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Bills would make HPV vaccine mandatory for NY students

A teenager getting a vaccine .

A teenager getting a vaccine . Credit: Fotolia / Bochkarev Photography

ALBANY — Two legislative proposals with strong sponsors would require elementary school children to be immunized against the sexually transmitted virus known as HPV, without requiring that their parents agree or even know about the shots.

The bills have already attracted a backlash from parents in a Facebook petition launched by a Suffolk County woman. They argue in part that the state shouldn’t take a parent’s role by requiring the vaccine as a requirement to attend school, that the vaccine could embolden youths to have sex at a younger age, and that the vaccine could be the cause of rising depression and anxiety in youths.

The measure in the Assembly and Senate would apply to children born since Jan. 1, 2009. Federal officials said the virus, human papillomavirus, has been contracted by 80 million Americans. It is so common that nearly all men and women will contract it sometime in their lives, the officials said.

A related bill introduced earlier this year would allow health care practitioners such as those at clinics and Planned Parenthood offices, not just physicians, to vaccinate youths under 18 years old for sexually transmitted diseases without the knowledge or consent of their parents or guardians.

Parents and guardians would have to provide written proof from their family physicians or other health care practitioners that their children were inoculated with the required vaccines before 14 school days pass in a new school year, according to state public health law. Exceptions can be made for students who transfer between schools.

Assemb. Amy Paulin (D-Scarsdale), who co-sponsors both bills, said she started thinking about the bill after a drug was approved to prevent HPV around 2006.

“I said, ‘Wow! What can we do?’ And one of the things I learned was we could require it in school,” Paulin said.

She said the “herd factor” — which is public health terminology — states that a malady like HPV can be nearly eradicated if a large enough part of a population is inoculated.

But critics say the bills trample parents' rights. “People should have the choice if they want the vaccination or not,” said Jessica Rudin of East Setauket. “Since it is not a huge issue, people aren’t dying from having HPV all the time, I don’t see why it should be mandatory, especially without parental consent.”

“We — I say ‘we’ because there is a huge amount of people behind me — we want our voices heard and we don’t want our voices taken away as parents,” Rudin said.

Supporters of the measure say the science is solid, but the politics is dicey.

Their task is harder after anti-vaccine demonstrators roiled the Capitol for part of the past legislative session trying to keep their children from mandated measles inoculation under a religious exemption. The 2020 legislative session is also an election year, when most legislators shy away from bold, controversial bills.

The virus is highly contagious with intimate or sexual contact and can lead to six kinds of cancer attacking the cervix, vagina, vulva, penis, anus, and the throat, according to the federal Centers for Disease Control. The American Cancer Society says HPV strains cause about 70% of all cervical cancers as well as many other cancers. HPV can also lead to warts and weaken immune systems, or it can show no symptoms and go away on its own, but still spark the cancers. The vaccine, however, can prevent the vast majority of those cancers and symptoms, the centers and cancer society said.

“If you can eradicate cervical cancer, we should,” Paulin said. “I don’t know why we wouldn’t do everything we can.”

The federal health authority recommends vaccinations in two doses for youths beginning when they are 11 to 12 years old, in part because advocates say the vaccine is most potent if used years before sexual activity begins. The Centers for Disease Control and Prevention calls the vaccine “very safe” after 10 years of testing and states the benefits “far outweigh” the side effects that include nausea, headache and dizziness.

New York already requires children to be inoculated against nearly a dozen diseases including measles, mumps and hepatitis B, which is also sexually transmitted, in order to attend school regardless of permission from their parents. Advocates want the HPV vaccine added to this group protected and enforced by law. In 2017, the state Health Department set a regulation that allows youths to seek the HPV vaccine without parental consent, as they can in seeking contraceptives and abortions, although the department warns that the state Immunization Information System “allows parents access to their child’s vaccine information, including HPV vaccination.”  

Under that regulation, youths seeking the vaccine at clinics or Planned Parenthood offices without wanting to alert their parents through their insurance company also would have to a find a way to pay for the inoculations, usually estimated at $250 to $570, although some federal programs can help defray the cost. 

Last week Pediatrics, the journal of the American Academy of Pediatrics, confirmed previous studies that the vaccine is safe and stops HPV and the many cancers it can trigger in women later in life. Yet only about half of youths get the vaccine, leading to 14 million new cases each year infected by HPV. The journal reported that 97% of side effects weren’t serious.

Other states have already pressed the issue. Rhode Island, Virginia and the District of Columbia require HPV immunization before kids can go to school and eight other states are considering similar proposals, according to the National Conference of State Legislatures. Virginia and the District of Columbia included an opt-out clause for the vaccination for medical, moral or religious opposition. Rhode Island’s legislature has bills pending that would also provide parents a way to avoid vaccinations for their children.

No major lawsuits were reported in Rhode Island, Virginia and the District of Columbia to block their measures. The National Institutes of Health said government immunization mandates against diseases have withstood several legal challenges. The “courts repeatedly have affirmed a state’s right to develop measures that ‘protect the health and safety’ of its citizens and the constitutionality of school entry requirements,” the institutes stated, noting the court precedents date to 1827, when Boston required inoculations against smallpox.

“It will require greater education among my colleagues and the general public about how the HPV vaccine prevents cancers and suffering in men and women,” said State Sen. Brad Hoylman (D-Manhattan), who co-sponsors the bill to require the HPV vaccine in schools.

“If you had a chance to prevent your child from getting cancers by immunizing them with a vaccine that is safe, you would do that. I think that’s the question every parent has to ask themselves … Science should dictate our policy, not surfing the internet for conspiracy theories.”

An online petition against the bills began within the last month and has attracted more than 72,000 signatures so far.

“These bills trample on parental rights and medical freedom and the government has no place in making medical decisions for our families!” states the petition fueled by Facebook supporters. “HPV can only be transmitted through sexual intercourse and our government is calling for kids to be injected with this vaccination by the age of 9! Better education about sex both in the home and in school is a more effective method rather than a vaccination with evidence of severe side effects.”

Larry Cook of the Los Angeles-based activist group Stop Mandatory Vaccinations said “The HPV vaccine has nothing whatsoever to do with ‘public health,’ just as mandating birth control for teens would have nothing to do with public health. The real question here is, ‘Who is benefiting from the HPV vaccine mandate?” referring to the pharmaceutical industry.

State Sen. Liz Krueger (D-Manhattan) knows the arguments. She co-sponsors the bill to allow youths to seek the vaccination without parental approval. She is one of several progressive legislators who say they have been regularly confronted at news conferences and at events in their districts by “anti-vaxxers” since the spring. Demonstrations were loud and frequent during the 2019 session, supported by wealthy advocates including Robert F. Kennedy Jr., son of slain Sen. Robert Kennedy and nephew of former President John F. Kennedy.

Those advocates fought against a law passed in June that ended the “religious exemption” that allowed parents to keep their children from being immunized for measles as a condition of attending school. The anti-vaccine advocates lost their lawsuit pursued by Kennedy in September, but their crusade continues.

“I just got a four-volume petition opposing some version of an HPV bill,” Krueger said. “I really am quite surprised at the reaction of people. I think some of it is that when you are talking about the HPV, it is sexually transmitted and some people get weird when you talk about sexual transmission. … I just don’t understand everyone’s hysteria.”

Some opponents of the vaccine argue that administering the inoculation may prompt teens to become sexually active sooner, although a 2014 study by the American Academy of Pediatrics found that wasn’t true. Claims that the vaccine could be linked to depression and anxiety also lack proof.

Krueger said she agreed it would be best if all youths could talk about premarital sex with their parents and the benefits of the HPV vaccine.

“I understand and respect that parents want to be the one convincing their teenager why they should wait for marriage or until they are 21,” Krueger said. “But, really, we all know statistically that story line has not been very successful.”

What is HPV?

  • Human papillomavirus or HPV is the most common sexually transmitted disease and there are many types of HPV.
  • It is spread by having sex even when the partner with HPV shows now symptoms.
  • It can be transmitted even if you have sex with only one person and symptoms may take years to develop.
  • Most of the time HPV goes away on its own without creating health problems, but when it doesn’t dissipate on its own, it can cause genital warts and cancer.
  • HPV also can cause cancer of the cervix, vulva, vagina, penis or anus and in tonsils, the tongue or back of the throat.
  • HPV vaccinations are recommended for youths beginning at 11 to 12 years old, but can start as early as 9 years old. Vaccinations are recommended for adults through age 26.
  • Condoms are also recommended to avoid HPV.

Source: Federal Centers for Disease Control and Prevention.

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