Mandated HPV vaccinations

The efforts in several states to mandate vaccinations for middle school girls against the HPV virus that causes cervical cancer is raising question not so much about the effectiveness of the vaccine, but about whether public health policy ought to be based on the advertising and lobbying clout of drug companies.

As noted in an editorial in Wednesday's Enquirer, Merck & Co., manufacturer of the vaccine, has been lobbying legislators around the country and has a national television campaign going to promote the vaccine among consumers.

Last week Texas made vaccinations mandatory for sixth-grade girls. This week Rep. Kathy Stine, D-Lexington, proposed the same thing for middle-school girls in Kentucky.

This is a vaccine with great promise. It should be used by people who understand fully what it is designed to prevent (several varieties of the HPV virus), and what it does not prevent (other sexually transmitted diseases or pregnancy). Nor have long-term studies determined for certain how long it remains effective.

The vaccination involves three shots over a six-month period and is recommended for girls and women between ages 11 and 26. This means it is not something that should be administered without discussion and understanding by the patient. And that means a frank and open discussion about sex. Given that many state legislators welcome frank and open sex education for 11-year-olds with the same enthusiasm that they would welcome an outbreak of head lice, I have my doubts about how well informed prospective recipients are likely to be in states where HPV vaccinations are mandated.

These vaccinations and their ramifications should be discussed between parents and their children; between patients and their doctors. It should be available for everyone who then decides they want it. But we need to educate ourselves and our children about the needs, benefits and limitations of this vaccine before we mandate its use.