MICHELE NORRIS, host:
From NPR News, this is ALL THINGS CONSIDERED. I'm Michele Norris.
ROBERT SIEGEL, host:
And I'm Robert Siegel.
Texas just became the first state to require that girls be vaccinated against the human papilloma virus. HPV is a sexually transmitted infection that can cause cancer. Last summer, the Centers for Disease Control and Prevention recommended that girls be vaccinated starting at age 12, before they become sexually active. More than 20 states are considering requiring the vaccine for teens.
That has focused attention on the manufacturer's campaign to promote the vaccine, as NPR's Brenda Wilson reports.
BRENDA WILSON: The move to require the HPV vaccine for adolescent girls began right after the CDC made its recommendation. Within months, the bill was introduced in the Michigan assembly. It was defeated. Another watered-down version was introduced again this year. Now 18 states and the District of Columbia have followed suit.
David Catania, a D.C. City Council member, says there's a simple reason — protection against cervical cancer.
Mr. DAVID CATANIA (City Council, District of Columbia): For 14,000 women per year, it means cervical cancer and for nearly 4,000, it means death. The district has a particular reason why this is important. We lead the nation in cases of cervical cancer.
WILSON: But as in most states where there have been proposals to require the vaccine, Catania had to take a lot of heat. A local newspaper columnist worried that the measure suggests girls in the District of Columbia's public schools — most of whom are African-American — are sexually promiscuous. Catania insists that the legislation doesn't target any particular group and the vaccination wouldn't exactly be mandatory.
Mr. CATANIA: What we are doing is we're forcing the conversation. Either you are going to have your child vaccinated, or you will make an informed decision to opt out.
WILSON: In the District, parents would not have to provide a reason for their objection. David Catania says he wants the District to move fast and stay in the lead nationally on childhood immunizations. By all accounts, Merck, the manufacturer of one vaccine - Gardasil, wants to move fast too. Drug maker GlaxoSmithKline is close on Merck's heels with its own HPV vaccine. So Merck has initiated a massive ad campaign that is part public education and part hard sell.
(Soundbite of Gardasil Advertisement)
Unidentified Woman #1: Each year in the U.S., dozens of women learn they have cervical cancer. I could be one less.
Unidentified Woman #2: One less statistic, one less.
Unidentified Woman #3: Because now, there's Gardasil. The only vaccine that may help -
WILSON: But Merck has gone beyond just promoting the vaccine to promoting and funding initiatives in states to require girls to get the vaccine. A company medical director at Merck, Dr. Richard Haupt, says the company supports vaccine mandates because they ensure that all girls get the vaccine.
Dr. RICHARD HAUPT (Merck): Through school requirements, you reach under-served populations, certain ethnic and socio-economic groups that wouldn't be reached otherwise. And that's why we support state initiatives that can improve immunization coverage rates.
WILSON: If the vaccine became widely used, analysts estimate that Merck stands to earn between two to four billion dollars on Gardasil. Most public health experts support requiring immunizations in general. Dr. Neal Halsey is a pediatrician and vaccine expert in the School of International Health at Johns Hopkins University. He would prefer a campaign to build acceptance of the HPV vaccine before it is required.
There are a lot of hurdles this one faces. For one, he says, it's going to take time to teach parents why young children need to be vaccinated against a sexually transmitted disease
Dr. NEAL HALSEY (John Hopkins University): We don't know when our children are going to be first sexually active. And unfortunately, we don't choose who they decide to have sex with. And that's why waiting until after they're sexually active is dangerous for the children because they can become infected very quickly.
WILSON: But there are some objections public education won't easily overcome. Some conservatives object to the vaccine because they fear it will encourage early sexuality, and some parents object to vaccines because they think kids are already subjected to too many vaccines. And this vaccine is not cheap — and not that simple to administer. It's $120 a shot. And the girl would have to get three shots over a six-month period.
And current problems with adolescent immunization programs, Halsey says, could lead to even more of a backlash against this vaccine.
Dr. HALSEY: I would like to see systems out there to deliver the vaccine, improve the supply guarantee, and we probably wouldn't see as much strong resistance if we would give it six months to a year additional. Get more experience - hundreds of thousands, if not millions of people, vaccinated.
WILSON: Still, the question that most parents will have to resolve is whether the fear of a potential cancer later in life trumps their inhibitions about sex in adolescence.
(Soundbite of Gardasil Advertisement)
Unidentified Woman #4: With Gardasil, you could be one less.
Unidentified Children: One less - O-N-E-L-E-S-S. I want to be one less. One less.
WILSON: Brenda Wilson, NPR News.
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