A Smart Shot
A D.C. bill would save lives and be in the best interest of public health.

Thursday, January 11, 2007

AMERICANS, history shows, have a visceral suspicion of mandatory vaccinations. Add sex to the mix and the result is likely to be incendiary. But emotion and ignorance shouldn't thwart a D.C. proposal that would save the lives of thousands of women.

The proposal would strongly encourage the inoculation of girls younger than 13 against a sexually transmitted virus that can cause cervical cancer. Before enrolling in the sixth grade, a female student would have to show either that she had received the vaccine against the human papillomavirus (HPV) or that her parents or legal guardian had chosen to opt out. The bill, introduced by council members David A. Catania (I-At Large) and Mary M. Cheh (D-Ward 3), is backed by every other member of the council. It also has science on its side.

The vaccine, known by the trade name Gardasil, was approved by the Food and Drug Administration in June after rigorous testing for safety and efficacy. Expectations that conservative groups would come out in forceful opposition or that the Bush administration would drag its feet did not materialize because of the clear public health benefits. Each day in the United States, 10 women die of cervical cancer; testing has proved the vaccine effective against four strains of the virus, which causes 70 percent of cervical cancer cases. An advisory committee to the Centers for Disease Control and Prevention recommended that girls and young women get the vaccine, and federal health programs that pay for vaccinations for uninsured youths will cover the costs. States as dissimilar as Texas and California are considering similar measures. As one advocate said, "It's a slam dunk."

Yet there is opposition. Some of it flows from the misguided belief that the virus doesn't pose the same kind of threat to the public as other transmissible pathogens. In fact, each year 6.2 million people of both sexes -- most in their late teens and early 20s -- get HPV. In most cases, the HPV goes away, but including the vaccine in school immunization programs is the best way to prevent a dreadful disease that afflicts an estimated 9,700 women a year. Similarly, the argument that receiving the vaccine will encourage promiscuity doesn't square with the fact that the vaccine is recommended to be administered at an age before girls are sexually active.

Parents are right to worry about their children and to want to have a say in their health management. This bill gives them that right. No child would be kept out of school for not getting the vaccine, but Mr. Catania and Ms. Cheh would mandate that parents get the data needed to make informed choices. If common sense wins out here, the District will lead the nation in an important area of public health -- and will save some lives.