HPV vaccine: Who chooses?

However, if history is any guide, people simply don't get vaccinated unless they are required to -- at least not in numbers large enough to reduce the rate of a disease. "Mandates provide a reminder," says Dr. Louis Cooper, a past president of the American Academy of Pediatrics. When several new vaccines came online in the 1950s and '60s, including vaccines for polio, measles, mumps and rubella, disease rates did not decline significantly until states started requiring vaccination for school enrollment, Cooper says.

Although he would recommend that girls receive the vaccine, Cooper believes now is not the right time to push for a mandatory immunization law. The public, he says, is increasingly wary of new vaccines and of medicine in general. "Public trust is at the heart of all public health measures," notes Cooper; pushing for mandatory HPV vaccination now could further erode that trust.

Cooper says there's been a backlash among some groups of parents as the number of required vaccinations has grown. "The public is increasingly skeptical" of new vaccines for all sorts of reasons -- medical, religious, political. So in the current climate, he favors waiting awhile before advocating the proposed laws, to afford the public the time to learn about the vaccine and to give health professionals a chance to gather more data on the vaccine's risks and benefits, which could build a compelling case for mandatory vaccination.

Choice in parents' hands

For now, parents will be the ones to decide whether their daughters get vaccinated. Several major insurers in California are covering the cost of the vaccine -- $360 for the three shots -- for girls in the recommended age groups. Children who are uninsured or qualify for Medi-Cal can receive the vaccine through the federal Vaccines for Children program.

Doctors report that many parents are inquiring about the vaccine. But choosing the vaccine and favoring a mandatory vaccine are two different things. Although advocates and opponents of mandatory vaccines are receiving the most attention, many parents are like Sarina Araujo -- still trying to figure it all out.

Araujo works for the National Cervical Cancer Coalition, a Van Nuys-based nonprofit that provides information about cervical cancer. All three of her daughters will receive the HPV vaccine. "I am hesitant to say that the vaccine should be mandatory," Araujo says.

"But I don't see any reason why anybody would not vaccinate."