Renewing the debate for an HPV school-entry vaccination mandate in Maryland


HPV vaccine being administered (JOE RAEDLE / GETTY IMAGES)

In 2007, a human papillomavirus (HPV) school-entry vaccination mandate was introduced and then withdrawn in the Maryland legislature.  The major concerns at the time was that the vaccine was too new, it was too costly, and that it was intended to prevent a sexually transmitted disease.

Since then, no substantial action has been taken and there has been no formal deliberation about re-introducing an HPV vaccine mandate in Maryland.  In the years since the mandate was introduced, cervical cancer has continued to rise in Maryland with nearly 200 new cases per year according to the most recent data from the Maryland Department of Health.

It is unanimous among the scientific community that nearly all cervical cancer cases are caused by HPV.  It is understandable that the public was apprehensive of the HPV vaccine in the past, but now we know that:

  • The vaccine has been administered for nearly 10 years and is proven to be safe
  • The vaccine is very effective and can prevent thousands of deaths from cervical cancer
  • There is no evidence that the HPV vaccine increases the chances of risky sexual behavior
  • Insurance plans are required to cover the cost of the vaccine under the ACA and it is also available at no cost through Medicaid’s Vaccines for Children Program

Virginia, the District of Columbia, and recently Rhode Island have enacted school-entry mandates for HPV vaccination.  DC passed the law in 2007 and as a result, they are now a national leader in HPV vaccination coverage.

It has been eight years since the HPV vaccine mandate was first debated in Maryland and it is time to renew that debate.  If Maryland is serious about preventing a deadly form of cancer, they should follow their neighbors’ lead and enact a school-entry HPV vaccination mandate.


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7 Responses to “Renewing the debate for an HPV school-entry vaccination mandate in Maryland”

  1. mgaul13 Says:

    As a Maryland resident, I would love to see this instituted! They could definitely take note of the progress DC has made.
    This article was recently posted:
    Discusses a new report published by the CDC that shows decreasing trends in HPV vaccination. Interviews among family and doctors alike showed a strong correlation to the decreasing numbers due to discomfort among parents and doctors discussing sexual health with children. I think there is also talk among parents, who can cause more of a stigma against the vaccination. In my opinion, creating a mandate to require the vaccination can reduce some of that stigma and take pressure off of the parents and doctors. Although, lack of comprehensive sexual health education, and discomfort among parents in discussing sex with the children is another important issue that also needs significant improvement.

  2. canakwe1 Says:

    Well written post. This issue is particularly important in Baltimore, given that Baltimore City has 25% more deaths from cervical cancer than the US average. I wanted to add that one of the Healthy People 2020 objectives is to vaccinate 80% of 13-15 year old boys and girls against HPV. Given that this is already a national priority, why is it that Maryland has not joined the nation in making cervical cancer prevention a priority? While I am surprised that this issue has not been re-introduced into legislature since 2007, I am also wondering how we, as public health professionals, have used other avenues to improve vaccination coverage. Most children make yearly contact with a physician (sick visits, sports physicals, other vaccines) but only 24.5-39.5% kids have received all 3 doses of the vaccine. Have we taken advantage of this and mobilized physicians to educate parents about the HPV vaccine? Maybe provider-led patient education could be a policy objective that would empower parents to make truly informed decisions about whether to vaccinate their children against cancer.

  3. sdell2 Says:

    Even in states that have passed laws mandating HPV vaccination, many of the requirements pertain only to females entering school. It is imperative that mandates include requirements for males as well, as it prevents them from acquiring and spreading HPV. Additionally, HPV has been found to contribute to anal and oral cancers in both men and women. The CDC supports HPV vaccination in boys as well:

  4. manishs1 Says:

    I agree, the mandate should apply to males and females. Requiring only one gender to get vaccinated was a contributing factor to the initial backlash against school-entry mandates. Virginia currently only requires females to get vaccinated. DC ( and Rhode Island ( require both males and females to get vaccinated.

  5. ehorinek Says:

    I feel like there is one very important aspect of this topic that everyone gets hung up on: that this vaccine prevents an STD. I can’t help but wonder what the outcome would be if everyone forgot that, and just realized that this is actually a vaccine that can prevent cancer.

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