HPV Vaccine:
Recommendation or Mandate?

All girls will be required to be vaccinated against the human papillomavirus (HPV), the primary cause of cervical cancer, by the time they enter the sixth grade, if legislation introduced last week in the District of Columbia becomes law. Maryland, Virginia, West Virginia and three other states are also poised to consider such legislation.

To place those proposals in a broader context, a new paper reviews some of the scientific, legal, ethical and financial issues surrounding the HPV vaccine and compulsory vaccinations. The paper, HPV Vaccine: Recommendation or Mandate?, is being issued through the Jacobs Institute of Women's Health, which is affiliated with the School of Public Health and Health Services at The George Washington University.

Click here to download the full report.

The paper concludes:

• State laws that require immunization as a condition of enrollment in school increase the use of vaccines, reduce disease, lessen racial disparities in vaccine coverage and increase available funding. According to a recent New England Journal of Medicine (December 7, 2006) commentary, "Requiring HPV vaccination by law will almost certainly achieve more widespread protection against the disease than will policies that rely exclusively on persuasion and education."
• Surveys have generally shown that young women are very interested in getting the HPV vaccine, that parents are willing to have their children vaccinated, and that clinicians are inclined to offer the vaccine in their practices. Both the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics endorse the use of the vaccine by their members.
• Experts emphasize the importance of creating immunization opportunities. Adolescents, especially from minority and low-income communities, have poorer access to care than any other population in the United States. A voluntary HPV vaccine is less likely to reach adolescents in medically underserved communities, contributing to further health disparities
• Concerns about individual liberties, patient autonomy, and parental rights, and attitudes towards adolescent sexuality, generally underlie objections to an HPV vaccine mandate.
• Whether or not the HPV vaccine becomes mandatory, existing financing mechanisms will leave some women without coverage for it, forcing them either to pay hundreds of dollars out-of-pocket, or to go without potentially lifesaving protection.

For more information about the HPV vaccine:

Alexandra Stewart, JD
Assistant Research Professor
Department of Health Policy
School of Public Health and Health Services
The George Washington University
2021 K Street, N.W., Suite 800
Washington, DC 20006
202-530-2331
E-mail: stewarta@gwu.edu