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O P P O S E D
HPV Vaccine Mandate
A 5810 Paulin
An Act to amend the public health law, in relation
to mandating immunization against the human papillomavirus (HPV)
New Yorkers for Constitutional Freedoms (NYCF) supports efforts to improve the health of women and all New Yorkers,
but believes that requiring minor girls to receive mandatory immunization against a sexually transmitted disease is a
violation of parental rights. NYCF asks members of the Legislature to consider the following information.
CORE FACTS:
- School-based immunization laws have been instituted since the 19th century to prevent the spread of highly
communicable diseases, such as smallpox and measles.
- Mandatory vaccination has been an effective way to prevent widespread infection in the school setting where
disease exposure is increased and transmission is intensified due to large numbers of children together for long
periods of time.
- The State of New York recognizes a parent or student’s right to refuse immunization due to a “sincere
religious conviction.” (see Regulations of the Commissioner, Section 136.9)
- HPV (human Papillomavirus) is a virus that can cause abnormal tissue growth on different cell surfaces,
in and on the human body. Over 100 types or strains of HPV exist. HPVs causing warts on outer skin layers, such
as hands, are different than HPVs which grow on mucus covered surfaces in the throat and genitals.1 Over 30 HPV
types are sexually transmitted.2
- Sexually transmitted HPV has been shown to be present in virtually all cases of cervical cancer, and it is
the leading cause of cervical cancer. High risk HPV types 16 and 18 cause 70 percent of cervical cancer cases.3
Gardasil, produced exclusively by Merck & Co., is a vaccine that protects against infection with four HPV types
which are responsible for 70% of cervical cancers (types 16 and 18), and 90% of genital warts (types 6 and 11).
CONCERNS:
- The vaccine can only protect against infection by each of these four HPV types if a person has never been exposed
to the HPV type before.4
- Gardasil will not protect against other strains of HPV. Thirty percent of cervical cancers are due to infection
with HPV types not included in the vaccine. Vaccination with Gardasil will not eliminate the need for regular Pap test
screening.
- Gardasil does not provide protection from other sexually transmitted diseases such as syphilis, chlamydia,
gonorrhea, HIV, etc.
- Although the vaccine is approved by the Food and Drug Administration, there are still significant concerns
about its safety:
o Is the vaccine safe for preteens considering the fact that Merck’s sample of preteens was significantly
smaller than other ages studied?
o What possible interactions might there be with other medications, particularly in light of an ever increasing
number of teens taking prescription drugs?
o What are the long term effects of this vaccine?
- The vaccine is not the only method of prevention; it is not even the most effective one. Sexual abstinence
until marriage, followed by sexual fidelity within marriage, reduces the risk of cervical cancer almost to zero.
CAUTION:
- There is no consensus in the public health community for school mandates. The American Academy of Pediatrics
is urging a go-slow approach, focused on raising public awareness and monitoring the safety of the vaccine.
- While the concern has not been unanimous, a large part of the medical community has either directly opposed
or urged caution towards mandatory vaccination at this time. For example, The Wall Street Journal quotes an HPV
expert and a specialist in adolescent medicine at Johns Hopkins as opposing a mandate. "It's not the vaccine community
pushing for this," says Dr. Martin Myers of the National Network for Immunization Information. "[T]his isn't as clear-cut
as with some previous vaccines."
- The reason it "isn't as clear-cut" is that the cancer-causing strains of HPV are not transmitted through casual
contact, as are other diseases that are subjects of mandatory vaccination, such as measles or mumps. If a disease is
actually transmitted in the classroom, then the public health risk to the school itself may be sufficient to justify a
mandate. This is not the case with HPV.
- The Centers for Disease Control recommends that vaccination for HPV be part of the routine standard of medical
care, but they take no position on the issue of making it mandatory for school attendance.
COSTS:
- Merck & Co is the only source for the vaccine Gardasil.
- The vaccine requires three separate injections at a cost of $120 each, or $360 for the series of three shots.
Total costs for administration of vaccine doses may be higher.5
CONCLUSION:
New Yorker’s for Constitutional Freedoms asks that Legislators reject A5810, and consider an alternative
such as A7403 (Benjamin) that “encourages voluntary, informed, vaccination against the human Papillomavirus.” NYCF favors
an “opt in” policy rather than an “opt out”.
NOTES:
1. National Cancer Institute, Dictionary of Cancer Terms. U.S. National Institutes of Health. www.cancer.gov
(February 6, 2007).
2. National Cancer Institute Fact Sheet, Human Papillomaviruses and Cancer: Questions and Answers. p.1. U.S. National
Institutes of Health, www.cancer.gov (February 6, 2007).
3. Human Papillomavirus: HPV Information for Clinicians, Centers for Disease Control and Prevention (November 2006):
pp. 7, 9
4. Human Papillomavirus: HPV Information for Clinicians, Centers for Disease Control and Prevention, (November 2006): p. 9
5. Fact Sheets: Women's Health Policy Facts. HPV Vaccine: Implementation and Financing Policy. The Henry J. Kaiser Family
Foundation, (January 2007).
5-18-07
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