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D.C. Bill Would Mandate Vaccine
Proposal for Girls Under 13 Targets Cervical Cancer

By Nikita Stewart and Rob Stein
Washington Post Staff Writers
Wednesday, January 10, 2007

The D.C. Council opened its legislative year by introducing a bill that could make the District one of the first jurisdictions in the country to require girls younger than 13 years old to get a new nationally debated vaccine against cervical cancer.

Female students enrolling in the sixth grade would be asked to show proof of receiving the vaccine against the sexually transmitted human papilloma virus (HPV) under the bill, introduced yesterday by council members David A. Catania (I-At Large) and Mary M. Cheh (D-Ward 3).

A parent or legal guardian would have the right to "opt out" of the requirement, Catania said, but the bill does not detail under what circumstances exemptions would be permitted.

Similar proposals are pending in Kentucky and California, and several other states are also considering such legislation. A bill to require the vaccine failed last year in Michigan.

In other business during the council's first working session, Marion Barry (D-Ward 8) withdrew a motion to override the veto of his bill that would protect former criminal offenders against job and housing discrimination.

Mayor Anthony A. Williams (D), who left office last week, rejected the measure, agreeing with business and community leaders that the bill could open employers to public safety issues and unfair litigation. Although the council approved the bill 10 to 2 last month, members of the new council said the bill needed re-examination.

Catania's decision to introduce the vaccine proposal was based in part on the high incidence of cervical cancer in the District. HPV causes cancer in about 10,000 women in the country annually and kills about 3,700, according to the American Cancer Society. The national incidence rate of the disease is 8.8 per 100,000 females, and the District's rate is 13.5 per 100,000, according to the society.

Catania also said he was introducing the bill now because federal support is available for the vaccine, which costs $360 for a full three-shot series. He said children receiving Medicaid benefits and others who are uninsured or underinsured can receive free HPV vaccinations. "With January being National Cervical Cancer Awareness Month, now is the perfect time for the District to lead the nation in the fight against what is in essence a preventable disease," Catania said at the council meeting.

Reaction to the local legislation was mixed. "I think this makes perfect sense," said Stanley A. Gall of the American College of Obstetricians and Gynecologists. "There would certainly be a significant health benefit."

There were questions by some about the timing of such a requirement. Although the American Academy of Pediatrics recommends the vaccine for all girls ages 11 and 12, an adviser to the academy said he thought it was premature to recommend making it mandatory. "I think it's too early," said Joseph A. Bocchini, who chairs the academy's committee on infectious diseases. "This is a new vaccine. It would be wise to wait until we have additional information about the safety of the vaccine."

Although a number of public health organizations have promoted widespread use of the vaccine, some groups and parents fear that such requirements can infringe on parental rights and unintentionally encourage sexual activity. "That's really a decision between parents and doctors," said Iris Toyer, co-chair of Parents United for D.C. Public Schools. "I understand the intent, but a lot of discussion must be done."

"It would be one thing if the American Medical Association or the D.C. Health Department was telling me to do it," she said.

An official at Focus on the Family, a Colorado-based conservative group, said that although the group supports widespread access and use of the vaccine, it was also concerned about actions that affect parental authority. "Parents should have total control over whether they vaccinate their children or not," said Linda Klepacki, an analyst for the group.

District students must be vaccinated against such diseases as chicken pox, measles and mumps, she said, but HPV is different because it can't be spread casually.

Klepacki expressed concern that a program that would give parents the chance to "opt out" might make it too difficult to do so or leave parents uninformed. "It depends on what 'opt out' means. How difficult is the process? Is it really their decision?" she asked.

The introduction of the bill does not specify how parents could take that step, but Catania stressed that the option would exist and that there would be no penalties for children who were not vaccinated.

He said he hoped parents and guardians would think long-term and use the vaccination to talk about the delicate subject of sexually transmitted diseases. "The hard stuff is putting the parents and guardians in a position to have this conversation," Catania said.

Other bills introduced at the council session are expected to generate months of debate, including a measure that would remove the city's emergency medical services agency from the Fire and Emergency Medical Services Department and make EMS a separate agency.

Another bill would abolish the Anacostia Waterfront Corp. and the National Capital Revitalization Corp., quasi-public agencies whose disputes have delayed the $800 million redevelopment of 47 acres along the District's Southwest waterfront.

The council also voted 10 to 1 to keep the $611 million cap on spending on the baseball stadium through emergency legislation. The cap, which the council approved last year, was established through emergency and temporary legislation, which expires Jan. 19.

The latest emergency legislation opened nearly two hours of debate about overspending, parking garages and other matters related to the ballpark. Permanent legislation on the cap will require hearings, and council member Kwame R. Brown (D-At Large), chairman of the Economic Development Committee, said he expected them to be extensive.

At the session, council members paused to chat with New York Mayor Michael R. Bloomberg (R), who was in town at the invitation of Mayor Adrian M. Fenty (D).

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