Time to Reconsider HPV Vaccination Mandate in New Mexico

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By: Ann Tukpah, Adaora Chima, Ryan Davis, Janie Pak

Human Papilloma Virus (HPV) is the leading cause of cervical cancer with an estimated 10,800 new cases diagnosed annually in the United States. It is the most common sexually transmitted infection (STI) in the U.S.  and has no known cure.

In 2006, Merck & Co. introduced Gardasil, the first vaccine to protect against the high risk cancer-causing strains of HPV. Soon thereafter, several states introduced legislation regarding HPV vaccination of school-aged girls. In New Mexico, the legislature passed a bill mandating all girls entering sixth grade to be vaccinated with a provision for parents to opt-out.

Although Governor Bill Richardson originally expressed support for the bill, he ultimately vetoed its passage citing concerns raised by medical professionals regarding inadequate infrastructure and public awareness to support such widespread vaccination.

Since 2007, concerns regarding vaccine safety and efficacy have been allayed following further studies of the HPV vaccine with both the FDA and CDC (audio) concluding that this vaccine is safe and effective.  

New Mexico is currently ranked the state with the highest teen pregnancy, disproportionately higher amongst minorities, inferring a relatively high rate of unprotected sex amongst teens with its concomitant risk of STIs including HPV. Cervical cancer is associated with early onset of sexual activity making it imperative that primary preventive measures begin at an early age. While pediatricians recommend HPV vaccination routinely, a mandate would diminish the discrepancies of vaccination coverage among high-risk groups with poor access to healthcare.

We urge Governor Richardson to reconsider the need for legislation mandating HPV vaccination.

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2 Responses to “Time to Reconsider HPV Vaccination Mandate in New Mexico”

  1. achen85 Says:

    The whole debate concerning HPV is undoubtedly an interesting one. The Texas governor attempted to place a mandate for girls entering sixth grade, but this was overturned by the legislature. I believe Kentucky and Virginia are the only states that do have a mandate standing right now and require the vaccination prior tho the start of sixth grade. Some argue that it brings up the topic of sex at way too early of an age and may even encourage early sexual behavior. Furthermore, there is the issue of why boys are not thrown into the argument for mandatory vaccination. Though they may not develop cancer, from a public health perspective it is just as important if not more, to vaccinate them as well. Lastly, one other thing to consider is the issue of cost. I don’t know how much the whole series of HPV shots cost, but someone will end up needing to bear the cost, which may have also effected Gov. Richardson’s decision (not arguing by any means that this is a good enough excuse).

  2. sftedrowazizi Says:

    Great post, and very good points brought up in the first comment! Coming from a feminist perspective, I am always a bit hesitant about supporting policies that mandate some specific health measure — it becomes an issue of autonomy, and the rights of individuals to regulate their own bodies. A wonderful compromise on this issue, though, is creating an opt-out policy. This is what my organization, ACOG, supports in states that mandate perinatal HIV testing for example (as opposed to not offering a choice at all). It’s de-stigmatized as a routine part of care, while still recognizing individuals’ rights to refuse. I am curious if the New Mexico measure would have included an opt-out policy, or if Gov. Richardson would have made a different decision if it were included.

    I agree with the first commenter that we have a great opportunity to remove the weight of the cervical cancer burden from women, and achieve some gender balance in battling the disease by having the same vaccination requirements for girls and boys. Mandated vaccination for girls/women reinforces society’s gender double-standard — after all, how do most heterosexual and bisexual women acquire HPV in the first place? Although vaccination of boys for their own sake has not proven as cost-effective as vaccinating girls, it does open the door to discussion of men’s role in HPV infection. Regarding sexuality, this is an area where health providers really need to begin to step up and work on getting more comfortable talking to their patients (or their patients’ parents).

    Public health officials and health providers, supported by professional medical associations, are also in a good position to lobby for effective change. Bach’s 2010 study in _Lancet_ showed that high-risk populations with reduced access to care are the ones who are most likely to benefit from the vaccine (and unfortunately, the least likely to receive it). Think about it — if you’re well-off enough to have private insurance that covers the vaccine (or can afford to pay out of pocket), and actively seek out the prevention, then likely you are part of the same group that gets annual Pap tests and already has a reduced risk for cervical cancer. But if you are low-income and can’t always access health care and regular HPV screenings, then the vaccine is highly cost-effective. I hope advocates can take this evidence-based research and convince Gov. Richardson to change his stance.

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