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Proposal to require HPV vaccine for girls stirs debate

KEVIN CASTLE • Feb 3, 2007 at 10:09 AM

It's been hailed by some medical experts as the greatest breakthrough of 2006, and if you have a school-age daughter, you might want to get acquainted with it because it could save her life.

Laws regarding the use of Gardasil - a Food and Drug Administration-approved vaccine designed to combat four types of human papillomavirus, or HPV - are being debated this winter by lawmakers in several states, including Virginia.

The states are considering requiring that girls entering the sixth grade be vaccinated with Gardasil. Most of the bills include an option for parents to exclude their daughters from the requirement.

But such laws have met with opposition from people who say the focus should be on preventing premarital sex instead.

HPV is spread through sexual transmission and skin-to-skin contact. The virus causes 99 percent of all cases of cervical cancer, which kills 10 women a day according to the Centers for Disease Control and Prevention.

"Because this is an issue that involves sexual health, everything changes," says Dr. Gene Rudd, a licensed gynecologist from Bristol and senior vice president of the Christian Medical and Dental Association.

"If this were a vaccine against the common cold and we wanted to prevent all of our future generations from getting a cold, we probably wouldn't be putting up much of a stink against the government saying they want broad distribution of the drug by mandating it.

"Further, it is an issue that there is another reliable means of preventing it. It's not like a disease you catch in the classroom. You do it through behavioral choices, in some cases. Because it is a sexual health issue, it ups the ante on the decision making."

If passed in Virginia, the law would take effect after Sept. 1, 2008, and the bill is currently being debated in committee discussion in the House of Delegates.

Gardasil is given in a series of three shots over a six-month period. According to Merck, the vaccine's producer, girls ages 9 to 26 are eligible to receive the shot pending a doctor's consultation.

According to Merck, the three doses of Gardasil cost $350, and they will have a program available that will help a woman finance the cost.

Rudd doesn't discount the drug's importance, saying that any medicine that can improve the protection against HPV is a notable breakthrough.

"The reliable alternative of abstinence has not been used with great propensity. The figures tell us that," Rudd said.

"Secondly, if we don't make it mandatory, the utilization of the vaccine will probably be low, in part because some people will not be motivated to get it and some will be discouraged by the financing of it.

"If a state mandates it, you're going to have better disease control. I'm not going out and advocating that states mandate this, but at the same time, I'm not going to resist it either. The state would unleash funding that would make the drug far more available to those who can't afford it or who wouldn't get it otherwise."

Rudd said the compromise is the opt-out clause for parents who would hold the final decision.

"Individuals have the option to not take it. That is what would be important, to let parents option their children out if they don't want them to take it," he said.

Other medical evidence that Rudd has collected shows that men are least likely to admit that they may be bringing a sexually transmitted disease into a relationship, therefore the drug would be used as protection in that sense.

"(The woman) might be exposed (to HPV) in marriage and might not even know it," he said.

"Take this example. I will try and teach my daughter to be abstinent before marriage. What if she makes a bad decision? Do I want her to get this disease? I don't.

"I think you can use the spiritual lesson that we learn about Jesus and the woman who was caught in adultery. She was facing the consequence of her sin, and that, being stoned to death. (Jesus) protected her from that, and offered forgiveness before he called for her righteousness. He didn't make it conditional on protecting her. Sin brings consequences, but our job as Christians is to help people with their suffering and the avoidance of consequences of being in a fallen world," Rudd added.

Rudd disagrees with critics of the proposed legislation who say the vaccine is essentially "a green light" for teenage girls to become sexually active.

He cites a recent study of 16,000 teenagers who were vaccinated against hepatitis A, another sexually transmitted disease.

"They were clueless, had no idea that was what it was for. They said ‘It was something my doctor and my parent wanted me to take,'" said Rudd.

One side effect that Rudd says the entire vaccine controversy might bring is the need to talk to teenagers about sexual issues.

"I hope it creates an opportunity for sexual counseling, because that is the age that it needs to start, at the age of 9, 10 and 11. This might be a stimulus for that," said Rudd.

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