[RE: Editorial, “Sex and (Bad) Politics,” April 12-18] I have focused nearly my entire career on studying human papillomaviruses (HPV) in New Mexico and other global populations. It is correct that my research group has contributed to HPV vaccine development and this fact is noted in the above-named article. I would like to clarify my position on Senate Bill 1174, which would have mandated all sixth-grade girls in the state to receive HPV vaccines. I applaud Gov. Richardson’s decision to veto this bill and the wisdom of his advisors to realize that the state was not prepared to deliver what was proposed. The governor’s decision was by no means an overreaction of the administration or its constituents but rather an appropriate response to a bill that was rushed, poorly written and did not incorporate some of the most critical components required to properly enable HPV vaccine mandate.
Before we consider further legislation on this matter, the governor has in effect acknowledged our need to have 1) the necessary allocation of dollars for associated infrastructure and resources required to deliver what is being proposed, 2) adequate preparation time for vaccine delivery by incorporating a “go-live” date with adequate lead time (two to three years following bill approval), 3) statewide education program rollout for our community of adolescents, parents and providers so that better and appropriate informed decision-making will be facilitated and 4) agreement by our state legislators that expert content advisors should help craft any legislation on this matter as our health is not something that should be left to an inadequately informed political process.
I would like to take this opportunity to clarify my position on mandated HPV vaccination with opt out once the necessary funding, infrastructure and groundwork has been put into place. The reason I support vaccine mandate is because history has shown that any vaccine will not reach much more than 30-50 percent of the population without mandate. Mandate will improve bringing HPV vaccines to those who would be least likely to receive them (underserved and rural multicultural populations) and these same populations are likely to derive the most benefit from the vaccines.
Cervical cancer is a disease of disparities. Today more than half of all cervical cancers that remain are found in women who did not receive Pap tests in the past five years. It will be very unlikely that women who don’t go to the doctor for a Pap test will take their 11- or 12-year-old daughter to a doctor on three separate occasions for a three-dose vaccine. Through school-based vaccine delivery we have the best chance to overcome the disparities likely to affect who does and does not have access to HPV vaccines.
It is imperative that everyone in the state of New Mexico understand a few things about HPV vaccines as follows: HPV vaccines are only fully effective in girls and women who have not been previously exposed through sexual activity. This is why vaccinating young girls before sexual activity is important and why girls between 9 and 14 would be the appropriate age at which to vaccinate. The current HPV vaccines protect against only a few of the many HPV types causing cervical cancer. If you are currently infected with any HPV type, these vaccines do nothing to help you get rid of those infections. All girls and women who receive HPV vaccines must continue with regular Pap tests as if they never received the vaccine because there are many other HPV types not in the vaccines that can cause disease and Pap tests are the only way to find the disease. If there is any failure of women to get Pap tests because they have a false sense of protection from having received an HPV vaccine, the rates of cervical cancer in our state may increase instead of decrease as a result of HPV vaccines. Please do not let this happen. To be healthy and safe, young girls and women receiving HPV vaccine or not must all also receive regular Pap tests.