As reported by the Boston Globe, January 28, 2007.

Preventing Cervical Cancer on Lawmakers' Agenda

By Dave Collins, Associated Press

HARTFORD, Conn. -- Connecticut lawmakers are joining their counterparts across the country this year in deciding whether to require girls to be vaccinated against the virus that causes cervical cancer.

The issue began sweeping the nation following the federal government's approval of Merck & Co.'s Gardasil vaccine last June and a subsequent recommendation by a federal advisory panel that all girls ages 11 and 12 receive the immunization.

Most states this year will be debating whether to mandate the vaccination of all girls in their states against the human papilloma virus, or HPV, according to the National Conference of State Legislatures. HPV is a leading cause of cervical cancer and genital warts,

Three bills have been introduced this month in the Connecticut General Assembly. The most wide-ranging proposal would require all girls in the state to receive an HPV shot around the age of 12.

Another bill would require the state's insurance program for the poor to cover HPV vaccinations. The third would make the Department of Public Health develop standards for immunization against the virus.

"I think that it is really important that we protect our young women to the absolute best of our ability," said state Rep. DebraLee Hovey, R-Monroe. "If we can vaccinate a young woman in her adolescence, she has a 70 percent chance of never seeing a glimmer of cervical cancer."

Researchers are still determining the vaccine's safety for boys. Hovey said she would support making it mandatory for boys if it turns out to be safe.

Hovey's proposal would make the cervical cancer vaccination a requirement for all girls in the state. It would also give an undetermined sum to the Public Health Department to study ways to prevent and treat cervical cancer and set aside $50,000 for a public education campaign.

Several other states, including California, Indiana, Maryland, Michigan and Texas, are considering bills that would require HPV vaccinations for all girls entering the sixth grade.

HPV is one of the most common sexually transmitted diseases, with about 6 million Americans diagnosed with it every year. This year, more than 11,000 new cases of cervical cancer are expected to be diagnosed in the United States, and nearly 3,700 women will die from cervical cancer, according to the National Cancer Institute.

In Connecticut each year, about seven of every 100,000 women are diagnosed with cervical cancer and about 37 women die, according to state and national data. Cervical cancer is one of the least prevalent cancers in the state, with breast and lung cancer at the top of the list.

"It's preventable, like polio and small pox," said Rep. Roberta Willis, D-Salisbury, who proposed having the state's HUSKY insurance program for low-income families cover HPV vaccinations.

"Thousands of women die every year from cervical cancer," said Willis, a leukemia survivor and mother of four adult children. "It's incumbent upon us to do something."

The cost of having the state's insurance program pay for the vaccinations has not yet been estimated by legislative researchers.

The vaccine is administered in three shots in a six-month period at a total cost of more than $300. Although it is expensive, many insurance companies have begun to cover the vaccine because of the expected reduction in expenses for treating cervical cancer. About $1.7 billion is spent on treating cervical cancer each year in the United States, the National Cancer Institute says.

The Gardasil vaccine was approved last year for use in girls 9 to 26 years old. The federal Advisory Committee on Immunization Practices recommended that the vaccine would be best given to girls before they become sexually active.

Dr. Henry Feder Jr., a professor of pediatrics and family medicine at the University of Connecticut Health Center and Connecticut Children's Medical Center in Hartford, said he supports immunizing girls against HPV, although some other doctors and parents are somewhat skeptical.

"It's going to prevent cases of cervical cancer," he said. "It's going to prevent cases of genital warts, which can cause problems with newborns. It will be a benefit in decreasing the number of Pap smears that are positive and have to be repeated."

Feder said other vaccines, such as those for rubella and chicken pox, sparked controversy when they were first introduced, but concerns eased once they had been around a while. He said there are no known side effects of Gardasil, other than minor irritation at the shot site.

"The tricky part is someone telling you, 'Trust me. It's for your benefit,'" Feder said.