Term Paper: Human Papilloma Virus Vaccine

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[. . .] Monthly teleconferences and meetings were held by the workgroup thrice a year to review published as well as unpublished data related to HPV vaccine clinical trials along with data on efficacy, immunogenicity and safety of the vaccine. Moreover, data on HPV epidemiology, natural history and sexual behavior in the United States was also reviewed. Economic and cost effective analyses were carried out. During ACIP meetings in 2005 and 2006, presentation on these topics were held. The ACIP HPV vaccine group devised and discussed the recommendation options. The expert opinion of the workgroup for the recommendations was taken when there was a lack of evidence. The recommendations were approved in 2006 ACIP meeting.

For effective control of vaccine-preventable diseases among the population, ACIP provides advice and guidance to the Secretary (HHS) and Director (CDC) for the best selection of vaccines and related products. It may also provide advice for disease control for which a U.S. licensed vaccine is present. This guidance encompasses right use of vaccine and might include recommendations for administration of antibody preparations or anti-microbial therapy that prove effective for controlling the same disease. Unlicensed vaccines may be employed in some circumstances. For every vaccine being recommended, the committee shall review the population groups and circumstances under which the vaccine is recommended. Guidance is developed by the committee on correct route, vaccine dose and frequency of administration, relevant antibody or antimicrobial agent.

Recommendations on precautions and side effects related to the vaccines are also be provided by the committee. Consideration of population-based studies like risk, efficacy and cost, are included in the committee deliberations on appropriate vaccine use. As new information comes or the disease risk varies, the committee withdraws or modifies their recommendations related to the particular vaccine. The committee also provides recommendations regarding the general use of vaccines and antibodies as a category of biological agents. These recommendations govern factors like administration method, dose and dosage interval, adverse effects, storage, handling and special conditions or populations requiring modifications in recommendations. The committee also produces a periodical review and revises the list of vaccines aimed at children or adolescents who are eligible to get vaccination through Vaccines for Children Program (Department of Health and Human Service, 2012).

The Vaccines for Children (VFC) program is the supplier of vaccines to all states and territories. These vaccines are delivered to the children free of cost. This program provides all the vaccines recommended by ACIP. The program has reduced the vaccine prices to a great extent and it guarantees that all the states pay the same contract prices for the vaccines (Centre for Disease Control and Prevention, 2007).

State's Role

There is a great debate on whether girls should be vaccinated against Human Papilloma virus (HPV) that is the root cause of cervical cancer and genital warts. This sequence of events branched from the June 2006 ACIP recommendations on routine vaccination of girls in the age group 11-12. This vaccine is now recommended for males as well (National Conference of State Legislatures, 2009).

The Michigan Senate was the first one to introduce legislation for HPV vaccination for girls entering sixth grade. However, the law was not enacted. In late 2006, Ohio also recommended legislation but that also failed. Since 2006, legislation to make the vaccine mandatory, funding and educating the public about HPV vaccine was introduced by 41 states along with Washington D.C. Almost 21 states like Louisiana, Maryland, Minnesota, New York etc. have enacted legislation.

CDC announced in 2006 that The New Hampshire Health Department would provide the vaccine free of costs to girls less than 18 years of age. It was reported that the department distributed almost 14,000 doses in the state. The Governor of South Dakota also announced a relevant plan that incorporated $7.5 million in federal vaccine funds and $1.7 million from the state's general fund. About 20, 000 doses of vaccines were distributed. In 2007, Texas also enacted a mandate by executive order with some exceptions that vaccine be received by girls entering sixth grade.

The Virginia legislature also passed a school vaccine requirement in 2007. In the same year, almost 24 states and Washington introduced legislation to mandate the HPV vaccines for school. The bill was enacted later. California and Maryland were among those who withdrew their bills.




SB116 demands from the Department of Health to adopt a rule for adding HPV to the list of communicable diseases having immunization recommendations, it requires that disease awareness and vaccine availability may be ensured by the schools to the parents and guardians of the school students. Died in committee in September, 2012).


HCR 71 would ask the Department of Health to make HPV vaccination accessible to the natives through the teen VAX program. It also urges the insurers to provide HPV immunization to female policy holders of the ages 11-26. The bill was deferred in committee in January, 2011.


SSB 3097 will develop a study bill for HPV public awareness program and enable provisions of vaccinations and cervical cancer screenings through this program.


HR80 would persuade females aging 9-26 and males of the age group 11-26 to acquire HPV vaccinations and all citizens to get awareness related to HPV vaccination benefits. The bill was passed in February, 2012.

Table. Legislations introduced in 2011-2012 at the state level (National Conference of State Legislatures, 2009).

Reasons why HPV vaccination should be mandatory for young girls

HPV infection is the leading cause of cervical cancer. In 2007, some 11,150 cases of invasive cervical cancer were reported out which some 3670 were chronic (Tamaki, 2007).

Prevention is better than care. HPV vaccine can prevent the disease which is preferable to treating the disease. By vaccinating young adolescents, thousands of them will be saved from hospitalization, surgery or premature death. According to CDC, cost per life saved by vaccinating against high risk HPV types 16 and 18 is almost $25,000 which is reasonable if other preventive interventions are compared. For example, cost saved by hypertension screening in 40-year-old men is almost $28,000.

Safety is the main concern for the use of vaccine. The studies conducted on the Gardasil's safety have guaranteed that it is safe to use. There is no potentially infectious live virus or active viral DNA in the vaccine. Also, other Gardasil components are used in some other vaccines.

HPV has no cure. The treatment options are there to deal with the disease conditions only. If the vaccine is made mandatory, greater number of women will reach to it and a lot of difference in cancer reduction will be achieved that would save millions of lives.

Reasons why HPV vaccination should not be mandatory for girls

Gardasil is not 100% effective against HPV. About 70% of the HPV strains that lead to cervical cancer could be prevented by it. If Gardasil is able to reduce the number of HPV infections and control mortality rate, that would be enough to motivate parents to get their young daughters vaccinated and there would be no need to involve government and make the vaccine mandatory.

In my view, peace of mind can only be obtained by personal choice not by government pressure. If Gardasil is made accessible and advertised increasingly, most parents will obviously get their daughters vaccinated.

People in the society try to eradicate the consequences of sin. The motive should be to encourage people to stop engaging in immoral sexual behaviors. It is ironic to say that people spend billions of dollars looking for ways to prevent the disease. If today, every man on earth starts following God's laws of sexual activity, HPV would disappear from a generation. HPV is turning into an epidemic because we refuse to obey God.

There is a possibility that taking the vaccine may make the young girls more prone towards the disease as their belief that vaccination ensures that they can sleep around with no fear, will result in more sexual encounters and more sexual intercourses means more HPV transmission.

Personal Perspective

In my view point, any mandate is a failure if it does not deal with three issues which are financing, school related matters and handling the refusals. Such mandate could do more harm than good. In case these issues are addressed effectively, I shall be a big advocate of mandate.

However, I believe that in the absence of mandate, the state will be less interested to ensure funding for the children who cannot afford the vaccine to get themselves vaccinated. Moreover, parents and children will not come across the vaccination issue much seriously if the vaccine is not mandated. Children at the preadolescent age (11, 12, 13 and so forth) rarely visit a doctor.

The vaccine is not able to eradicate cervical cancer or papilloma warts. Vaccinating young girls enable them to make sure that whatever they experience in their life, they are able to prevent 70% of HPV infections leading to… [END OF PREVIEW]

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