Should States Require HPV Vaccine?

Over the last few weeks many State Governments have debated if girls entering the sixth grade should be vaccinated against a particular sexually transmitted disease. The specific STD in this case is the human papiloma virus, or HPV. According to the Centers for Disease Control and Prevention, HPV can lead to cervical cancer in some women. Gardasil is a new vaccine designed to protect against four of the HPV strains that account for 70 % of cervical cancer cases and 90 % of genital warts.

There are eight states currently debating if the state should require girls 11-12 years old get vaccinated for HPV before they can enter the sixth grade. The states are California, Georgia, Kansas, Kentucky, Michigan, New Jersey, Texas, and Virginia. Over the last few years, Merck, the manufacturer of Gardasil, has tested the vaccine in girls 9-26 years in age and have not noted any harmful side effects. However, this debate has led some to question if these state governments are overstepping their authority.

Many critics of the HPV vaccine question the wisdom of having an 11 year old girl vaccinated for a STD. The American College of Pediatricians has commended Merck for its ground breaking research, but is against any legislation requiring the vaccine. The organization believes the vaccine should be made available, but that patients and their parents (in the case of young girls) should be made aware of the limits of the knowledge of this vaccine. While there are no known harmful side effects from the vaccine, no one is certain how long the vaccine is good for. There is the possibility that booster shots could be required after the initial three shot series. The American College of Pediatricians argues that it makes more sense to give the vaccine when a girl is closer to sexual activity. When is that? For each girl that is a unique age that should be taken into account. The vaccine appears to work best in subjects within the first two years after receiving it. If a girl decides not to be sexually active until later in life, she might want to wait to get the vaccine until then when it can be most effective.

Because HPV is not a communicable disease, I don’t think the states have the right to force all girls to get this shot. If there is a compelling reason to protect the other students in the class, then I could be convinced to side with the states that want to require the shot. Currently, many kids are required to be vaccinated for Measles, Mumps, Rubella, and other highly communicable diseases. However, HPV is only transmitted though sex. For states to require a STD vaccine prior to entering the sixth grade or any other grade would be a precedent setting decision. If a state requires the STD vaccine, should it require other vaccines, such as Hepatitis? Will states start requiring children submit to a STD screening process before they can attend school each year?

I think this decision is best left to the individual doctors, parents, and girls. There are risks with any vaccine, and there is still more research that needs to be done on this one. Parents should have the flexibility to evaluate their children and decide when it is appropriate to give this shot to their children. I have a three year old daughter. One day, she will probably be vaccinated for HPV. But that should be at a time that my wife and I decide to have her vaccinated based on her doctors recommendation and her own maturity. Girls mature differently and families have different values. To require this “one size fits all” solution doesn’t accommodate different families with different values.