The Enid News and Eagle, Enid, OK

February 23, 2007

Oklahoma politicians look at, shelve a vaccine mandate for young girls

By Cindy Allen Managing Editor

A Texas governor has ordered it, and an Oklahoma senator wants it to become part of public policy.

However, the idea of mandating girls 11 or 12 years old receive a new vaccine to prevent HPV, the human papilloma virus, is getting lukewarm reception in Enid — at least for the time being.

Following a surprise move by Texas Gov. Rick Perry in creating an executive order that will mandate sixth-grade girls in Texas receive the vaccine beginning in 2008, at least two dozen states, in-cluding Oklahoma, have had legislation proposed mandating the same thing.

This week, how-ever, the drug company that developed the vaccine stopped its efforts to have states mandate such a policy. And, Sen. Constance Johnson, of Oklahoma City, also decided against requesting a hearing for her Senate Bill 487.



The vaccine



The drug company, Merck, that developed the new vaccine called Gardasil had been actively lobbying for states to mandate the vaccine for young girls.

The HPV vaccine was developed to protect women from infection by the highest risk HPV types. The vaccine prevents infection from four types of HPV considered very high risk and are responsible for 70 percent of cervical cancers. The vaccine just recently came on the market and is licensed for females ages 9 through 26.

The vaccine is most effective when given to women before they become sexually active. That’s why the target audience, at least for the mandate, is adolescent girls, doctors say.

The positives



Local OB/GYN Dr. David Keuchel said the vaccine can significantly reduce cervical cancer or pre-cancerous lesions of the cervix.

“HPV is a real problem, a real problem everywhere,” Keuchel said. “The guestimation is that 50 percent of the population have it.”

Johnson’s bill would have required sixth-grade girls to have the vaccine. However, Johnson decided not to request a hearing on the bill, saying in a press statement, “My main motivation for introducing this bill was to bring a public dialogue and raise public awareness. For the first time in the history of medicine, we have a vaccine that can prevent a type of cancer. It’s something people need to know about.”

Keuchel agrees more education on the vaccine is needed. So far, requests for the vaccine at his practice have been light.

“I think once there’s a little more information on it, there will be more requests for it,” he said.



The cost



Cost for the vaccine in his office is around $200 per injection, he said. He also said most insurance companies are getting better at providing coverage for the vaccine.

One of the reasons for states considering a mandate for the vaccination is so insurance will cover the costs, experts say.

While he is impressed with the clinical trials for the vaccine, Keuchel said he believes more evaluation needs to be done before the vaccine is mandated for every adolescent girl.

“I think (the vaccine) is going to be a positive, we just need a little more data on it,” Keuchel said. “I think vaccination for girls in that range, specifically ones that have not been sexually active, will decrease their risk of getting cervical cancer.”



The debate



State Rep. Mike Jackson, R-Enid, said one of the major debates in the House over mandating the vaccine is whether it takes away the choice of the parent.

“For the most part, it takes away the decision from the parent,” Jackson said. “At this point, to structure public policy to adhere to what is brand new without a lot of research is probably too quick of a step.”

Jackson said he doesn’t see Oklahoma Gov. Brad Henry following in his Texas colleague’s footsteps and issuing an executive order to mandate the vaccine.

“(It) is an issue we will discuss, and we need to have ample amount of time to publicly debate it,” Jackson said.

Johnson said she would bring a Senate resolution to the floor to help continue to raise awareness about the impact of cervical cancer in Oklahoma as well as the effectiveness of the HPV vaccine in preventing the disease.

“I want to encourage us all to continue to learn everything we can about the benefits of this immunization and how it could save lives right here in Oklahoma,” she said.