Although much of the "resistance" to state efforts to mandate vaccination against human papillomavirus is "misguided," mandating the vaccine would be a "mistake at the present time," Arthur Allen -- a Washington, D.C.-based writer and author of the book "Vaccine: The Controversial Story of Medicine's Greatest Lifesaver" -- writes in Washington Post opinion piece (Allen, Washington Post, 4/8). Merck's HPV vaccine Gardasil in clinical trials has been shown to be 100% effective in preventing infection with strains 16 and 18, which together cause about 70% of cervical cancer cases, and about 99% effective in preventing HPV strains 6 and 11, which together with strains 16 and 18 cause about 90% of genital wart cases, among women not already infected with these strains. FDA in July 2006 approved Gardasil for sale and marketing to girls and women ages nine to 26, and CDC's Advisory Committee on Immunization Practices later that month voted unanimously to recommend that girls ages 11 and 12 receive the vaccine (Kaiser Daily Women's Health Policy Report, 4/5). According to Allen, "the fact that HPV is sexually transmitted is no reason to keep children from being vaccinated against it." Allen writes that a "controversial" decision in 1992 to vaccinate infants and adolescents against hepatitis B "has clearly shown that public health campaigns can prevent disease without causing moral turpitude," adding that HPV "is not linked to risky sexual behavior" and is "as common as influenza." In addition, "as long as the HPV vaccine is not required, the people who need it most probably won't get it." However, Allen writes that he has "reservations" about mandating HPV vaccination because of cost concerns, the vaccine's lack of a "track record" and its current lack of "credibility." According to Allen, only Merck and "a few" advocates are calling for mandates. The "rickety" pediatric vaccination system is a "three-legged stool whose stability relies on the participation" of drug companies, the government and parents, according to Allen. "In failing to include two legs of the system, those pushing for immediate mandatory vaccination are risking it's collapse," Allen writes, concluding, "The HPV vaccine may do great things, but we shouldn't rush it" (Washington Post, 4/8).

"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

View drug information on Gardasil.