillomavirus vaccine.[13] Perry's Vaccine Mandate Incited Anger In Texas[14] HPV vaccine, Merck and Rick Perry's money[15] Early Push To Require The HPV Vaccine May Have Backfired