Battle Creek - Parents and physicians concerned about state lawmakers requiring HPV immunizations without knowing the long-term physical and social effects won a victory this week.
Bills introduced in January have not left Senate and House health policy committees. "We're on hold for now," said anesthesiologist and committee chair man Sen. Tom George, R-Portage, noting the controversial nature of the issue being discussed across the country.
The bills would require human papillomavirus inoculation for school entry, but allow girls to opt out with parental permission.
HPV is the most common sexually transmitted disease, according to the American Cancer Society, and at least half of sexually active people will carry it sometime in their lives.
Sheila Bronson, family and consumer science teacher at Harper Creek High School, said her students have many questions about HPV immunization.
"Some of the kids said it's a private matter. It's something the parents should choose," Bronson said. "The other half said it's a great idea. They think it would keep us safe and is good for the public."
Dr. Joe Schwarz, a former Battle Creek congressman, testified Feb. 21 in favor of mandating the vaccine for school-age girls.
"We have this tool at our disposal now to essentially prevent (cervical cancer) in probably two generations," he said. "There will be the odd case, obviously, but we have this at our fingertips."
Others argued that because it is a sexually transmitted disease, the decision to immunize girls is better left for parents to decide.
Developed by Merck and Co., the vaccine called Gardasil protects against two HPV strains responsible for 70 percent of all cervical cancers - HPV 16 and 18 - and two strains responsible for almost all genital warts, according to the national Centers for Disease Control and Prevention. There are more than 100 strains of HPV.
According to a study published Feb. 28 in The Journal of the American Medical Association, 3.4 percent of women ages 14 to 59 were infected with high-risk types HPV 16 and 18.
The FDA approved Gardasil in June on the condition that Merck continue to study the vaccine's long-term effectiveness. Many complain the FDA fast-tracked the drug's approval and claim drug company lobbyists are pressing legislation.
"Merck has done a phenomenal amount of push on this, and I think a lot of physicians are concerned about that," said Dr. Mary Ellen Benzik, family physician and obstetrician for the Family Health Center of Battle Creek.
Merck said in February it would halt under-the-radar lobbying campaigns to get states to pass legislation requiring vaccination of school-age girls because of pressure from medical groups and parents, according to The Associated Press.
Texas, so far, is the only state to require the vaccine for girls entering sixth grade in 2008. Suspicion arose when the AP reported Texas Gov. Rick Perry, who had sidestepped his state's Legislature to mandate the shots, received money for his gubernatorial campaign from Merck's political action committee.
Texas' legislature is likely to overturn the governor's decision, according to the AP.
Studies showed Gardasil to be nearly 100 percent effective against the two virus strains responsible for most precancerous lesions that lead to cervical cancer, the FDA reported.
Benzik, however, said there's confusion over the vaccine's ability to prevent cancer, adding it may be "sending a wrong message because women may perceive that they do not need routine Pap smears."
Pap smears are recommended to detect changes in the cervix that may be cancerous. The vaccine only protects against two of the approximately 100 HPV strains, and other strains can trigger precancerous lesions. Family genetic history may also be a factor.
Deborah Johnson-Shija, medical assistant at the Family Health Center of Battle Creek and mother of a 13-year-old girl, is concerned that without education, the immunization may encourage teens to have sex or be less diligent about protecting against sexually transmitted diseases.
"I think the vaccine would be OK so long as we are not sending the wrong message to kids," Johnson-Shija said.
Also backing the bills in Michigan are state Rep. Lorence Wenke, R-Richland Township, and state Sen. Mark Schauer, D-Bedford Township.
State Rep. Mike Nofs opposes the legislation.
"In the past, polio and measles were so contagious, and they needed to be mandated because we were all at risk from just walking around and breathing," said Nofs, R-Battle Creek. "I think it should be a parental decision on this one. Let them decide it with their daughters."
Kristin Muma, 15, has gotten two of the three shots needed for immunization, saying any protection against cancer was worth it. The Battle Creek 10th-grader has been joined by her sister, Kimberly Muma, 17, and cousin, Kathleen Owens, 17.
Kristin's and Kimberly's mother, Becky Muma, was previously diagnosed with a nonsexually transmitted type of cervical cancer.
Although the vaccine won't protect against a genetic form of cervical cancer, Becky Muma said she hopes her daughters can at least be protected against the two most cancerous strains of HPV.
"Every vaccine is a gamble, so you run the risk," she said. "But from everything I know and what I've learned about the vaccine, it's worth the risk."
Elizabeth Huff covers health and features. She can be reached at 966-0684 or ehuff@battlecr.gannett.com.
FAQs on HPV
What is the HPV vaccine?
Called Gardasil, it's the first vaccine made to prevent cervical cancer, pre-cancerous genital lesions and genital warts.
Who is it for?
The vaccine has been tested and approved for girls age 9 to 26. It is most effective for girls who are not yet sexually active, or those who have not yet contracted one of the four strains of HPV the vaccine protects against.
What about boys?
The vaccine has not been approved for boys, but studies are under way to find out if the vaccine works for them.
How common is HPV?
It is the most common sexually transmitted disease. At least 50 percent of sexually active people will contract at least one of the about 100 strains of HPV. The virus is more likely to cause cervical cancer in older women, and is associated with several other types of cancer in both men and women.
How do you get the vaccine?
It's a three-shot series over a six-month period. It costs at least $120 per shot, plus administration fees. Some insurance companies cover the vaccine's cost. It is available for the uninsured and underinsured at Planned Parenthood of South Central Michigan and the Calhoun County Department of Public Health.
Are pelvic exams still necessary?
Yes. The vaccine does not protect against all forms of cervical cancer.
How long does the vaccine last?
Studies have shown people are protected for at least five years, but more research is needed to determine if a booster shot would be necessary.
Sources: The national Centers for Disease Control and Prevention, www.cdc.gov, and Dr. Mary Ellen Benzik, family physician and obstetrician for the Family Health Center of Battle Creek.
HPV proposed legislation
State House bills 4104 and 4164 and state Senate bills 0132 and 0133 would require parents to have their daughters get the HPV vaccine before entering sixth grade, starting in 2008. Girls may opt out of getting the vaccine with a parent's signed exemption.
House bills 4104 and 4164 are sponsored by Reps. Mark Meadows, D-East Lansing, and Brenda Clack, D-Flint, respectively. Senate bills 0132 and 0133 are sponsored by Sens. Deborah Cherry, D-Burton, and Tony Stamas, R-Midland, respectively.
Elizabeth Huff, The Battle Creek EnquirerIn your voice
