Findings

The Congress finds as follows: (1)HPV, the human papillomavirus, is the most common sexually transmitted infection in the United States. HPV types 16 and 18 cause about 70 percent of cervical cancers. The Centers for Disease Control and Prevention estimates that about 6,200,000 Americans become infected with HPV each year and that over half of all sexually active men and women become infected at some time in their lives. On average, there are 9,710 new cases of cervical cancer and 3,700 deaths attributed to it in the United States each year. (2)Early detection is the key to diagnosing and curing cervical cancer, and therefore the Food and Drug Administration (FDA) recommends that all women get regular Pap tests. The Pap test looks for cell changes caused by HPV, so the cervix can be treated before the cells turn into cancer. The FDA also states the Pap test can also find cancer in its early stages so it can be treated before it becomes too serious, and reaches the conclusion that it is rare to die from cervical cancer if the disease is caught early. (3)On June 8, 2006, the FDA approved Gardasil, the first vaccine developed to prevent cervical cancer, precancerous genital lesions, and genital warts due to human papillomavirus (HPV) types 6, 11, 16, and 18. Gardasil is a recombinant vaccine, it does not contain a live virus, and it is given as three injections over a six-month period. The vaccine is approved for use in females 9–26 years of age. However, the FDA also states that since the vaccine is new, more studies need to be done to determine how long women will be protected from HPV. For example, the FDA does not know if a booster is needed after a couple of years to ensure continuity of protection. (4)As detailed by the FDA, four studies were conducted in 21,000 women, one in the United States and three multinational, to show how well Gardasil worked in women between the ages of 16 and 26. The study period was not long enough for cervical cancer to develop; however, preventing cervical precancerous lesions is believed highly likely to result in the prevention of cervical cancer. (5)In January 2007 the Advisory Committee on Immunization Practices (ACIP), under the Centers for Disease Control and Prevention, issued changes to the previous childhood and adolescent immunization schedule. The ACIP recommends the new human papillomavirus vaccine (HPV) to be administered in a 3-dose schedule with the second and third doses administered 2 and 6 months after the first dose. Routine vaccination with HPV is recommended for females aged 11–12 years, the vaccination series can be started in females as young as age 9 years, and a catch up vaccination is recommended for females aged 13–26 years who have not been vaccinated previously or who have not completed the full vaccine series. (6)States historically have maintained the practice of applying immunization recommendations to their school admittance policies so as to protect schoolchildren from outbreaks of contagious disease. The Association of American Physicians and Surgeons states that there is no public health purpose for mandating HPV vaccine for schoolchildren. HPV is a sexually transmitted disease. (7)With at least 16 States entertaining legislation which takes the unprecedented step in requiring young girls to obtain a vaccine for a disease that is not spread by casual contact in order to attend school, many organizations and associations have come out against mandatory HPV vaccine programs. (8)The Texas Medical Association has stated that although it strongly supports the ability of physicians to provide the HPV vaccine, at this point, it does not support a State mandate. (9)The American College of Pediatricians and the Association of American Physicians and Surgeons are opposed to any legislation which would require HPV vaccination for school attendance. They have stated that excluding children from school for refusal to be vaccinated for a disease spread only by intercourse is a serious, precedent-setting action that trespasses on the right of parents to make medical decisions for their children as well as on the rights of the children to attend school. (10)Federal funds should not be used to implement a mandatory vaccine program for a disease that does not threaten the public health of schoolchildren in the course of casual, daily interaction between classmates and inserts the government into the lives of children, parents, and physicians.