South Dakota Gov. Mike Rounds (R) on Monday said the state will provide Merck's human papillomavirus vaccine Gardasil at no cost to girls and women ages 11 to 18, the AP/Yankton Press & Dakotan reports (Brokaw, AP/Yankton Press & Dakotan, 1/8). Gardasil in clinical trials has been shown to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases. FDA in July 2006 approved the vaccine 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,1/9). The South Dakota Department of Health plans to purchase the vaccine using $1.7 million in state funds and $7.5 million in federal funds, state Health Secretary Doneen Hollingsworth said. State officials aim to provide Gardasil to physician offices and health department clinics by Jan. 22 for the roughly 44,000 girls in the state eligible to receive the vaccine, according to Hollingsworth. Physicians will be permitted to charge a fee for administering Gardasil but only to those who can afford it, the AP/Press & Dakotan reports. Hollingsworth said the voluntary vaccination program likely will focus on girls ages 11 and 12 in future years, adding that South Dakota will be the second state, after New Hampshire, to make the vaccine available at no cost (AP/Yankton Press & Dakotan, 1/8).

Reaction
According to the Yankton Press & Dakotan, legislators from the southeast region of the state in general support efforts to provide Gardasil at no cost. "Anybody who thinks, if you go out and get this vaccination, that you are promiscuous -- that is a misnomer," state Rep. Garry Moore (D) said, adding, "I don't think that's fair at all." According to Moore, providing the vaccine is a health, not a moral, issue. State Rep. Gary Jerke (R) said that he is concerned about the message being sent to young girls because HPV can be sexually transmitted. "It makes me nervous that we don't have a corresponding emphasis on abstinence or those things that would discourage" sexual activity, Jerke said, adding, "To me, this makes a statement that the state endorses that type of lifestyle, of sexual promiscuity" (Dockendorf, Yankton Press & Dakotan, 1/10). Rounds on Monday said that children still should be taught that abstinence is the best way to prevent sexually transmitted infections, according to the Argus Leader. "We've still got to be watching out for values," he said (Myers, Sioux Falls Argus Leader, 1/9).

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