In the District of Columbia and Virginia, the HPV vaccination is available, but not all are choosing to have it
FOR DENISE Haggans, the decision to get her 11-year-old daughter Lanise vaccinated against the human papillomavirus (HPV) was an easy one.
“It wasn’t really a choice,” says Haggans while waiting in line at Kelly Miller Middle School during one of the District of Columbia’s free immunisation clinics. Lanise received her second of three doses of the HPV vaccine at the clinic. “The school said she needed it, so I got her it,” Haggans says.
For the first time since the US Food and Drug Administration (FDA) approved the controversial vaccine in June 2006, schools in the District and Virginia are asking that girls entering sixth grade receive the vaccine designed to protect them against HPV, which causes genital warts and can result in cervical cancer.
Parents in both jurisdictions can choose to opt out of having their daughters vaccinated. In the District, parents must fill out a form affirming their decision; in Virginia, parents can simply choose not to have their daughters vaccinated.
“This is a liberal opt-out policy,” says Sandra Sommer, of Virginia’s Department of Health. “The legislation was passed but parents can opt out without a waiver.”
Supporters of the vaccine say it will help millions of young people avoid contracting one of the most common sexually transmitted diseases in the nation. According to the Centers for Disease Control and Prevention, more than 20 million people in the US are infected with HPV and at least half of all sexually active people will acquire the virus in their lifetime. Gardasil, the vaccine, is most effective if administered before a girl becomes sexually active.
“Certainly in terms of preventing the most common strains of the disease that cause genital warts, this vaccine is effective,” says Kathy Woodward, a doctor at Children’s National Medical Center in Washington who specialises in sexually transmitted diseases. “As opposed to being resigned that everyone will get HPV, we now have a tool that can prevent it.”
Opponents say the drug has not been tested enough and that parents have not been properly educated about potential side effects.
Tilli Williams, a licensed naturopathic doctor in Washington, counsels her patients against receiving the vaccine. She believes schools should wait to see the effects of the drug after 10 or 15 years before requiring it. “I’m just totally against mandating this,” she says.
After the release of Gardasil, the Maryland General Assembly commissioned a group of school officials, doctors and parents to study whether the state should require vaccinations. After reviewing the drug’s availability, affordability and effectiveness, the group recommended in June that the HPV vaccination should remain voluntary, says Greg Reed, a programme manager at Maryland’s Department of Health and Mental Hygiene.
Tracy Lloyd (32), who is among about a dozen activists in the Parents’ and Citizens’ Committee to Stop Medical Experimentation in DC, says she fears “they are using our girls as guinea pigs. I wouldn’t have my daughter vaccinated”.
She also believes the city’s efforts to educate parents have fallen short. “The city is steamrolling this legislation through as if it has made a good faith effort to educate the community,” Lloyd says.
Pierre Vigilance, director of the District’s Department of Health, says his office held community forums in each ward, passed out fliers and e-mailed school discussion groups to help parents understand the issues surrounding the vaccine. “We hope parents can make informed decisions about whether to follow through with this decision,” he says.
An analysis published in last week's Journal of the American Medical Associationfound that at least three medical associations promoted Gardasil using funds provided by Merck, the vaccine manufacturer. Lloyd and Williams believe that such tactics have caused parents to have their daughters vaccinated without proper scrutiny of the drug's effects.
“I wish they would have made it an opt-in policy,” Williams says. “To make it an opt-out policy makes it hard on parents who don’t have the time, the energy and the knowledge to see if is something that they have to do.” – (Los Angeles Times/Washington Post)