This week, the District became the latest jurisdiction to propose adding the vaccine to the list of shots girls would have to get before enrolling in the sixth grade. Yesterday, Mayor Adrian M. Fenty (D) voiced his support, saying hearings to flesh out the program should satisfy parental concerns.
At least two similar bills were introduced last week in the Virginia General Assembly. And in Maryland, state Sen. Delores G. Kelley (D-Baltimore County) has prepared a bill that requires middle school vaccinations. Kelley said she expects strong support from teachers and female lawmakers.
I addressed this topic back in June when Gardasil was approved by the FDA. Then as now I can justify a parent wanting his or her daughter vaccinated. This vaccine does prevent a sexually transmitted disease that can lead to cervical cancer. What I cannot justify is making the vaccine mandatory. Contrary to the hype, this vaccine does not prevent cancer. It prevents a sexually transmitted disease, human papillomavirus(HPV). It is true that most cases of cervical cancer are linked to an infection with HPV, but prevention of cervical cancer is a secondary, not a primary effect of the vaccine. Other vaccines are mandatory because the diseases they prevent cause a public health risk with casual contact in a school setting. Unless the lesson plans have gotten way out of hand, the risk of spreading HPV in school is very low.
Of course the pharmaceutical companies are very savvy. They aren’t marketing this as STD prevention. It is cancer prevention only. Who wouldn’t want to prevent cancer? You can see this is muddying the debate.
Joseph Zanga, professor of pediatrics at East Carolina University's Brody School of Medicine, favors the vaccine for girls who plan to be sexually active. But "mandating is the wrong approach to this issue," he said.
"If a kid with measles is sitting in a classroom, he or she is going to infect many other classmates. A kid with HPV infects no one other than one she might have sex with," he said. "We're not protecting the public health in the same way that we protect public health when we require measles vaccine."
Virginia Del. Phillip A. Hamilton (R-Newport News), sponsor of a bill that would mandate HPV inoculation for middle school children, disagrees.
"This is not a prevention for a sexually transmitted disease. This is a prevention for cancer," he said. "And if a vaccine can eliminate even one case of that, I think it's a worthwhile initiative."
Sorry, Delegate Hamilton. This is prevention of a sexually transmitted disease. A noteworthy bonus is it will tremendously decrease the incidence of cervical cancer. Interestingly, widespread behavior modification, aka chastity, would do the same thing. Of course it is much easier to mandate a vaccine than it is to mandate chastity.
UPDATE: This post got a look from someone at Merck, manufacturer of Gardasil