[House Report 117-182]
[From the U.S. Government Publishing Office]


117th Congress    }                                     {      Report
                        HOUSE OF REPRESENTATIVES
 1st Session      }                                     {     117-182

======================================================================



 
     PROMOTING RESOURCES TO EXPAND VACCINATION, EDUCATION, AND NEW 
                 TREATMENTS FOR HPV CANCERS ACT OF 2021

                                _______
                                

 November 30, 2021.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

 Mr. Pallone, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 1550]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 1550) to amend the Public Health Service Act to 
provide for a public awareness campaign with respect to human 
papillomavirus, and for other purposes, having considered the 
same, reports favorably thereon with an amendment and 
recommends that the bill as amended do pass.

                                CONTENTS

                                                                     Page
   I. Purpose and Summary.............................................  3
  II. Background and Need for the Legislation.........................  4
 III. Committee Hearings..............................................  5
  IV. Committee Consideration.........................................  6
   V. Committee Votes.................................................  6
  VI. Oversight Findings..............................................  6
 VII. New Budget Authority, Entitlement Authority, and Tax Expenditure  6
VIII. Congressional Budget Office Estimate............................  7
  IX. Federal Mandates Statement......................................  8
   X. Statement of General Performance Goals and Objectives...........  8
  XI. Duplication of Federal Programs.................................  8
 XII. Committee Cost Estimate.........................................  8
XIII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits.....  8
 XIV. Advisory Committee Statement....................................  8
  XV. Applicability to Legislative Branch.............................  8
 XVI. Section-by-Section Analysis of the Legislation..................  8
XVII. Changes in Existing Law Made by the Bill, as Reported..........  10

    The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Promoting Resources to Expand 
Vaccination, Education, and New Treatments for HPV Cancers Act of 
2021'' or the ``PREVENT HPV Cancers Act of 2021''.

SEC. 2. PREVENTING HPV AND HPV-ASSOCIATED CANCERS; REAUTHORIZING 
                    JOHANNA'S LAW.

  Section 317P of the Public Health Service Act (42 U.S.C. 247b-17) is 
amended--
          (1) in subsection (c)(1)--
                  (A) in subparagraph (B), by striking ``cervical'';
                  (B) in subparagraph (C), by striking ``and'' at the 
                end;
                  (C) in subparagraph (D) by striking ``other'' and all 
                that follows through ``cancer.'' and inserting 
                ``recommended diagnostics for early intervention for, 
                and prevention of, HPV-associated cancers; and''; and
                  (D) by adding at the end the following:
                  ``(E) the importance of recommended vaccines for 
                prevention of HPV and HPV-associated cancers, including 
                for males;''; and
          (2) by amending subsection (d) to read as follows:
  ``(d) Johanna's Law.--
          ``(1) National public awareness campaign.--
                  ``(A) In general.--The Secretary shall carry out a 
                national campaign to increase the awareness and 
                knowledge of health care providers and individuals with 
                respect to gynecologic cancers, HPV, and HPV-associated 
                cancers, and the importance of HPV vaccines in 
                preventing HPV and HPV-associated cancers.
                  ``(B) Written materials.--Activities under the 
                national campaign under subparagraph (A) shall 
                include--
                          ``(i) maintaining a supply of written 
                        materials that provide information to the 
                        public on gynecologic cancers, HPV, and HPV-
                        associated cancers; and
                          ``(ii) distributing the materials to members 
                        of the public upon request.
                  ``(C) Public service announcements.--Activities under 
                the national campaign under subparagraph (A) shall, in 
                accordance with applicable law and regulations, include 
                publishing materials in digital or print form, public 
                engagement, and developing and placing public service 
                announcements intended to encourage individuals to 
                discuss with their physicians--
                          ``(i) their risk of gynecologic cancers and 
                        HPV-associated cancers; and
                          ``(ii) the importance of HPV vaccines in 
                        preventing HPV and HPV-associated cancers.
                  ``(D) Targeted populations.--Activities under the 
                national campaign under subparagraph (A) shall include 
                culturally and linguistically competent public service 
                announcements and other forms of communication and 
                public engagement under subparagraph (C) targeted to--
                          ``(i) specific higher-risk populations of 
                        individuals based on race, ethnicity, level of 
                        acculturation, and family history, including 
                        African-American and Ashkenazi Jewish 
                        individuals;
                          ``(ii) communities with high rates of 
                        unvaccinated individuals, including males;
                          ``(iii) rural communities;
                          ``(iv) populations affected by increasing 
                        rates of oropharynx cancers;
                          ``(v) health care providers specializing in 
                        assisting survivors of sexual assault; and
                          ``(vi) such other communities as the 
                        Secretary determines appropriate.
          ``(2) Consultation.--In carrying out the national campaign 
        under this section, the Secretary shall consult with--
                  ``(A) health care providers;
                  ``(B) nonprofit organizations (including gynecologic 
                cancer organizations and organizations that represent 
                communities and individuals most affected by HPV-
                associated cancers and low vaccination rates);
                  ``(C) State and local public health departments; and
                  ``(D) elementary and secondary education 
                organizations and institutions of higher education.
          ``(3) Demonstration projects regarding outreach and education 
        strategies.--
                  ``(A) In general.--
                          ``(i) Program.--The Secretary may carry out a 
                        program to award grants or contracts to public 
                        or nonprofit private entities for the purpose 
                        of carrying out demonstration projects to test, 
                        compare, and evaluate different evidence-based 
                        outreach and education strategies to increase 
                        the awareness and knowledge of women, their 
                        families, physicians, nurses, and other key 
                        health professionals with respect to 
                        gynecologic cancers, including with respect to 
                        early warning signs, risk factors, prevention, 
                        screening, and treatment options.
                          ``(ii) Science-based resources.--In making 
                        awards under clause (i), the Secretary shall 
                        encourage awardees to use science-based 
                        resources such as the Inside Knowledge About 
                        Gynecologic Cancer education campaign of the 
                        Centers for Disease Control and Prevention.
                  ``(B) Preferences in awarding grants or contracts.--
                In making awards under subparagraph (A), the Secretary 
                shall give preference to--
                          ``(i) applicants with demonstrated expertise 
                        in gynecologic cancer education or treatment or 
                        in working with groups of women who are at 
                        increased risk of gynecologic cancers; and
                          ``(ii) applicants that, in the demonstration 
                        project funded by the grant or contract, will 
                        establish linkages between physicians, nurses, 
                        other key health professionals, health 
                        profession students, hospitals, payers, and 
                        State health departments.
                  ``(C) Application.--To seek a grant or contract under 
                subparagraph (A), an entity shall submit an application 
                to the Secretary in such form, in such manner, and 
                containing such agreements, assurances, and information 
                as the Secretary determines to be necessary to carry 
                out this paragraph.
                  ``(D) Certain requirements.--In making awards under 
                subparagraph (A), the Secretary shall--
                          ``(i) make awards, as practicable, to not 
                        fewer than five applicants; and
                          ``(ii) ensure that information provided 
                        through demonstration projects under this 
                        paragraph is consistent with the best available 
                        medical information.
                  ``(E) Report to congress.--Not later than 24 months 
                after the date of the enactment of the PREVENT HPV 
                Cancers Act of 2021, and annually thereafter, the 
                Secretary shall submit to the Committee on Energy and 
                Commerce of the House of Representatives and the 
                Committee on Health, Education, Labor, and Pensions of 
                the Senate a report that--
                          ``(i) summarizes the activities of 
                        demonstration projects under subparagraph (A);
                          ``(ii) evaluates the extent to which the 
                        projects were effective in increasing awareness 
                        and knowledge of risk factors and early warning 
                        signs in the populations to which the projects 
                        were directed; and
                          ``(iii) identifies barriers to early 
                        detection and appropriate treatment of such 
                        cancers.
          ``(4) Authorization of appropriations.--For the purpose of 
        carrying out this subsection, there is authorized to be 
        appropriated $25,000,000 for the period of fiscal years 2022 
        through 2026.''.

                         I. Purpose and Summary

    H.R. 1550, the ``Promoting Resources to Expand Vaccination, 
Education, and New Treatments for HPV Cancers Act of 2021'' or 
the ``PREVENT HPV Cancers Act of 2021,'' amends the Public 
Health Service Act to require the Secretary of Health and Human 
Services (the Secretary) to carry out a national campaign to 
increase the awareness and knowledge of health care providers 
and individuals with respect to gynecologic cancers, human 
papillomavirus (HPV), and HPV-associated cancers, highlighting 
the importance of HPV vaccines in preventing HPV and HPV-
associated cancers.

                II. Background and Need for Legislation

    HPV is a group of more than 200 related viruses, of which 
more than 40 are spread through direct sexual contact.\1\ HPV 
infections are common, with more than 42 million Americans 
currently infected with the virus and about 13 million 
Americans infected each year.\2\ While nine in every 10 HPV 
infections go away by themselves within two years, in some 
circumstances, HPV can cause certain cancers, leading to 36,000 
cases of cancer in men and women each year.\3\
---------------------------------------------------------------------------
    \1\National Cancer Institute, Human Papillomavirus (HPV) Vaccines 
(https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-
agents/hpv-vaccine-fact-sheet-what-are-hpv-vaccines) (2021).
    \2\Centers for Disease Control and Prevention, HPV Infection 
(https://www.cdc.gov/hpv/parents/about-
hpv.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fhpv%2Fparents%2F 
whatishpv.html) (2021).
    \3\Id.
---------------------------------------------------------------------------
    Many of these infections and cancer diagnoses could be 
prevented through greater use of HPV vaccines. The first HPV 
vaccine, Gardasil, was licensed in the United States in 2006, 
and was indicated for the prevention of four types of HPV.\4\ 
An updated vaccine on the market since 2016 Gardasil 9, 
prevents infection from nine types of HPV.\5\ The Advisory 
Committee on Immunization Practices (ACIP) recommends HPV 
vaccination for all adolescents to begin at age 11 or 12, 
though vaccination could begin as young as age nine. ACIP also 
recommends catch-up vaccination for individuals as old as 26 if 
they weren't vaccinated earlier.\6\ Those aged 27 to 45 are not 
routinely recommended for catch-up vaccines, but vaccines may 
be recommended for certain individuals in consultation with a 
physician.\7\
---------------------------------------------------------------------------
    \4\Supra note 1.
    \5\Id.
    \6\Elissa Meites, et al., Human Papillomavirus Vaccination for 
Adults: Updated Recommendations of the Advisory Committee on 
Immunization Practices, Morbidity and Mortality Weekly Rept. (Aug. 16, 
2019).
    \7\Id.
---------------------------------------------------------------------------
    HPV vaccination rates among teens have increased each year 
but have not risen to the level of other routinely recommended 
vaccines. As of 2020, only 58.6 percent of adolescents were up 
to date on the HPV vaccine, well below the Centers for Disease 
Control and Prevention's (CDC) target of 80 percent of 
adolescents.\8\\9\ Male adolescents lag behind females, with 56 
percent up to date on their HPV vaccination, compared to 61.4 
percent of females.\10\ Moreover, there is an even wider gap 
between male and female young adults. According to a study from 
the University of Michigan, 34.1 percent of males from age 18 
to 21 reported being vaccinated against HPV, compared to 55.2 
percent of females of the same age.\11\
---------------------------------------------------------------------------
    \8\Id.
    \9\Cassandra Pingali, et al., National, Regional, State, and 
Selected Local Area Vaccination Coverage Among Adolescents Aged 13-17 
Years--United States, 2020, Morbidity and Mortality Weekly Rept. (Sept. 
3, 2021).
    \10\ Id.
    \11\Michelle M. Chen, et al., HPV Vaccination Among Young Adults in 
the U.S., Journal of the Am. Med. Assn. (Apr. 27, 2021).
---------------------------------------------------------------------------
    CDC data indicate that vaccination has been effective at 
reducing the incidence of HPV infections, anogenital warts, and 
cervical precancers.\12\ Incidences of cervical cancer have 
also decreased over time in young women, and those who are 
vaccinated against HPV have been shown to be 90 percent less 
likely to develop cervical cancer.\13\ Nevertheless, some HPV-
associated cancers, including head and neck cancers, have been 
on the rise, especially among men.\14\
---------------------------------------------------------------------------
    \12\Supra note 6.
    \13\National Cancer Institute, Large Study Confirms that HPV 
Vaccine Prevents Cervical Cancer (https://www.cancer.gov/news-events/
cancer-currents-blog/2020/hpv-vaccine-prevents-cervical-cancer-sweden-
study) (Oct. 14, 2020).
    \14\Memorial Sloan Kettering Cancer Center, 5 Reasons Boys and 
Young Men Need the HPV Vaccine, Too (https://www.mskcc.org/news/5-
reasons-boys-and-young-men-need-hpv-vaccine-too) (June 10, 2021).
---------------------------------------------------------------------------
    Because adolescents and young adults are below target 
vaccination rates, and HPV-associated cancers remain on the 
rise, H.R. 1550 aims to promote vaccination against HPV by 
improving and reauthorizing programs at CDC to increase 
awareness of HPV vaccines. Since 2006, as authorized by 
``Johanna's Law,'' CDC has implemented the ``Inside Knowledge 
About Gynecologic Cancer Campaign,'' which promotes early 
screening of gynecologic cancers and HPV vaccines for 
recommended populations.\15\\16\ Because HPV can cause cancers 
in individuals regardless of sex, and there is a rise in some 
non-gynecologic HPV-associated cancers, H.R. 1550 would 
reauthorize and expand this program to require the Secretary to 
conduct a national campaign to educate health care providers 
and the public that include information on gynecologic cancers, 
HPV, all HPV-associated cancers, and the importance of HPV 
vaccines in preventing HPV-associated cancers. In executing the 
national campaign, the Secretary would be required to include 
culturally and linguistically competent public service 
announcements and other forms of communication to specific 
higher-risk populations of individuals; communities with high 
rates of unvaccinated individuals, including males; rural 
communities; populations affected by increasing rates of 
oropharynx cancers; health care providers specializing in 
assisting survivors of sexual assault, and other communities as 
the Secretary determines appropriate. The Secretary would be 
required to consult with health care providers; nonprofit 
organizations, including gynecologic cancer organizations and 
those that represent communities and individuals most affected 
by HPV-associated cancers and low vaccination rates; State and 
local public health departments; and elementary and secondary 
education organizations and institutions of higher education. 
In addition, the bill authorizes the Secretary to award grants 
or contracts to public or nonprofit entities to carry out 
demonstration projects to test, compare, and evaluate different 
evidence-based outreach and education to increase awareness of 
gynecologic cancers. H.R. 1550 would authorize $25 million for 
the period of fiscal years 2022 through 2026 to carry out these 
activities.
---------------------------------------------------------------------------
    \15\Johanna's Law, Public Health Service Act Sec.  317P(d).
    \16\Centers for Disease Control and Prevention, About the Inside 
Knowledge Campaign (https://www.cdc.gov/cancer/gynecologic/knowledge/
about.htm) (2021).
---------------------------------------------------------------------------

                        III. Committee Hearings

    For the purposes of section 3(c) of rule XIII of the Rules 
of the House of Representatives, the following hearing was used 
to develop or consider H.R. 1550:
    The Subcommittee on Health held a legislative hearing on 
June 15, 2021, entitled ``Booster Shot: Enhancing Public Health 
through Vaccine Legislation.'' The Subcommittee received 
testimony from the following witnesses:
           Phyllis Arthur, Vice President, Infectious 
        Diseases and Emerging Science Policy, Biotechnology 
        Innovation Organization;
           Rebecca Coyle, Executive Director, American 
        Immunization Registry Association;
           Yvonne Maldonado, M.D., Chair, Committee on 
        Infectious Diseases, American Academy of Pediatrics; 
        and
           Lijen (L.J.) Tan, Ph.D., Chief Strategy 
        Officer, Immunization Action Coalition.

                      IV. Committee Consideration

    H.R. 1550, the ``Promoting Resources to Expand Vaccination, 
Education, and New Treatments for HPV Cancers Act of 2021'' or 
the ``PREVENT HPV Cancers Act of 2021,'' was introduced on 
March 3, 2021, by Representatives Kathy Castor (D-FL) and Kim 
Schrier (D-WA) and referred to the Committee on Energy and 
Commerce. Subsequently, on March 4, 2021, H.R. 1550 was 
referred to the Subcommittee on Health. A legislative hearing 
was held on the bill on June 15, 2021.
    On July 15, 2021, the Subcommittee on Health met in open 
markup session, pursuant to notice, to consider H.R. 1550 and 
18 other bills. During consideration of the bill, an amendment 
in the nature of a substitute (AINS) offered by Representative 
Castor was agreed to by a voice vote. Upon conclusion of 
consideration of the bill, the Subcommittee on Health agreed to 
report the bill favorably to the full Committee, amended, by a 
voice vote.
    On July 21, 2021, the full Committee met in open markup 
session, pursuant to notice, to consider H.R. 1550 and 23 other 
bills. An amendment offered by Representative Burgess was 
agreed to by a voice vote. Upon conclusion of consideration of 
the bill, the full Committee agreed to a motion on final 
passage offered by Representative Pallone (D-NJ), Chairman of 
the Committee, to order H.R. 1550 reported favorably to the 
House, amended, by a voice vote.

                           V. Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list each record vote 
on the motion to report legislation and amendments thereto. The 
Committee advises that there were no record votes taken on H.R. 
1550.

                         VI. Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII and clause 2(b)(1) 
of rule X of the Rules of the House of Representatives, the 
oversight findings and recommendations of the Committee are 
reflected in the descriptive portion of the report.

 VII. New Budget Authority, Entitlement Authority, and Tax Expenditures

    Pursuant to 3(c)(2) of rule XIII of the Rules of the House 
of Representatives, the Committee adopts as its own the 
estimate of new budget authority, entitlement authority, or tax 
expenditures or revenues contained in the cost estimate 
prepared by the Director of the Congressional Budget Office 
pursuant to section 402 of the Congressional Budget Act of 
1974.

               VIII. Congressional Budget Office Estimate

                                     U.S. Congress,
                               Congressional Budget Office,
                                Washington, DC, September 21, 2021.
Hon. Frank Pallone, Jr.,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 1550, the PREVENT 
HPV Cancers Act of 2021.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Sarah 
Sajewski.
            Sincerely,
                                         Phillip L. Swagel,
                                                          Director.
    Enclosure.

[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
    

    H.R. 1550 would authorize appropriations of $25 million 
over the 2022-2026 period for the Secretary of Health and Human 
Services to conduct a national public awareness campaign on 
human papillomavirus (HPV) and HPV-associated cancers. The 
campaign would include public service announcements about the 
risk of gynecological cancers and the importance of HPV 
vaccines as well as an annual Congressional report. It also 
could include grants to evaluate strategies to increase 
awareness of gynecologic cancers. The bill would update the 
requirements for educational materials on HPV to include the 
importance of vaccination.
    For this estimate, CBO assumes H.R. 1550 will be enacted 
near the beginning of fiscal year 2022. Based on historical 
spending on similar activities, CBO estimates that implementing 
H.R. 1550 would increase federal spending by $25 million over 
the 2022-2026 period, subject to the availability of 
appropriated funds.
    The CBO staff contact for this estimate is Sarah Sajewski. 
The estimate was reviewed by Leo Lex, Deputy Director of Budget 
Analysis.

                     IX. Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

        X. Statement of General Performance Goals and Objectives

    Pursuant to clause 3(c)(4) of rule XIII, the general 
performance goal or objective of this legislation is to support 
efforts to increase HPV vaccination rates, and otherwise 
prevent and treat gynecologic cancers and HPV-associated 
cancers, including through a public awareness campaign, and 
support for demonstration projects to support outreach and 
education strategies.

                  XI. Duplication of Federal Programs

    Pursuant to clause 3(c)(5) of rule XIII, no provision of 
H.R. 1550 is known to be duplicative of another Federal 
program, including any program that was included in a report to 
Congress pursuant to section 21 of Public Law 111-139 or the 
most recent Catalog of Federal Domestic Assistance.

                      XII. Committee Cost Estimate

    Pursuant to clause 3(d)(1) of rule XIII, the Committee 
adopts as its own the cost estimate prepared by the Director of 
the Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974.

   XIII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits

    Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the 
Committee finds that H.R. 1550 contains no earmarks, limited 
tax benefits, or limited tariff benefits.

                   XIV. Advisory Committee Statement

    No advisory committee within the meaning of section 5(b) of 
the Federal Advisory Committee Act was created by this 
legislation.

                XV. Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

          XVI. Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 designates that the Act may be cited as the 
``Promoting Resources to Expand Vaccination, Education, and New 
Treatments for HPV Cancers Act of 2021'' or the ``PREVENT HPV 
Cancers Act of 2021.''

Sec. 2. Preventing HPV and HPV-associated cancers; reauthorizing 
        Johanna's Law.

    Section 2 amends the Public Health Service Act by 
broadening existing language on HPV education and prevention to 
include all HPV and HPV-associated cancers, and by 
reauthorizing Johanna's Law and extending it to carry out a 
national campaign to increase awareness and knowledge of 
gynecologic cancers, HPV, and HPV-associated cancers, and the 
importance of HPV vaccines in preventing HPV and HPV-associated 
cancers.
    The updated provisions of Johanna's Law would require the 
Secretary, when carrying out the campaign, to include 
culturally and linguistically competent public service 
announcements and other forms of communication and public 
engagement targeted to specific higher risk populations of 
individuals based on race, ethnicity, level of acculturation, 
and family history; communities with high rates of unvaccinated 
individuals; rural communities; populations affected by 
increasing rates of oropharynx cancer; health care providers 
specializing in assisting survivors of sexual assault; and 
other communities as the Secretary determines appropriate.
    Section 2 also requires the Secretary to consult with 
health care providers, nonprofit organizations (including 
gynecologic cancer organizations and organizations that 
represent communities and individuals most affected by HPV-
associated cancers and low vaccination rates); state and local 
public health departments; and elementary and secondary 
education organizations and institutions of higher education.
    Additionally, section 2 authorizes the Secretary to award 
grants to public or nonprofit organizations for purposes of 
carrying out demonstration projects to test, compare, and 
evaluate different evidence-based outreach and education 
strategies to increase the awareness and knowledge of women, 
their families, physicians, nurses, and other key health 
professionals with respect to gynecologic cancers. Priority for 
grants would be given to applicants with demonstrated expertise 
in gynecologic cancer education or treatment or in working with 
groups of women who are at increased risk of gynecologic 
cancers; and to applicants that will establish linkages between 
physicians, nurses, and other health professionals, health 
profession students, hospitals, payers, and State health 
departments. The Secretary is required to make awards to no 
fewer than five applicants, as practicable, and ensure that 
information provided under demonstration projects is consistent 
with the best available medical information. Section 2 requires 
the Secretary to report to the Committee on Energy and Commerce 
of the House of Representatives as well as the Committee on 
Health, Education, Labor, and Pensions of the Senate within 24 
months of enactment, and annually thereafter, on demonstration 
projects funded by these grants. Such report shall summarize 
the activities of the demonstration projects, evaluate the 
effectiveness in increasing awareness and knowledge in the 
populations to which projects were directed, and identify 
barriers to early detection and appropriate treatment of such 
cancers.
    Section 2 authorizes $25 million for the period of fiscal 
years 2022 through 2026 to carry out these activities.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italics, and existing law in which no 
change is proposed is shown in roman):

                       PUBLIC HEALTH SERVICE ACT




           *       *       *       *       *       *       *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE

           *       *       *       *       *       *       *



Part B--Federal-State Cooperation

           *       *       *       *       *       *       *



                  human papillomavirus (johanna's law)

  Sec. 317P. (a) Surveillance.--
          (1) In general.--The Secretary, acting through the 
        Centers for Disease Control and Prevention, shall--
                  (A) enter into cooperative agreements with 
                States and other entities to conduct sentinel 
                surveillance or other special studies that 
                would determine the prevalence in various age 
                groups and populations of specific types of 
                human papillomavirus (referred to in this 
                section as ``HPV'') in different sites in 
                various regions of the United States, through 
                collection of special specimens for HPV using a 
                variety of laboratory-based testing and 
                diagnostic tools; and
                  (B) develop and analyze data from the HPV 
                sentinel surveillance system described in 
                subparagraph (A).
          (2) Report.--The Secretary shall make a progress 
        report to the Congress with respect to paragraph (1) no 
        later than 1 year after the effective date of this 
        section.
  (b) Prevention Activities; Education Program.--
          (1) In general.--The Secretary, acting through the 
        Centers for Disease Control and Prevention, shall 
        conduct prevention research on HPV, including--
                  (A) behavioral and other research on the 
                impact of HPV-related diagnosis on individuals;
                  (B) formative research to assist with the 
                development of educational messages and 
                information for the public, for patients, and 
                for their partners about HPV;
                  (C) surveys of physician and public 
                knowledge, attitudes, and practices about 
                genital HPV infection; and
                  (D) upon the completion of and based on the 
                findings under subparagraphs (A) through (C), 
                develop and disseminate educational materials 
                for the public and health care providers 
                regarding HPV and its impact and prevention.
          (2) Report; final proposal.--The Secretary shall make 
        a progress report to the Congress with respect to 
        paragraph (1) not later than 1 year after the effective 
        date of this section, and shall develop a final report 
        not later than 3 years after such effective date, 
        including a detailed summary of the significant 
        findings and problems and the best strategies to 
        prevent future infections, based on available science.
  (c) HPV Education and Prevention.--
          (1) In general.--The Secretary shall prepare and 
        distribute educational materials for health care 
        providers and the public that include information on 
        HPV. Such materials shall address--
                  (A) modes of transmission;
                  (B) consequences of infection, including the 
                link between HPV and [cervical] cancer;
                  (C) the available scientific evidence on the 
                effectiveness or lack of effectiveness of 
                condoms in preventing infection with HPV; [and]
                  (D) the importance of regular Pap smears, and 
                [other diagnostics for early intervention and 
                prevention of cervical cancer purposes in 
                preventing cervical cancer.] recommended 
                diagnostics for early intervention for, and 
                prevention of, HPV-associated cancers; and
                  (E) the importance of recommended vaccines 
                for prevention of HPV and HPV-associated 
                cancers, including for males;
          (2) Medically accurate information.--Educational 
        material under paragraph (1), and all other relevant 
        educational and prevention materials prepared and 
        printed from this date forward for the public and 
        health care providers by the Secretary (including 
        materials prepared through the Food and Drug 
        Administration, the Centers for Disease Control and 
        Prevention, and the Health Resources and Services 
        Administration), or by contractors, grantees, or 
        subgrantees thereof, that are specifically designed to 
        address STDs including HPV shall contain medically 
        accurate information regarding the effectiveness or 
        lack of effectiveness of condoms in preventing the STD 
        the materials are designed to address. Such requirement 
        only applies to materials mass produced for the public 
        and health care providers, and not to routine 
        communications.
  [(d) Johanna's Law.--
          [(1) National public awareness campaign.--
                  [(A) In general.--The Secretary shall carry 
                out a national campaign to increase the 
                awareness and knowledge of health care 
                providers and women with respect to gynecologic 
                cancers.
                  [(B) Written materials.--Activities under the 
                national campaign under subparagraph (A) shall 
                include--
                          [(i) maintaining a supply of written 
                        materials that provide information to 
                        the public on gynecologic cancers; and
                          [(ii) distributing the materials to 
                        members of the public upon request.
                  [(C) Public service announcements.--
                Activities under the national campaign under 
                subparagraph (A) shall, in accordance with 
                applicable law and regulations, include 
                developing and placing, in telecommunications 
                media, public service announcements intended to 
                encourage women to discuss with their 
                physicians their risks of gynecologic cancers. 
                Such announcements shall inform the public on 
                the manner in which the written materials 
                referred to in subparagraph (B) can be obtained 
                upon request, and shall call attention to early 
                warning signs and risk factors based on the 
                best available medical information.
          [(2) Report and strategy.--
                  [(A) Report.--Not later than 6 months after 
                the date of the enactment of this subsection, 
                the Secretary shall submit to the Congress a 
                report including the following:
                          [(i) A description of the past and 
                        present activities of the Department of 
                        Health and Human Services to increase 
                        awareness and knowledge of the public 
                        with respect to different types of 
                        cancer, including gynecologic cancers.
                          [(ii) A description of the past and 
                        present activities of the Department of 
                        Health and Human Services to increase 
                        awareness and knowledge of health care 
                        providers with respect to different 
                        types of cancer, including gynecologic 
                        cancers.
                          [(iii) For each activity described 
                        pursuant to clause (i) or (ii), a 
                        description of the following:
                                  [(I) The funding for such 
                                activity for fiscal year 2006 
                                and the cumulative funding for 
                                such activity for previous 
                                fiscal years.
                                  [(II) The background and 
                                history of such activity, 
                                including--
                                          [(aa) the goals of 
                                        such activity;
                                          [(bb) the 
                                        communications 
                                        objectives of such 
                                        activity;
                                          [(cc) the identity of 
                                        each agency within the 
                                        Department of Health 
                                        and Human Services 
                                        responsible for any 
                                        aspect of the activity; 
                                        and
                                          [(dd) how such 
                                        activity is or was 
                                        expected to result in 
                                        change.
                                  [(III) How long the activity 
                                lasted or is expected to last.
                                  [(IV) The outcomes observed 
                                and the evaluation methods, if 
                                any, that have been, are being, 
                                or will be used with respect to 
                                such activity.
                                  [(V) For each such outcome or 
                                evaluation method, a 
                                description of the associated 
                                results, analyses, and 
                                conclusions.
                  [(B) Strategy.--
                          [(i) Development; submission to 
                        congress.--Not later than 3 months 
                        after submitting the report required by 
                        subparagraph (A), the Secretary shall 
                        develop and submit to the Congress a 
                        strategy for improving efforts to 
                        increase awareness and knowledge of the 
                        public and health care providers with 
                        respect to different types of cancer, 
                        including gynecological cancers.
                          [(ii) Consultation.--In developing 
                        the strategy under clause (i), the 
                        Secretary should consult with qualified 
                        private sector groups, including 
                        nonprofit organizations.
          [(3) Full compliance.--
                  [(A) In general.--Not later than March 1, 
                2008, the Secretary shall ensure that all 
                provisions of this section, including 
                activities directed to be carried out by the 
                Centers for Disease Control and Prevention and 
                the Food and Drug Administration, are fully 
                implemented and being complied with. Not later 
                than April 30, 2008, the Secretary shall submit 
                to Congress a report that certifies compliance 
                with the preceding sentence and that contains a 
                description of all activities undertaken to 
                achieve such compliance.
                  [(B) If the Secretary fails to submit the 
                certification as provided for under 
                subparagraph (A), the Secretary shall, not 
                later than 3 months after the date on which the 
                report is to be submitted under subparagraph 
                (A), and every 3 months thereafter, submit to 
                Congress an explanation as to why the Secretary 
                has not yet complied with the first sentence of 
                subparagraph (A), a detailed description of all 
                actions undertaken within the month for which 
                the report is being submitted to bring the 
                Secretary into compliance with such sentence, 
                and the anticipated date the Secretary expects 
                to be in full compliance with such sentence.
          [(4) Consultation with nonprofit gynecologic cancer 
        organizations.--In carrying out the national campaign 
        under this subsection, the Secretary shall consult with 
        nonprofit gynecologic cancer organizations, with a 
        mission both to conquer ovarian or other gynecologic 
        cancer and to provide outreach to State and local 
        governments and communities, for the purpose of 
        determining the best practices for providing 
        gynecologic cancer information and outreach services to 
        varied populations.
          [(6) Authorization of appropriations.--For the 
        purpose of carrying out this subsection, there is 
        authorized to be appropriated $16,500,000 for the 
        period of fiscal years 2007 through 2009 and 
        $18,000,000 for the period of fiscal years 2012 through 
        2014.]
  (d) Johanna's Law.--
          (1) National public awareness campaign.--
                  (A) In general.--The Secretary shall carry 
                out a national campaign to increase the 
                awareness and knowledge of health care 
                providers and individuals with respect to 
                gynecologic cancers, HPV, and HPV-associated 
                cancers, and the importance of HPV vaccines in 
                preventing HPV and HPV-associated cancers.
                  (B) Written materials.--Activities under the 
                national campaign under subparagraph (A) shall 
                include--
                          (i) maintaining a supply of written 
                        materials that provide information to 
                        the public on gynecologic cancers, HPV, 
                        and HPV-associated cancers; and
                          (ii) distributing the materials to 
                        members of the public upon request.
                  (C) Public service announcements.--Activities 
                under the national campaign under subparagraph 
                (A) shall, in accordance with applicable law 
                and regulations, include publishing materials 
                in digital or print form, public engagement, 
                and developing and placing public service 
                announcements intended to encourage individuals 
                to discuss with their physicians--
                          (i) their risk of gynecologic cancers 
                        and HPV-associated cancers; and
                          (ii) the importance of HPV vaccines 
                        in preventing HPV and HPV-associated 
                        cancers.
                  (D) Targeted populations.--Activities under 
                the national campaign under subparagraph (A) 
                shall include culturally and linguistically 
                competent public service announcements and 
                other forms of communication and public 
                engagement under subparagraph (C) targeted to--
                          (i) specific higher-risk populations 
                        of individuals based on race, 
                        ethnicity, level of acculturation, and 
                        family history, including African-
                        American and Ashkenazi Jewish 
                        individuals;
                          (ii) communities with high rates of 
                        unvaccinated individuals, including 
                        males;
                          (iii) rural communities;
                          (iv) populations affected by 
                        increasing rates of oropharynx cancers;
                          (v) health care providers 
                        specializing in assisting survivors of 
                        sexual assault; and
                          (vi) such other communities as the 
                        Secretary determines appropriate.
          (2) Consultation.--In carrying out the national 
        campaign under this section, the Secretary shall 
        consult with--
                  (A) health care providers;
                  (B) nonprofit organizations (including 
                gynecologic cancer organizations and 
                organizations that represent communities and 
                individuals most affected by HPV-associated 
                cancers and low vaccination rates);
                  (C) State and local public health 
                departments; and
                  (D) elementary and secondary education 
                organizations and institutions of higher 
                education.
          (3) Demonstration projects regarding outreach and 
        education strategies.--
                  (A) In general.--
                          (i) Program.--The Secretary may carry 
                        out a program to award grants or 
                        contracts to public or nonprofit 
                        private entities for the purpose of 
                        carrying out demonstration projects to 
                        test, compare, and evaluate different 
                        evidence-based outreach and education 
                        strategies to increase the awareness 
                        and knowledge of women, their families, 
                        physicians, nurses, and other key 
                        health professionals with respect to 
                        gynecologic cancers, including with 
                        respect to early warning signs, risk 
                        factors, prevention, screening, and 
                        treatment options.
                          (ii) Science-based resources.--In 
                        making awards under clause (i), the 
                        Secretary shall encourage awardees to 
                        use science-based resources such as the 
                        Inside Knowledge About Gynecologic 
                        Cancer education campaign of the 
                        Centers for Disease Control and 
                        Prevention.
                  (B) Preferences in awarding grants or 
                contracts.--In making awards under subparagraph 
                (A), the Secretary shall give preference to--
                          (i) applicants with demonstrated 
                        expertise in gynecologic cancer 
                        education or treatment or in working 
                        with groups of women who are at 
                        increased risk of gynecologic cancers; 
                        and
                          (ii) applicants that, in the 
                        demonstration project funded by the 
                        grant or contract, will establish 
                        linkages between physicians, nurses, 
                        other key health professionals, health 
                        profession students, hospitals, payers, 
                        and State health departments.
                  (C) Application.--To seek a grant or contract 
                under subparagraph (A), an entity shall submit 
                an application to the Secretary in such form, 
                in such manner, and containing such agreements, 
                assurances, and information as the Secretary 
                determines to be necessary to carry out this 
                paragraph.
                  (D) Certain requirements.--In making awards 
                under subparagraph (A), the Secretary shall--
                          (i) make awards, as practicable, to 
                        not fewer than five applicants; and
                          (ii) ensure that information provided 
                        through demonstration projects under 
                        this paragraph is consistent with the 
                        best available medical information.
                  (E) Report to congress.--Not later than 24 
                months after the date of the enactment of the 
                PREVENT HPV Cancers Act of 2021, and annually 
                thereafter, the Secretary shall submit to the 
                Committee on Energy and Commerce of the House 
                of Representatives and the Committee on Health, 
                Education, Labor, and Pensions of the Senate a 
                report that--
                          (i) summarizes the activities of 
                        demonstration projects under 
                        subparagraph (A);
                          (ii) evaluates the extent to which 
                        the projects were effective in 
                        increasing awareness and knowledge of 
                        risk factors and early warning signs in 
                        the populations to which the projects 
                        were directed; and
                          (iii) identifies barriers to early 
                        detection and appropriate treatment of 
                        such cancers.
          (4) Authorization of appropriations.--For the purpose 
        of carrying out this subsection, there is authorized to 
        be appropriated $25,000,000 for the period of fiscal 
        years 2022 through 2026.

           *       *       *       *       *       *       *


                                  [all]