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Ohio may require HPV vaccine

Bill proposes 6th grade females be given STD immunizations

By Christine Brady
On March 30, 2007

In addition to the usual measles, mumps and rubella vaccines children must receive before entering middle school, Ohio's female sixth graders could add the new human papillomavirus virus (HPV) vaccine to their list of immunizations.

Ohio Rep. Edna Brown (D-Toledo) proposed the bill requiring young girls to receive the vaccine to the Ohio General Assembly in December, but the session expired before voting took place.

The bill will be discussed and voted on later this spring, according to Brown's office.

HPV is a sexually transmitted disease that can be most easily prevented in young women, explained James Slager, senior administrative director of Miami University's health services.

Representative Brown's legislative aide, Mercy Sutyak, said the legislation was proposed because of the evidence between contraction of HPV and cervical cancer.

The proposed legislation would require female students to receive the vaccine Gardisil, which protects women from HPV. Gardisil, made by the pharmaceutical company Merck, was approved by the Food and Drug Administration June 8.

Students would have to obtain the vaccine within the first 14 days of the 2007-08 school year.

While this vaccine proposal is new to Ohio, it has sparked debate in other states that have proposed similar legislation.

Of the 33 states that considered bills to require HPV vaccinations of adolescent girls, only Virginia has enacted the law. The Texas legislature overrode the bill's enactment in the state in February, according to Sutyak

Still, Sutyak said Rep. Brown believe the preventative nature of the legislation and the health benefits of such an act are important in Ohio.

Sutyak said research done by pharmaceutical companies like Merck and Glaxo Smith Klein show the importance of early vaccine in decreasing the risk for cervical cancer, a health issue Brown believes must be addressed.

"She feels (the vaccine) is prevention for women's health," Sutyak said. "If that prevention is available, we should avail ourselves to it. She doesn't think it's political."

Opponents of the bill say the vaccine may encourage girls to engage in risky sexual behavior or promote sex in students as young as 12 years old.

In another opposing view, Slager believes the medical benefits of the vaccine are important, but opposes government regulations of such decisions.

"While I think (the vaccine) is a good thing ... I don't like that it is required," he said. "You inform people as best you can and let them choose whether or not to get the vaccine."

Slager also said the age requirement selected seems to be on the low end of the sexual activity spectrum, if the goal is to protect as many children as possible before they become sexually active.

Sharon Lytle, principal of Talawanda Middle School, said her district will comply with the law if it is passed, but sees it as troublesome for low-income parents.

"This is going to be another burden for those parents who struggle to take care of medical needs," she said.

No federal or Ohio law currently exists for HPV immunizations, but other immunizations must be received by children before they enter middle school and high school. Parents have a grace period of about two weeks before the child is excluded from school until the vaccines are given and verified by a physician. The HPV vaccine law would utilize a similar approach to school attendance policies.

Lytle added that to assist with the medical needs of students, the district attempts to find free clinics and other programs to guarantee the child receives the proper immunizations, a service that would include the HPV vaccine.

Lytle said the school allows parents ample time at the beginning of the year to immunize their child, especially if the family has recently moved to the area or is in a situation that requires more time.

"If parents don't have proof of immunizations we give them time to take care of that before we exclude the student from school," she said.

Lytle has her own ideas about why this particular age group was chosen the proposed bill.

She said that the legislation is probably proposed in the sixth grade because of building transitions that more easily facilitate immunization requirements.

Parents and guardians of girls entering the sixth grade will be presented with information regarding the virus upon visiting their family doctor or the local health department that would administer the immunization.

As with other vaccine preparation, they may choose not to vaccinate their child, but will assume the risks of that decision if the bill is passed, according to Sutyak. She said this option is also available in other immunization requirements to place the liability of the child's health, in the event of infection, directly on the parent.

Both Sutyak and Lytle said children insured under Medicaid, who receive government assistance for healthcare or who are uninsured, qualify to receive the vaccine free of charge under the federal Vaccines for Children program.

Those who do not qualify must pay for the vaccine at approximately $120 per dose, and the vaccine is required in three doses. It is available at county health departments and private physicians' offices, according to Sutyak.

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