States propose laws requiring HPV vaccine

Some doctors worry about the high costs for the new immunization.

By Kevin B. O'Reilly, AMNews staff. Jan. 29, 2007.

Over the objections of social conservatives and parents opposed to forced immunizations, politicians in at least six states are pushing laws that would require girls entering middle school to receive the human papillomavirus vaccine.

Physicians see the new vaccine as a breakthrough in preventing cervical cancer but are split on how society should proceed. Many doctors support school-entry mandates, while some say lawmakers eager to require the vaccine should proceed with caution, given the cost.

In December 2006, Michigan fell just three votes shy of becoming first to mandate the HPV vaccine for girls entering sixth grade. The bill has been reintroduced there, and lawmakers in Texas, California, Kentucky and Washington, D.C., are considering similar legislation. A bill is expected to be introduced in Illinois soon. The bills would allow parents who object to the vaccine on religious, moral or philosophical grounds to opt out of having their children immunized.

Supporters note that mandates dramatically increase uptake of a vaccine and broaden the protection as widely as possible. It also is best to get to girls before they become sexually active, according to Carolyn Johnston, MD, a gynecologic oncologist at the University of Michigan Comprehensive Cancer Center.

"The point of making it mandatory is that a lot of people don't think about girls that young having sex, nor do they think that cervix cancer starts early," Dr. Johnston said. "But it's pretty clear that if you prevent infection with the HPV vaccine that you can reduce the precursor lesions of cervical cancer."