Proposed law would require middle-school age
girls to be vaccinated against HPV
researcher says new drug very effective against disease
that strikes 200 S.C. women each year
Carolina is among a growing number of states seeking to require all
middle school-aged girls to get a new vaccine that can prevent cervical
“I think we’ve been
given a miracle and I would like to see us take advantage of it,” said
Rep. Joan Brady, R-Richland.
Brady and nine
co-sponsors have introduced a bill to require the human papillomavirus
(HPV) cervical cancer vaccination for all 11-year-old female students
before they can enroll in the seventh grade in any South Carolina
school, public or private.
HPV is the cause of
genital warts and can cause cervical cancer which afflicts some 10,000
American women and kills 3,700 annually.
South Carolina ranks
third in the country in the incidence of cervical cancer, with
approximately 200 new cases annually, according to the S.C. Department
of Health and Environmental Control. The state ranks eights in cervical
cancer deaths. DHEC reported that 55 S.C. women died from the disease
DHEC also calculates
an annual cost of some $25 million to treat HPV-related conditions in
requirement would become effective for the 2009-2010 school year and
would be contingent on adequate state and federal funding to pay for the
vaccinations. Parents whose religious beliefs conflict with
vaccinations could opt out of the requirement.
Meantime, the S.C.
Department of Health and Environmental Control is asking the General
Assembly to add $2 million to its budget to begin a vaccination program
for uninsured and underinsured young girls, Brady said.
The vaccine, which
became available last fall, is called Gardasil. It was approved in June
by the Food and Drug Administration. Soon after, the Centers for Disease
Control and Prevention advised women and girls 9 to 26 to get
maker, said the vaccine costs $360 for a full, three-shot course. That
makes it among the most expensive vaccines ever made.
lasting infections from two HPV strains that cause 70 percent of cancers
and another two strains that cause 90 percent of genital warts.
but not all, private insurance plans cover the vaccine. “That’s why we
encourage people to check with their insurance providers,” said Dr.
Heather Brandt, research faculty
member in the Department of Health Promotion, Education, and Behavior at
the Arnold School of Public Health.
Brandt also is a
full-time researcher in the Cancer Prevention and Control Program which
is affiliated with the Arnold School.
Blue Cross Blue
Shield, the state's largest private insurance provider, covers Gardasil
for clients who have preventive vaccination coverage as a part of their
Brandt has spent
most of the past eight years working in prevention and control of
cervical cancer and HPV, particularly among disadvantaged women many of
whom will have to rely on public assistance to vaccinate their
Brandt describes the
vaccine as “amazing because it produces such a robust response to our
immune system,” while providing lifelong protection against cervical
cancer caused by these two types of HPV.
Brandt and Brady
agree both the public and members of the General Assembly need to be
educated about HPV, a belief substantiated by research showing public
awareness and knowledge about HPV are still very limited.
Only 40 percent of
women ages 18 to 75 have heard of HPV and of that group, less than half
know that it is associated with cervical cancer, a 2006 research paper
Brady says she intends
to be vigilant in support of the bill, but she also concedes that it may
take two legislative sessions to get it passed.
Merck, which stands
to make a lot of money on Gardasil, also is engaged in a national print,
television and online advertising campaign to increase awareness of the
vaccine. The campaign is entitled “One Less” -- as in 'one less life
affected by cervical cancer'. The TV ads can be viewed on the
Brady says her
legislation has an ally in the
S.C. Commission for Women, which advises the
governor on matters related to the needs of women. Led by Dr. Lilly S.
Filler, a Columbia obstetrician/gynecologist, the commission has
identified the HPV vaccine as its No. 1 women’s health initiative for
Vaccination also is
supported by American Academy of Pediatrics, the American College of
Obstetricians and Gynecologists, the American Academy of Family
Physicians and the American Medical Association.
But Brady adds that
to her surprise the bill has some strong opposition. "My naiveté was in
assuming that everyone would embrace and support this cure for cancer.
After all, who would be against a cure for cancer?"
The high cost of the
vaccine and religious objections are the main concern of many opponents,
said Brady. Others argue that the vaccine would encourage promiscuity.
But Brady said the
vaccination program would help open a healthy dialog between parents and
the child before she becomes sexually active. “I just don’t buy the
argument that it would encourage or increase promiscuity,” she said.
In other states
considering vaccination programs, conservative Christian groups such as
Focus on the Family, have praised the development
of “safe, effective,
and ethical vaccines against HPV and other viruses.”
But these same
groups say no to making the vaccine mandatory because it would interfere
with the parents’ rights to make key health decisions for their
conducted by Brandt and colleagues at USC has shown high levels of
support for an HPV vaccine among a sample of women living in the Pee Dee
Region. Further, members of the Community Advisory Group of the
USC-Claflin EXPORT Center presented similar support from members of
their community at the South Carolina HIV/STD Conference in October.
This is promising; however, Brandt cautions that high levels of support
do not always lead to uptake.
Carolina, efforts to encourage or require HPV vaccinations are under way
Colorado, Kentucky, Maryland, South Dakota, Texas, Virginia and the
District of Columbia.
New Hampshire has
established a program that allows girls 18 and younger to get the
vaccine for free through a pool that is financed by the federal
government and private insurers.
The Senate in
Michigan passed a vaccination bill last fall, but the initiative died in
Besides Brady, nine
other House members are co-sponsors of the Cervical Cancer Prevention
Act (H. 3136). They include Republicans Wallace Scarborough of
Charleston, Nikki Haley of Lexington and Catherine Ceips of Beaufort.
Democrats include Gilda Cobb-Hunter of Orangeburg, Laurie Funderburk of
Kershaw, Vida Miller of Georgetown, Cathy Harvin of Clarendon, Anne
Parks of Greenwood and Denny Neilson of Darlington.
Genital HPV Infection - CDC Fact Sheet
Cancer Risk – Understanding the Puzzle
(National Cancer Institute Cancer Information Service)