Vaccine a good idea, just don't mandate it

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Medical advancements, parental concerns, government clout and the powerful drug industry are facing off in what promises to be vigorous nationwide debate over vaccination of young girls against the sexually transmitted human papillomarivus virus, often a precusor to cervical cancer.

Sen. Richard T. Moore (D-Uxbridge), co-chairman of the Massachusetts Joint Committee on Health Care Financing, would like to see administration of the HPV vaccine Gardasil to sixth-grade girls become requisite to school attendance, much like shots for other childhood illnesses.

He just proposed legislation based on American Cancer Society recommendations that females as young as nine be vaccinated against HPV, which disproportionately affects minority communities.

Some parents, however, will feel enforcement runs counter to the value they place on sexual abstinence and would push them into discussions they do not wish to have with young children. These sentiments reflect arguments around condoms for protection against HIV, the virus responsible for AIDS.

We believe mandatory vaccination goes too far. A striking difference between HPV and illnesses which once wreaked havoc, such as whooping cough, polio, rubella and measles, is this: The latter are highly contagious - to classmates, for instance - with even casual, non-intimate proximity. HPV is not.

That said, we support a powerful campaign to provide information and free or low-cost vaccines to all in the state through pediatricians and gynecological clinics such as Four Women of Attleboro.

There are 9,710 new cases of cervical cancer and 3,700 deaths in the U.S. each year, according to the CDC, and Merck & Co., manufacturer of Gardasil, claims it prevents 99 percent of infections by two HPV strains that cause most cervical cancer and two strains that cause most genital warts.

Merck is the sole provider of an HPV vaccine, approved last year by the Food and Drug Administration. Another is reportedly in the works by a different pharmaceutical giant.

It's not yet known how long protection lasts and, of course, the vaccine enters a pre-existing climate of misgivings among some parents about perceived risk versus benefit of other childhood vaccines.

However, cervical cancer can be a stealthy killer that forms in tissues of the cervix (the organ connecting the uterus and vagina). It is usually slow-growing and may not have symptoms. It can be found with regular Pap tests, a procedure in which cells are scraped from the cervix and looked at under a microscope.

U.S. Census data from 2000 shows more than 400,000 girls between ages 10 and 19 in Massachusetts. Vaccinating all against HPV would cost $150 million. It is unclear, according to Moore, how many would be covered by their insurance or how many are part of low-income households eligible for state assistance. HPV vaccine costs $360 for the three-shot regimen.

His proposal to mandate vaccination has precedence in Texas. Gov. Rick Perry last Friday ordered the Health and Human Services Commission to draw up plans to make it the first state to require the vaccine, intended to be given before girls become sexually active.

Many other states are floating the idea.

We'd like Massachusetts to get the word out also, but through a vigorous informational campaign spearheaded by the Department of Public Health and supported by local boards of health, rather than through a vote in the legislature.

Source: The Sun Chronicle