State to offer HPV shots

OLYMPIA – State officials are planning to spend millions of dollars on more than 100,000 doses of a new vaccine that helps prevent cervical cancer, Washington state Secretary of Health Mary Selecky said Monday. The state hopes to distribute enough of the free human papillomavirus vaccine to treat every girl in the state.

The state will not, however, follow Texas’ lead and make the HPV shots mandatory for young girls, Gov. Chris Gregoire said. At least not now.

“I told the medical association that I was reticent to dictate when I think there is a lot of public education that needs to go on,” the governor told reporters Monday at the Capitol. “To go out and start just saying everybody mandatorily has to have this is a little bit troublesome for me.”

The Merck-made vaccine, called Gardasil, can help prevent the spread of human papillomavirus, the most common sexually transmitted disease in the United States. An estimated 20 million Americans are infected. Certain strains of the virus have been linked to cervical cancer.

Selecky said she hopes to have the free doses of Gardasil available by late spring.

“We’re getting calls all over saying, ‘When is this going to start?’ ” she said.

On Friday, Texas Gov. Rick Perry ordered state health officials there to require the vaccination for all sixth-grade girls, starting in the fall of 2008. Parents with religious or other conscience-based concerns could opt their daughters out. Some parents are concerned that immunizing girls against a sexually transmitted disease might encourage promiscuity.

In Texas – home to the second highest number of women with cervical cancer – there were 1,169 new cases and nearly 400 cervical cancer deaths last year.

Spokane Regional Health District officials have had no trouble obtaining Gardasil, which became available in July. Since fall, about 50 people have paid the full $360 price for the vaccine, leaving “a couple hundred” doses available, said Julie Graham, health district spokeswoman.

More insurance companies that cover local families have expanded benefits to include Gardasil, Graham said. But increasing access to people who don’t have coverage would be a boon.

“Anything that we can do to make it so more girls can get it, we’re excited about,” Graham said.

In Washington, state health officials already order large quantities of most common childhood vaccines and distribute them free to doctors, hospitals and clinics. Regardless of the parents’ income, the state and federal government pick up the tab for children’s vaccines for whooping cough, measles, mumps, hepatitis A and other illnesses. The fee charged by a doctor is for administering the shot.

“What’s in the needle is free,” said Tim Church, spokesman for the state health department. The HPV doses are about $360 for a typical course of three shots, Selecky said. By buying in bulk, the state cuts that to about $270.

Between last year’s supplemental budget and the 2007-2009 budget proposed by Gov. Chris Gregoire, the state plans to spend $26 million on vaccines for HPV and for rotavirus, an unrelated childhood illness.

Spokane pediatrician Robert Maixner said benefits of the HPV vaccine will take longer to realize than those of rotavirus, which causes severe gastrointestinal illness. But the HPV vaccine can be lifesaving as young girls grow into womanhood, he said.

“I can eliminate a large chunk of cervical cancer with this vaccine,” said Maixner. “It’s really difficult to pick a fight with it.”

Initially, Church said, the state plans to buy 143,000 doses of HPV vaccine per year. Since it must be administered three times to be fully effective, that’s enough vaccine to treat about 47,000 girls annually.

The number’s based on an estimate of how many kids that age get other vaccines, Church said, plus extras for older girls who would also want the shots. Federal health guidelines recommend routine vaccination of 11- to 12-year-old girls, Church said, although the state program will cover any girl up to age 18. Since HPV is spread through sex, the goal is to vaccinate girls before they become sexually active.

“Once you’re infected with it, the vaccine’s not going to help,” he said.

About 30 people a week have been calling regional Planned Parenthood offices, asking about the HPV vaccine, said Jet Tilley, the agency’s public policy director. Advertising campaigns targeting teen girls and their parents are boosting interest, she said.

So far, the agency hasn’t bought any HPV vaccine, primarily because of the high cost for providers and clients alike. Tilley praised Gregoire’s plan to provide the vaccine statewide.

“We would love that,” she said.

Maixner said he’s had parents specifically requesting information about the HPV vaccine. Maixner liked the idea of funding combined costs for rotavirus and HPV vaccines.

Rotavirus vaccine is far more likely to become mandatory for school entrance in Washington simply because the gastrointestinal illness it causes can keep kids out of school, he said.

“It’s the bad actor, the one most likely to land someone in the hospital,” Maixner said.