Campaign For HPV Vaccine Requirement May Have Been Hasty, Backfired

Gardasil, the brand name for the human papillomavirus (HPV) vaccine, serves as a shield against nine strains of the virus which cumulatively comprise 90 percent of cervical cancer cases in the United States. So why are public schools so reticent to require it?

According to the Journal of the American Medical Association (JAMA), only Virginia and the District of Columbia require the vaccine; Rhode Island will soon follow suit. But in both Virginia and D.C., parents can easily opt out of the program. Eight years after its introduction, these numbers seem especially rare. However, as science writer Robin Merentz Henig suggests in an article for NPR, low adoption rates may have everything to do with the way the vaccine was ushered into the medical scene. From NPR:

“Part of the problem is that the original testing on the vaccine was done only on girls, and its 2006 approval was for girls only; approval for boys didn’t come until 2009, and it wasn’t added to the list of vaccines for boys until 20011.”

The sex-based staggering of approval dates proved fertile ground for those who opposed the drug. Exclusively requiring the HPV vaccine for young girls—typically, it is administered to 11- and 12-year-olds—encouraged arguments that the vaccine, which protects against a sexually-transmitted infection leading to cancer, “would introduce sexuality, that would inappropriately introduce promiscuity,” says professor of health policy and management Sarah Gollust.

Gollust, who is on faculty at the University of Minnesota School of Public Health, argues that if girls and boys had been approved at the same time, Gardasil might be required more widely. “No other vaccine is require for just one gender,” she explains, “so it felt like there was something different about this one.”

What’s more, calls for HPV’s universal requirement followed fast on the heels of its introduction, and Gardasil’s manufacturers were extraordinarily involved in the drive for legislation, leaving some question as to intention. And yet, Princeton University researcher Jason Schwartz explains,

“Even if well-intentioned, it wasn’t the right time to talk about requirements. That should come at a particular time in a vaccination program, when all the foundational work has been in place.”

Schwartz continues that every vaccine must undergo scrutiny for safety, and “questions of…supply and financing” must be answered as well, not to mention the “mechanisms of public health education.”

The HPV vaccine has been so embroiled in controversy that the Centers for Disease Control and Prevention (CDC) are attempting to “reframe the debate” and encourage its use the way one would any other drug that could save thousands of lives. “No drama needed,” says physician John Hallberg.