Photo Illustration by Mark CoffeySOME KANSAS LAWMAKERS support those who say preventing a type of cervical cancer and genital warts in women is a good reason for the state to mandate Gardasil injections for prepubescent girls, but others are concerned about mandating something that could cost parents $360. --------------------- TIPS: Use this template for all photo cutlines. Take out the photo by name here and enter the name of the photographer.
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Gardasil
BY: Arley Hoskin, Staff Writer
Mary Anne Caster said she always envisioned a large family for her future, but cervical cancer destroyed that dream.
Caster, Wichita, testified to state lawmakers about a proposed bill to require sixth-grade girls to receive the human papillomavirus vaccination.
The Federal Drug Administration in June approved Gardasil, a vaccine that protects against four strains of sexually transmitted HPV, for girls ages 9-26.
Rep. Delia Garcia, Wichita, co-wrote Kansas House bill 2227, which could mandate the vaccine for Kansas girls. Gardasil protects against two strains of HPV that represent about 70 percent of cervical cancer cases and two strains of HPV responsible for about 90 percent of genital warts cases.
The Health and Human Services Committee did not release the bill, which is not expected to reach the House floor this session.
But Garcia said the cancer prevention bill still has a chance to become law.
“It’s not completely dead,” she said. “We still have an opportunity on the Senate side.”
For cancer survivors like Caster, the value of a state mandate is evident. She shared her story with Health and Human Services Committee members.
Caster said people think incorrectly that HPV affects promiscuous women only.
“A girl can contract HPV after just one sexual encounter,” Caster said. “My first sexual encounter was on my wedding night.”
Caster said Catholicism taught her to reserve sex for marriage.
Like most infected women, Caster did not realize she had HPV until years after she had contracted the virus. Caster had three children when she received the diagnosis.
“I started experiencing some problems a month before my yearly exam,” Caster said.
Tests revealed Caster had cervical cancer. Treatment included external and internal radiation, chemotherapy and a hysterectomy.
The treatment saved Caster’s life, but nothing could reverse the cancer’s damage.
“I was brought up in a very strong Catholic family and I wanted more kids,” Caster said. “I would love to have another child, but cervical cancer robbed me of that.”
Caster said she advocates mandatory vaccinations because most parents do not realize their children are at risk.
“Parents are so resistant,” Caster said.
Studies show the vaccine is most effective when received before a girl becomes sexually active. Caster said her experience shows why they should receive the vaccine.
“I have two teenage daughters and they have both started the vaccine,” Caster said.
Last year, Kansas had 100 reported cervical cancer cases resulting in about 34 deaths.
Garcia said legislators should “embrace this medical breakthrough” and mandate the vaccine.
“This is no different than any other vaccine,” she said.
But some parents disagree.
“Having it available is a good idea, but the fact that they were going to make it mandatory shocked me,” Olathe parent Mimi Henwood said.
Henwood she said she and her husband should decide whether their 8-year old daughter gets the vaccine.
Parent Janet Kincaid, Olathe, agreed.
“I’d rather it be my choice. I don’t think it is something that should be mandated,” Kincaid said.
Garcia said parents’ reluctance is not a surprise.
Every year parents choose to opt out of mandatory vaccines such as chicken pox, measles, mumps and rubella. Garcia said HB 2227 offers the same autonomy.
“Just like all the other vaccines, they can opt out for any reason,” she said.
Parents would be able to opt out after the family receives information about the vaccine and HPV.
Parent Jacque Estes, Olathe, said she supports the proposed mandate. Estes has daughters ages 3, 8 and 11.
“It’s an excellent thing to do,” Estes said. “I would support anything that would keep them from getting an STD (sexually transmitted disease).”
Health and Human Services Committee member Cindy Neighbor said she wanted the proposed mandate discussed on the House floor.
“If we can do something to prevent cancer and we have that capability I think that is something we need to take seriously,” Neighbor said.
Garcia said she wants to educate legislators and taxpayers about benefits of her proposed mandate.
Garcia said she seeks a mandate enforced by 2009. She said two years would give the state time to secure funds to make the vaccine accessible to everyone and allow time for other drug companies to create similar vaccines. The three-shot series costs $360.
Merck spokeswoman Jennifer Allen did not disclose the company’s profit margin on Gardasil. Merck reported $235 million in sales in 2006.
Most insurance companies cover Gardasil because the vaccine joined the Advisory Committee on Immunization Practices’ list of recommended vaccines.
Gardasil is available at the Johnson County Health Department Clinic for children in the state’s Vaccines for Children program.
Disease Containment Division Director Nancy Tausz said the clinic has administered the vaccine to maybe six girls since Feb. 1.
Crystal Newby, an obstetrician/gynecologist at Overland Park Regional Medical Center, said she has administered the vaccine to patients. Newby recommended the vaccine, saying the same HPV strains that cause cervical cancer cause lesions that lead to abnormal pap smears.
“These would not be a problem if they had had a vaccine,” Newby said.
Newby questioned the proposed government mandate.
“It’s a patient’s choice,” Newby said.
Retired ob/gyn Henry Buck said the government is responsible for medical choices that could prevent certain viruses and diseases.
“(Mandates) are more likely to get the entire population vaccinated,” Buck said.
Buck serves on the National Advisory Board for Merck.
“The arguments against (mandates) don’t make any sense to me because they are not based on facts,” Buck said.
Other health care professionals worry that Gardasil could create a false sense of security for vaccinated girls.
“There is always a bit of that kind of concern,” Hansen said. “This is a vaccine against one form of cancer, one sexually transmitted disease.”
About 100 strains of HPV exist; 30 are transferred sexually. About 80 percent of women acquire HPV before age 50, but most cases do not result in cervical cancer.
“Most HPV infections have no signs or symptoms,” Centers for Disease Control spokeswoman Karen Hunter said. “Very rarely HPV results in anal or genital cancers.”
Hunter said the CDC recommends the vaccine, but emphasized the importance of yearly exams for all sexually active women.
“If caught early (cervical cancer) is very treatable. That is also the reason why everyone recommends yearly pap tests,” Hunter said.
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Caster, Wichita, testified to state lawmakers about a proposed bill to require sixth-grade girls to receive the human papillomavirus vaccination.
The Federal Drug Administration in June approved Gardasil, a vaccine that protects against four strains of sexually transmitted HPV, for girls ages 9-26.
Rep. Delia Garcia, Wichita, co-wrote Kansas House bill 2227, which could mandate the vaccine for Kansas girls. Gardasil protects against two strains of HPV that represent about 70 percent of cervical cancer cases and two strains of HPV responsible for about 90 percent of genital warts cases.
The Health and Human Services Committee did not release the bill, which is not expected to reach the House floor this session.
But Garcia said the cancer prevention bill still has a chance to become law.
“It’s not completely dead,” she said. “We still have an opportunity on the Senate side.”
For cancer survivors like Caster, the value of a state mandate is evident. She shared her story with Health and Human Services Committee members.
Caster said people think incorrectly that HPV affects promiscuous women only.
“A girl can contract HPV after just one sexual encounter,” Caster said. “My first sexual encounter was on my wedding night.”
Caster said Catholicism taught her to reserve sex for marriage.
Like most infected women, Caster did not realize she had HPV until years after she had contracted the virus. Caster had three children when she received the diagnosis.
“I started experiencing some problems a month before my yearly exam,” Caster said.
Tests revealed Caster had cervical cancer. Treatment included external and internal radiation, chemotherapy and a hysterectomy.
The treatment saved Caster’s life, but nothing could reverse the cancer’s damage.
“I was brought up in a very strong Catholic family and I wanted more kids,” Caster said. “I would love to have another child, but cervical cancer robbed me of that.”
Caster said she advocates mandatory vaccinations because most parents do not realize their children are at risk.
“Parents are so resistant,” Caster said.
Studies show the vaccine is most effective when received before a girl becomes sexually active. Caster said her experience shows why they should receive the vaccine.
“I have two teenage daughters and they have both started the vaccine,” Caster said.
Last year, Kansas had 100 reported cervical cancer cases resulting in about 34 deaths.
Garcia said legislators should “embrace this medical breakthrough” and mandate the vaccine.
“This is no different than any other vaccine,” she said.
But some parents disagree.
“Having it available is a good idea, but the fact that they were going to make it mandatory shocked me,” Olathe parent Mimi Henwood said.
Henwood she said she and her husband should decide whether their 8-year old daughter gets the vaccine.
Parent Janet Kincaid, Olathe, agreed.
“I’d rather it be my choice. I don’t think it is something that should be mandated,” Kincaid said.
Garcia said parents’ reluctance is not a surprise.
Every year parents choose to opt out of mandatory vaccines such as chicken pox, measles, mumps and rubella. Garcia said HB 2227 offers the same autonomy.
“Just like all the other vaccines, they can opt out for any reason,” she said.
Parents would be able to opt out after the family receives information about the vaccine and HPV.
Parent Jacque Estes, Olathe, said she supports the proposed mandate. Estes has daughters ages 3, 8 and 11.
“It’s an excellent thing to do,” Estes said. “I would support anything that would keep them from getting an STD (sexually transmitted disease).”
Health and Human Services Committee member Cindy Neighbor said she wanted the proposed mandate discussed on the House floor.
“If we can do something to prevent cancer and we have that capability I think that is something we need to take seriously,” Neighbor said.
Garcia said she wants to educate legislators and taxpayers about benefits of her proposed mandate.
Garcia said she seeks a mandate enforced by 2009. She said two years would give the state time to secure funds to make the vaccine accessible to everyone and allow time for other drug companies to create similar vaccines. The three-shot series costs $360.
Merck spokeswoman Jennifer Allen did not disclose the company’s profit margin on Gardasil. Merck reported $235 million in sales in 2006.
Most insurance companies cover Gardasil because the vaccine joined the Advisory Committee on Immunization Practices’ list of recommended vaccines.
Gardasil is available at the Johnson County Health Department Clinic for children in the state’s Vaccines for Children program.
Disease Containment Division Director Nancy Tausz said the clinic has administered the vaccine to maybe six girls since Feb. 1.
Crystal Newby, an obstetrician/gynecologist at Overland Park Regional Medical Center, said she has administered the vaccine to patients. Newby recommended the vaccine, saying the same HPV strains that cause cervical cancer cause lesions that lead to abnormal pap smears.
“These would not be a problem if they had had a vaccine,” Newby said.
Newby questioned the proposed government mandate.
“It’s a patient’s choice,” Newby said.
Retired ob/gyn Henry Buck said the government is responsible for medical choices that could prevent certain viruses and diseases.
“(Mandates) are more likely to get the entire population vaccinated,” Buck said.
Buck serves on the National Advisory Board for Merck.
“The arguments against (mandates) don’t make any sense to me because they are not based on facts,” Buck said.
Other health care professionals worry that Gardasil could create a false sense of security for vaccinated girls.
“There is always a bit of that kind of concern,” Hansen said. “This is a vaccine against one form of cancer, one sexually transmitted disease.”
About 100 strains of HPV exist; 30 are transferred sexually. About 80 percent of women acquire HPV before age 50, but most cases do not result in cervical cancer.
“Most HPV infections have no signs or symptoms,” Centers for Disease Control spokeswoman Karen Hunter said. “Very rarely HPV results in anal or genital cancers.”
Hunter said the CDC recommends the vaccine, but emphasized the importance of yearly exams for all sexually active women.
“If caught early (cervical cancer) is very treatable. That is also the reason why everyone recommends yearly pap tests,” Hunter said.
Comments on "Gardasil"
Comments are limited to 200 words or less.Caroline wrote on Mar 3, 2007 11:20 AM:
" Garcia said that you can opt out for any reason. That is false information.
In Missouri, at least, all children, must be up to date on all vaccines before they are allowed to enter kindergarten. The only opt out is for "religious reasons". The state governments should not be able to mandate anything like that! It's a parent's choice what poisons they would allow the be injected into their children. The health officials don't know & don't seem to care if this is good for my child. They don't know their allergies or what reactions my child could have. My daughter will NOT be a guinea pig for studies.
And what would my 8 year old be needing a vaccine for SEXUALLY transmitted diseases? She's a CHILD!
I have a question or two for Merk...WHAT mercury levels ARE safe for my child? It's also a shame that the govt. makes citizens hide under a "religious umbrella"/what happens when they try to take THAT away? They ARE trying to take GOd out of our country which was founded by & on those very principles by Jefferson et al., our founding fathers. "
Judy Smith, RPh wrote on Mar 3, 2007 8:12 AM:
" Gardasil protects against 70 percent of cervical cancers in women. Although it is estimated that one in four women will contract HPV infection sometime in their lives, only 3.4 percent will actually contract cervical cancer, easily detected by annual Pap smear exams. The "protection" that Gardasil affords is not complete, but parents will only hear "protected," not seventy percent protected. A parent should make the decision to have their child vaccinated based on risk/benefit for their own child; the state should not pre-empt parental authority.
There are too many other air-borne and food-borne communicable diseases potentially affecting so many more people that need the public funding dollars. This expensive ($360 for a three-shot regimen) vaccine should not pre-empt scanty public funding for vaccines that prevent serious diseases. In addition, Gardasil has had no longitudinal studies to survey its efficacy over long-term and its safety. "
Nancy wrote on Mar 1, 2007 8:55 AM:
" I would like to see the research showing how long this vaccine will last. By vaccinating 11 year olds, will they still be protected at age 15, 18, 21? How many of the 100 HPV strains are included in the vaccine? Are there any long term side-effects? Do other countries use this vaccine? What is the prevention success rate? Let's get answers to these and other questions before we jump on the bandwagon. "