Here's a quick summary from CDC about why HPV vaccines are offered:
Why are HPV vaccines needed?
HPV vaccines prevent serious health problems, such as cervical cancer and other, less common cancers, which are caused by HPV (human papillomavirus). In addition to cancer, HPV can also cause other health problems, such as genital warts. HPV is a common virus that is easily spread by skin-to-skin contact during sexual activity with another person. It is possible to have HPV without knowing it, so it is possible to unknowingly spread HPV to another person. Safe, effective vaccines are available to protect females and males against some of the most common types of HPV and the health problems that the virus can cause.
How common are the health problems caused by HPV?
HPV is the main cause of cervical cancer in women. There are about 11,000 new cervical cancer cases each year in the United States. Cervical cancer causes about 4,000 deaths in women each year in the United States.
About 1 in 100 sexually active adults in the United States have genital warts at any one time.
Who should get HPV vaccine?
Cervarix and Gardasil are licensed, safe, and effective for females ages 9 through 26 years. CDC recommends that all girls who are 11 or 12 years old get the 3 doses (shots) of either brand of HPV vaccine to protect against cervical cancer. Gardasil also protects against most genital warts, as well as some cancers of the vulva, vagina, and anus. Girls and young women ages 13 through 26 should get all 3 doses of an HPV vaccine if they have not received all doses yet.
That's pretty straightforward. At least, it was until Rick Perry decided to run for president, and his Republican politicial opponents decided to make an issue of his executive order mandating the vaccine in Texas in 2007 (an action quickly rescinded by the legislature). From an excellent piece by
Laura Bassett:
In the two most recent presidential debates, Perry has had to repeatedly explain and defend the executive order, which he says he signed in order to help prevent girls from developing cervical cancer as a result of the sexually transmitted virus. But his fellow Republican candidates have seized the opportunity to attack him over the issue, at times using some alarming and misleading rhetoric about the vaccine.
Rep. Michele Bachmann (R-Minn.) blasted Perry for the vaccine mandate on Monday, calling it a "government injection" of a "potentially dangerous drug." Then Tuesday morning, she insinuated to NBC's "Today Show" that the vaccine can cause mental retardation.
Bad move by Bachmann, who was slammed by health authorities. This is from the
American Academy of Pediatrics (PDF):
The American Academy of Pediatrics would like to correct false statements made in the Republican presidential campaign that HPV vaccine is dangerous and can cause mental retardation. There is absolutely no scientific validity to this statement. Since the vaccine has been introduced, more than 35 million doses have been administered, and it has an excellent safety record.
The American Academy of Pediatrics, the Centers for Disease Control and Prevention, and the American Academy of Family Physicians all recommend that girls receive HPV vaccine around age 11 or 12. That's because this is the age at which the vaccine produces the best immune response in the body, and because it's important to protect girls well before the onset of sexual activity. In the U.S., about 6 million people, including teens, become infected with HPV each year, and 4,000 women die from cervical cancer. This is a life-saving vaccine that can protect girls from cervical cancer.
Bachmann is being hit on one issue (the appropriateness and safety of the vaccine) while Perry is being hit on another issue: an exec order mandating its use.
What's the status of that around the country? A useful thumbnail is provided by the National Conference of State Legislatures. Lots of states have discussed mandating the vaccine (with parental opt-out for various reasons) but only DC and TX [and VA, see Laura Bassett] have gone there, and doing it by exec order is a sure way to get sucked into controversy. Something like that requires homework and consensus building.
Perry is also mired in an associated donor fund controversy (see Rick Perry and HPV vaccine-maker have deep financial ties) but the issues are separate: Is HPV vaccine appropriate and safe? Yes. Should it be mandated? Not the way Perry did.
For an opinion on the Big Picture, I asked for comment from the American Public Health Association's Georges Benjamin. Here's what he said:
Vaccines save lives. The HPV vaccine in particular attacks cancer through it's infectious source and will save the lives of thousands. It is the forerunner of a new approach to disease prevention; an approach that has enormous promise to save millions of lives in the future and be part of our 21st century tool chest to end cancer as we know it. Some vaccines should be required, as we do for some of our childhood vaccines. however the decision to mandate the vaccine in Texas did not go through an appropriate public policy decision making process, and we are now seeing the negative political and social ramifications of that decision.
We have in place several mechanisms to give policy makers sound advice to aid them in their decisions that effect the health of our citizens. National Groups like the Advisory Committee for Immunization Practices (ACIP), the Institute of Medicine as well as professional groups like the American Academy of Pediatrics or the American Public Health Association are available to give sound professional advice. Many local affiliates of these and other groups are also available. They bring a evidence based approach that brings credibility to the policy making process. Policy makers would be wise to seek their guidance and craft both their policy approaches and their remarks accordingly.
Georges C. Benjamin,MD
Joan H. Tisch Distinguished Fellow in Public Health
Adjunct Professor, Hunter College
Executive Director
American Public Health Association
That's a pretty good summary of the whole situation. There are very good reasons to administer this vaccine, but no reason to take public policy shortcuts to get there. So from the political side, Michele Bachmann and Rick Perry each deserve to be slammed, but for entirely different reasons.
