Few doctors, parents or medical ethicists would dispute the astounding potential of the new human papilloma virus vaccine -- it protects against infections that cause 70% of all cervical cancer and most genital warts.
"We use 'breakthrough' way too often, but this is a breakthrough," says Dr. Bradley Monk, an associate professor of gynecologic oncology at UC Irvine School of Medicine. "We are unbelievably enthusiastic to have a vaccine that prevents you from getting cancer."
But should it be mandatory?
In December, California Assemblywoman Sally Lieber (D-Mountain View) introduced a bill that would require girls entering sixth grade to receive the three standard doses of the HPV vaccine. Although state law permits parents to receive an exemption to required immunizations for medical, religious or personal reasons, the bill aims to ensure that most girls are vaccinated before they become sexually active. Similar bills have been introduced in 16 other states and the District of Columbia.
"Requiring vaccinations against a number of diseases for school enrollment gives us the best chance of controlling preventable diseases in society," Lieber says. "Young people deserve to be protected against these diseases."
Reaction to the bills has varied. Evangelical groups have strongly criticized the proposed mandates. Focus on the Family says such measures would violate parents' rights, although the group adds that the vaccine should be available for those who want it. An editorial in the Washington Post said a mandatory vaccine would save lives, while a Wall Street Journal editorial in July labeled the proposals coercion.
It is too early to tell how many of the bills will be approved. In Maryland, the chief sponsor of an HPV bill that appeared to have strong legislative backing withdrew the bill last week following criticism from parents and groups opposed to the legislation. In California, the bill introduced by Lieber has not been assigned to a committee. Lieber's office says that several organizations, including the NAACP, have registered their support.
Nor is it clear how many parents would favor mandating the HPV vaccine, although many appear to want their daughters vaccinated. In a recent phone survey of 522 parents in California whose daughters would be eligible for the vaccine, UC Berkeley public health researchers found that 75% would probably opt for the vaccine.
