Cervical Cancer Vaccine Continues to Spark Debate

Anderson believes Gardasil will go a long way to stemming the current "epidemic" of HPV infection. "In their lifetime, 75 percent of U.S. women will be exposed to the HPV virus. At any one time, about 25 percent have been infected with the virus," he said. "If that's not epidemic proportions, I don't know what is."

Not all the objections to mandating the vaccine are medical. Others have voiced political and moral objections.

"It's an end run around parental rights," said Wendy Wright, president of Concerned Women for America, a conservative lobbying group. "Parents know what's best for their daughters. Even with an opt-out option, it puts the parents in a position where they have to justify themselves to government officials," she said.

Wright also objects to the vaccine, because it has not been proved to be safe for the general population. "It could be putting people at risk with the assumption that since the government approved it, and it's being mandated by the states, it must be safe," she said. "But they really can't say that for certain."

She also questioned the need for Gardasil in the first place. According to Wright, the threat of cervical cancer has diminished significantly with the use of regular Pap smears and more effective treatment.

HPV is sexually transmitted, so Wright believes there's a clear way to avoid it: Practice abstinence. "The best prevention is being sexually responsible," she said. "That means being abstinent outside of marriage and faithful inside of marriage."

In addition, women should continue to get regular Pap tests as recommended, she said. "The vaccine should be a third option," Wright said.

Strong negative reaction from some segments of the public to state mandates caused pharmaceutical giant Merck, which makes the vaccine, to pull back on lobbying efforts advocating mandated vaccination. Repeated calls to Merck for comment were not returned.

Wright is also concerned that mandating the vaccine will lead to mandates for other vaccines. "That's what happened with the hepatitis B vaccine," she said. "It kind of slipped through in the early 1990s. The public health community rammed that through."

Abramson agreed that vaccines for other cancers should not be mandated. Mandated vaccines should be limited to those diseases that are highly contagious and spread by casual contact, he said. "Right now, I am not willing to cross that line," he said.

More information

For more information on cervical cancer, visit the American Cancer Society.

SOURCES: Robert Frenck, M.D., professor, pediatrics, Cincinnati Children's Hospital, member, American Academy of Pediatrics Committee on Infectious Diseases; Ralph Anderson, M.D., chairman, obstetrics and gynecology, University of North Texas Health Center, Denton; Jon Abramson, M.D., professor, infectious diseases, Wake Forest University Medical School, Winston-Salem, N.C., and chairman, U.S. Centers for Disease Control and Prevention, Advisory Committee on Immunization Practice; Wendy Wright, president, Concerned Women for America, Washington, D.C.