States, France Take Actions On HPV Vaccination

About two dozen states are "struggling to decide" how to recommend girls ages 11 and 12 receive an HPV vaccine, the Chicago Tribune reports. One option would be to provide state funding to pay for vaccines or force insurance carriers to do so, and the second option would be to add the HPV vaccine to the list of mandatory vaccinations for admission to school (Peres/Japsen, Chicago Tribune, 2/11). Merck's HPV vaccine Gardasil and GlaxoSmithKline's HPV vaccine Cervarix in clinical trials have been shown to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases. FDA in July 2006 approved Gardasil for sale and marketing to girls and women ages nine to 26, and CDC's Advisory Committee on Immunization Practices later that month voted unanimously to recommend that girls ages 11 and 12 receive the vaccine. GSK in April plans to file for FDA approval of Cervarix, and it expects approval by the end of this year (Kaiser Daily Women's Health Policy Report, 2/8). Merck has "fanned out" across the U.S. to urge states to either mandate HPV vaccines for young girls or to spend millions of dollars of public funds to purchase the vaccine for use in health clinics, the Washington Post reports. The company also has launched a television advertising campaign about HPV, cervical cancer and Gardasil. "We're certainly very proud of our efforts," Margaret McGlynn, president of Merck's vaccines division, said, adding, "We spent over 10 years developing Gardasil. We think this is a very important advance in women's health" (Gardner, Washington Post, 2/11). France and several states recently have taken actions on HPV vaccination. Summaries appear below.

• California: A bill (AB 16) that would require all California girls entering the sixth grade to receive an HPV vaccine, with an exception for girls whose parents file a letter stating that participation is against their beliefs, has some parents "decrying" what they believe to be an "incursion on parental rights," the Los Angeles Times reports. Gov. Arnold Schwarzenegger (R) has not taken a public stand on the bill, but his proposed fiscal year budget for 2007 includes about $11 million in additional funding to cover the vaccination for 50,000 Medi-Cal beneficiaries ages 19 to 26 (Uribarri, Los Angeles Times, 2/12).
  
  
• New York: State Assembly member Amy Paulin (D) plans to introduce a measure this week that will mandate the HPV vaccine to girls ages 11 and 12, Long Island Newsday reports. Christine Anderson, spokesperson for Gov. Eliot Spitzer (D), said whether the HPV vaccine "will be mandated is something that will be looked at" by the governor, adding that $1.5 million has been included in the executive budget "to promote and expand access to the vaccine" for low-income women and girls. If the budget is approved, the funds would provide the vaccine to an estimated 4,000 women and girls annually (Ricks, Long Island Newsday, 2/11).
  
  
• Vermont: Rep. Denise Barnard (D) recently introduced a bill (H 256) that would require girls entering the sixth grade to receive an HPV vaccine, the Barre-Montpelier Times Argus reports (Larkin, Barre-Montpelier Times Argus, 2/11). The measure would allow girls to opt out of the requirement if their parent or guardian submits in writing that the "person, parent or guardian has religious beliefs or moral convictions opposed to immunization" and has received information about the vaccine and the link between HPV and cervical cancer (H 256 text, 2/12).

Editorials

• Chicago Tribune: FDA approval of Gardasil has "ripped open a riveting debate about how far lawmakers should go to protect us from ourselves" a Tribune editorial says. As "emotions hea[t] up, a lot of misinformation and unnecessary anxieties are being stirred," the editorial says, adding, "For now, Gardasil appears to be a very important and welcome life-saving step in the fight against cancer" (Chicago Tribune, 2/11).
  
  
• Washington Post: The debate over requiring girls to be vaccinated "should be about what's in the best interests of ... young women" and should "not be about the interests of the maker of the vaccine," a Post editorial says. According the editorial "the two are being confused" because of Merck's lobbying campaign. "The best move Merck can now make is to back off," the Post says (Washington Post, 2/11).

France
Health Minister Xavier Bertrand on Friday announced that France will subsidize the cost of Gardasil during the first half of 2007, Reuters reports. It is a "major step towards improving the health of the public," Bertrand said, adding, "We have already got the process under way, and before the end of the first half of 2007, before July, it will be subsidized" (Reuters, 2/9).

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