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News of the Day ... In Perspective

12/11/2006

Lawmakers rush to mandate HPV

Less than 3 months after the Food and Drug Administration licensed a vaccine against human papillomavirus, Michigan lawmakers proposed making it mandatory for girls entering sixth grade.

Women in Government, a Washington-based organization of female legislators, is leading a push to make HPV vaccine compulsory in every state. The purpose is to prevent cervical cancer, which is diagnosed in about 10,000 women per year.

Advocates argue that “minors have a right to be protected against vaccine-preventable illness, and a society has an interest in safeguarding the welfare of children who may be harmed by the choices of their parents or guardians,” explains James Colgrove in a publicly accessible article in the Dec 7 issue of the New England Journal of Medicine.

While initial opposition came from religious conservatives concerned about undermining an abstinence-based message, Colgrove notes that the controversy raises issues far beyond religion and adolescent sexuality. At issue are the acceptability of mandatory public health measures and the scope of parental autonomy.

Efficacy claims are based on a surrogate endpoint (cytologic changes), as the period of observation was not long enough for any study subjects to develop cervical cancer. The latent period for cervical cancer is around 35 years, stated vaccine researcher Kenneth Hatch, M.D., in response to questions at a CME conference.

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