HPV Vaccine Mandate Stirs Debate in Maryland

Published January 29, 2007

| FoxNews.com

Even though Monet Edwards, 14, has never heard of the sexually transmitted human papillomavirus, she would welcome a vaccine for it if it prevented cervical cancer, even if it meant having to talk with her parents about sex.

Fellow Crossland High School student Jasmine Pierce, 17, agreed.

"I want to be protected from cancer," Pierce said. "It sounds dangerous."

Some parents don't want to have "the talk" so early in their children's lives, particularly when the girls may be as young as 9 when they get the shot.

There is a movement afoot to add Merck and Co.'s HPV vaccine, Gardasil, to the state's list of required school immunizations. Doctors recommend the vaccine, released in June, for pre-sexually active girls so they become immune before there's an opportunity to contract the virus.

The effectiveness of the vaccine is not under debate. Instead, the discussion is focused on whether the state should require such a new product, as well as one that might force parents to have the "birds and the bees" talk earlier than anticipated.

Doug Stiegler, executive director of the Family Protection Lobby based in Glen Burnie, Md., said the state should not force a conversation that has children 9, 10, 13-years-old asking their parents, "'Mommy, why am I having this vaccine?" and parents responding, "'So when you have sex you won't get cancer."

"That argument's absurd," said Dr. Martin Wasserman, executive director of MedChi, the Maryland State Medical Society. "In my experience as a pediatrician and a parent, all you need to say is that this will prevent a very dangerous disease when you get much older."

Dr. Joshua Sharfstein, Baltimore commissioner of health, also questioned the opposition's argument.

"Hepatitis B is transferred through sex and I.V. drug use...what does the opposition say about that?" he asked. The Hepatitis B vaccine was added to the list of required school immunizations in 2006.

Stiegler said he "didn't really know about that."

Other vaccine proponents include state Sen. Delores Kelley, D-Baltimore County, author of Senate Bill 54 to add the vaccine to the list of requirements for enrollment in Maryland schools by 2008. The bill includes an "opt-out" choice for parents whose religious beliefs conflict with the vaccination like those for other required immunizations.

"Why a mandate when the research and the vaccine is so fresh and so new?" asked Tonya Miles, a State Board of Education member and a mother of three children in the Prince George's County School system. Miles spoke as a woman and a mother, not as a board member.

"We don't know what the long-term effect will be...as a mother, I really want to understand the history and be shown what the impact could be," Miles said.

Maryland's health department does usually wait for a new vaccine to be on the market 18 to 24 months before making it a requirement to "give it a chance to shake out," said Greg Reed, program manager at the Center for Immunization at the Department of Health and Mental Hygiene.

"There are over 100,000 girls in grades six, seven and eight...that's 100,000 girls who have to find the product," Reed said.

The extra time not only gives students the chance to get it on their own and avoid the current situation where students cannot attend school because they have not fulfilled the immunization requirements, but it also lends the schools and the health department time to educate the public.

"The vaccine requirement in schools equals a catching net for those kids who never got it," Reed said. "Over time, that number will reduce on its own and become much more manageable."

The Anne Arundel Department of Health is ready to respond if the vaccine does become a requirement.

It plans to post information on its Web site and print brochures for distribution in clinics and libraries as part of its routine outreach program, said Elin Jones, the public information officer for the department.

While Sharfstein said the vaccine is a great public service and will save lives, one problem will be the cost.

At $360 for the three required doses, the price is out of range for many Maryland families.

A report released this year by the non-profit group Women in Government ranks Maryland eighth out of 50 states plus the district with the largest number of low-income, uninsured women.

Uninsured or Medicaid eligible children under the age of 19 should be able to receive the vaccine for free through the Vaccines for Children program at local health centers, Wasserman said. He added that it would be highly unusual for the program and large insurance companies not to cover this vaccine.

What we have to remember, he continued, is that "cancer's more costly."

The General Assembly and the Maryland health department set all vaccination requirements, although other agencies like the Maryland State Department of Education can testify at the hearing for or against the bill.

The Capital News Service contributed to this report.

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