SAHM Position & Statement Papers
- Although rates of meningococcal disease have remained low in the United States since 2000, the severity of the disease, rapidity with which it strikes, and significant sequelae remain compelling reasons to employ all means possible to prevent it. Meningococcal disease has a bimodal peak distribution in the United States with its highest incidence rates in infants and adolescents aged 16 years and older. The 2005 recommendations from the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention were intended to protect youth entering adolescence including individuals 16–21 years of age, the ages at which meningococcal disease rates peak for children and young adults.
- An increasing number of vaccines are now recommended for adolescents. These vaccines may greatly improve the health of adolescents and their communities. However, adolescent vaccine coverage rates lag behind those for infants and behind goals set by Healthy People 2010 . Financial constraints have been reported to be a significant obstacle to immunizing adolescents and young adults . At the Society for Adolescent Health and Medicine, we believe that to achieve increased vaccine coverage in this age group, financial barriers to immunization must be removed.
- Vaccination is considered one of the greatest public health achievements in the U.S. and the world, leading to the virtual eradication of poliomyelitis in North and South America, and of smallpox worldwide . To a large extent, the success of vaccination in this country is due to compulsory school vaccination laws, which have ensured widespread coverage and minimized vaccine-related health disparities [2–4]. Although these laws frequently have been challenged, U.S. courts have consistently upheld states’ authority to require vaccination .
- Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) worldwide, causing genital warts and nearly all cases of cervical cancer. On June 8, 2006, the Food and Drug Administration approved a three-dose HPV vaccine for use in females 9 to 26 years of age. The vaccine has been shown to be safe and effective in preventing infection with HPV types 16 and 18 (which cause approximately 70% of cervical cancers) as well as types 6 and 11 (which cause >90% of genital warts). As a prophylactic vaccine, it is most effective when administered before the onset of sexual activity.
- Abstinence from sexual intercourse represents a healthy choice for teenagers, as teenagers face considerable risk to their reproductive health from unintended pregnancy and sexually transmitted infections (STIs) including infection with the human immunodeficiency virus (HIV). Remaining abstinent, at least through high school, is strongly supported by parents and even by adolescents themselves. However, few Americans remain abstinent until marriage, many do not or cannot marry, and most initiate sexual intercourse and other sexual behaviors as adolescents.
- The Society for Adolescent Medicine issued its first position paper on the subject of HIV/AIDS in adolescents in 1994 . In the ensuing decade, great progress has been made in our scientific understanding of the virus at the root of this 25-year pandemic, in the diagnosis and treatment of people living with HIV, and in the prevention of perinatal transmission. However, great challenges remain for those of us working to prevent HIV/AIDS in adolescents and young adults and to provide treatment and care and support for those who already are infected.
- As physicians and other health care professionals, we have an ethical obligation to provide the best possible care for our adolescent patients. A key tenet for all health professionals is to ensure that adolescents have access to the health services they need, including sexual and reproductive health services. A medical evaluation that addresses sexual and reproductive health includes a careful assessment for abusive or unwanted sexual encounters and the reporting of such cases to the proper authorities.
- The Society for Adolescent Medicine (SAM) and the American Academy of Pediatrics (AAP) have the protection of the health and well-being of adolescents as a primary goal. With this joint policy statement, SAM and AAP express our strong opposition to the juvenile death penalty and call upon the United States Supreme Court, the federal government, and states to abolish the practice of executing juvenile offenders.