Will states follow Texas on HPV shot mandate?

In early February, 18 state legislatures were considering a mandate. Some doctors have raised concerns about the drugmaker's involvement in the push.

By Kevin B. O'Reilly, AMNews staff. Feb. 26, 2007.

Pediatric and family physician leaders are taken aback by the speed with which Merck & Co. Inc. has lobbied states to mandate its new human papillomavirus vaccine. Academy officials say safety and cost concerns about the cervical cancer immunization need to be addressed before school girls are forced to get it.

Texas Gov. Rick Perry's February executive order made his state the first to mandate the HPV vaccine for girls entering the sixth grade. The order does allow parents to exempt their children for medical, religious or philosophical reasons.

Nationwide, 18 other states are considering bills to mandate the HPV vaccine for school entry, and 28 states have considered some kind of legislation related to the drug, such as education about the vaccine or insurance coverage mandates.

The Texas Medical Assn. came out against Perry's executive order, as did the American Academy of Family Physicians and the American Academy of Pediatrics.

In a statement, the AAFP said it is "premature" to consider HPV mandates because "the long-term safety with widespread use, stability of supply, and economic issues" need to be clarified.

AAFP President Rick Kellerman, MD, said problems can crop up with a vaccine after it goes to market. He cited as an example Rotashield, which was FDA-approved in 1998 to immunize against rotavirus but withdrawn from the market a year later after 76 cases of intussusception were reported.

Joseph A. Bocchini, MD, chair of the AAP's Committee on Infectious Diseases, agreed that "it's too early to consider mandates. There are other priorities that are more important right now."