Waive parental consent for HPV vaccination?

That's the position of physicians from Brown Medical School, The Miriam Hospital, and elsewhere in a letter published in the July issue of The Lancet Infectious Diseases. The letter, "Where to begin human papillomavirus vaccination?" (subscription required), emphasizes the need to direct HPV vaccination efforts at African-American women, a group disproportionately affected by cervical cancer in the U.S. For those without subscription access, here's a press release from the lead author's institution.

The authors cite data showing that African-American women have a lifetime risk of cervical cancer 0.25% higher than in white women (0.94% compared to 0.69%) and are twice as likely to die from it. The reasons underlying these disparities aside, the authors propose a multi-dimensional, targeted HPV vaccination campaign for African-American women, including school-based vaccination clinics in schools with high percentages of African-American students as well as vaccine distribution in juvenile detention centers. Finally, the authors write,

"Parental consent ought to be waived for HPV vaccination as it is for other sexually transmitted infection-related health care."

It's a provocative claim for which no further explanation is offered. While the authors' interest in maximizing the availability of HPV vaccines is clear, it's possible that attempting to circumvent parental authority in this case would actually have the reverse effect. Such a move would greatly increase the level of criticism the vaccine receives, particularly from groups already arguing strongly that the decision to vaccinate should be left to parents in all cases.