Vaccine proposal likely to stir debate

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http://www.chron.com/disp/story.mpl/front/4459579.html


Jan. 10, 2007, 8:28AM

Vaccine proposal likely to stir debate

Cost, rights are key issues in plan requiring girls to get shot for virus spread by sex

By TODD ACKERMAN
Copyright 2007 Houston Chronicle

A plan requiring sixth-grade girls to be vaccinated against a sexually transmitted virus that causes cervical cancer can expect a flurry of opposition in the Texas Legislature.

Critics contend that bills already filed in both houses would take away parents' rights, send the wrong message to impressionable young girls and cost more than many parents can afford.

"Don't we put seat belts on our kids, helmets on bike riders?" asked state Sen. Leticia Van De Putte, D-San Antonio, sponsor of the Senate bill. "This is one more thing we can do to protect our daughters."

State Rep. Jessica Farrar, D-Houston, the sponsor of the bill in the House of Representatives, said she is hopeful about its chances but not quite optimistic. She said "ideology has prevailed over science" lately.

The bills would require girls to have received the vaccine to enter the sixth grade, but include opt-out provisions.

The vaccine, known under the trade name Gardasil, was approved by the Food and Drug Administration in June, and a Centers for Disease Control and Prevention advisory committee soon after it was recommended that girls and women 11 to 26 receive it.

The vaccine targets the human papillomavirus, the most common sexually transmitted infection in the country and the cause of nearly all cervical cancers.

Though the infection often clears up on its own, it leads to about 10,000 U.S. cases of cervical cancer a year and 3,700 deaths.


Wrestling with mandate

Texas could become the first state to mandate the vaccination. Last month, a bill died in Michigan's legislature, largely over questions about why government should be involved with the delivery of the HPV vaccine.

Two other states — California and Kentucky — also are considering bills to make the vaccine mandatory, and legislatures in some other states are expected to consider the matter when they convene.

Even CDC spokesman Curtis Allen acknowledged that mandatory vaccination against HPV isn't "as straightforward as it would be against measles or whooping cough because it's not as contagious."

He says requiring the parents of girls to pay for the vaccine, but not the parents of boys, poses gender-equity issues.

The drug is expensive — Merck lists the three doses at $120 apiece, but a quick survey of Houston providers found it typically sells for $150 to $200 a shot.

According to the Texas Department of Insurance, many private insurers are not offering coverage of the shots. In addition, an estimated one-quarter of Texans do not have health insurance.

Advocates for mandatory testing argue that it's only a matter of time before individuals' health insurance covers the vaccine and that a state law will expedite the process. They also note that a federal vaccine-for-children program is expected to provide the shots for low-income families for free or nearly free.


Local opinions

A few Houstonians interviewed about the legislation Tuesday were supportive of the idea.

"I'm all for anything we can do to help prevent cancer," said Nancy Clites, a Houston homemaker with a daughter in graduate school and a 24-year-old son recently diagnosed with colon cancer. "It's going to require an effort on the part of parents to educate their children when they get the vaccine. But if my daughter were entering sixth grade now, I think I'd have her vaccinated, even if it wasn't required."

But Susie Moore, a retired Conroe resident, said she's sympathetic to the argument that the shot could give young girls implicit permission to have sex.

"I'm old enough to remember when the Pill was introduced," Moore said. "People raised the issue that it would cause promiscuity and advocates denied it, but promiscuity definitely followed."

Moore, who added that she thinks there are bigger problems with the health care system to fix, nevertheless said she is leaning toward supporting the legislation.

One thing that seems clear is that without legislation mandating the vaccine, not that many girls figure to line up for the shots.

Dr. Stephen Tyring, a University of Texas Medical School at Houston professor and investigator in the study that found Gardasil prevents cancer, said that before the chicken pox vaccine was made mandatory, about 10 percent of eligible Texas children got the shot. Since the law went into effect, 90 percent get it.

A local Planned Parenthood spokeswoman said demand for the vaccine at its clinics has come more from women in college and their 20s than from parents seeking it for their pre-teen daughters.


Effectiveness questioned

The president of Parents Requesting Open Vaccine Education, a Texas organization whose lobbying led to state law allowing parents to sign a waiver to opt out of receiving a required vaccine, argued there are still too many unknowns to require the HPV vaccine.

"There's no proof this vaccine will protect women from cancer, given how short a time women in the study were followed and the lengthy incubation time the HPV virus requires," said group co-founder Dawn Richardson. "By mandating the vaccine, the Texas Legislature would be sending the message that being vaccinated against an STD is more important than receiving education."

Van De Putte says there are 162,000 sixth-grade girls in Texas who would be eligible for the shot.

todd.ackerman@chron.com

URL:
http://www.chron.com/disp/story.mpl/front/4459579.html
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