Gardasil state mandates unwarranted

State mandates for HPV vaccination unwarranted and unwise Published: Thursday, 13-Nov-2008 Printer Friendly Email to a Friend Women's Health News The HPV vaccine, sold as Gardasil in the U.S., is intended to prevent four strains of the human papillomavirus, the most common sexually transmitted infection in the world. The vaccine also prevents against cervical cancer. While the vaccine represents a significant public health advance, a new article in the Journal of Law, Medicine & Ethics suggests that it is premature for states to currently mandate the HPV vaccine as a condition for school attendance. Gail Javitt, J.D., M.P.H., Deena Berkowitz, M.D., M.P.H., and Lawrence O. Gostin, J.D., LL.D., review the scientific evidence supporting Gardasil's approval and the legislative actions in the states that followed and raise several concerns about state mandates for HPV vaccination. To begin with, they assert that Gardasil is relatively new and long-term safety and effectiveness in the general population is unknown. Outcomes of those voluntarily vaccinated should be followed for several years before mandates are imposed. Additionally, they argue that the HPV vaccine does not represent a public health necessity of the type that has justified previous vaccine mandates, so Constitutional concerns are raised. It is possible that state mandates could lead to a public backlash that will undermine both HPV vaccination efforts and existing vaccination programs. Finally, they note that the economic consequences of mandating HPV are significant and could have a negative impact on financial support for other vaccines as well as other public health programs. Such consequences should be evaluated before the vaccine is mandated. The paper argues that state lawmakers' push to mandate HPV has led to significant concern that the government is overreaching its police powers and authority, and unduly interfering with parental rights to make health care decisions for their children. At this time, Javitt warns a mandate could actually do more harm than good, "It could not only pose Constitutional concerns, but could also lead to public backlash, undermining both HPV vaccines and existing vaccine programs." Gardasil is the first vaccine developed for a disease that is not easily communicable (i.e. airborne) or immediately life-threatening. "There will likely be other vaccines available in the future that don't fit the traditional conditions that have justified state mandates," says Javitt, "and we need to figure out a legally and ethically appropriate way to provide such vaccines to the public." http://www.wiley.com/wiley-blackwell