Actions taken on HPV vaccine proposals in Alabama, Louisiana, Utah, Washington

The following highlights recent news of state actions on human papillomavirus vaccine proposals. Merck's HPV vaccine Gardasil and GlaxoSmithKline's HPV vaccine Cervarix in clinical trials have been shown to be 100% effective in preventing infection with HPV strains 16 and 18, which together cause about 70% of cervical cancer cases.

FDA in July 2006 approved Gardasil for sale and marketing to girls and women ages nine to 26, and CDC's Advisory Committee on Immunization Practices later that month voted unanimously to recommend that girls ages 11 and 12 receive the vaccine.

GSK in April plans to file for FDA approval of Cervarix, and it expects approval by the end of this year (Kaiser Daily Women's Health Policy Report, 2/1). CDC has added Gardasil to its Vaccines for Children Program, which provides no-cost immunizations to children ages nine to 18 covered by Medicaid, Alaska Native and American Indian children, and some uninsured and underinsured children (Kaiser Daily Women's Health Policy Report, 1/18). Summaries appear below.

• Alabama: State Health Officer Don Williamson on Wednesday said he plans to ask state legislators for $4 million to provide HPV vaccines to women and girls ages 11 to 19 who do not qualify for the Vaccines for Children's Program, the AP/Decatur Daily reports. Williamson said the funding would allow the health department to provide 10,000 HPV vaccinations annually. "It ought to be readily available and, in my opinion, it ought to be voluntary," he said, adding, "As long as it's a voluntary vaccine, we don't anticipate having any problems." Senate Health Committee member Myron Penn (D) said he would support providing funding for HPV vaccines as long as the state does not mandate vaccination. Williamson said he hopes to receive the funding for the fiscal year that begins Oct. 1 and begin providing vaccines in the fall (Hunter, AP/Decatur Daily, 2/8).
• Louisiana: Public health units have begun offering adolescent girls HPV vaccines at no cost through the state's Vaccine for Children Program, which covers low-income families, the Baton Rouge Advocate reports. The vaccines also are available through physicians and clinics participating in the immunization program, according to the Advocate. According to assistant state health officer Erin Brewer, Louisiana negotiated a discounted price of $96.75 per dose with Merck for Gardasil. She added that the state has received 29,040 doses and an additional 19,300 have been ordered (Shuler, Baton Rouge Advocate, 2/7). The state's vaccine program offers women and girls ages 13 to 18 with access to no-cost HPV vaccines, according to Brewer (AP/Fox News, 2/7).
• Utah: The House Health and Human Services Committee on Tuesday voted not to approve a bill (HB 358) that would have provided $1 million to the Utah Department of Health to educate girls and women about cervical cancer and would offer Gardasil to girls and women whose insurers do not cover the vaccine, the Salt Lake Tribune reports (Hamilton, Salt Lake Tribune, 2/7). The committee vote on the measure was 4-4 (AP/KUTV, 2/7). Some committee members said they had received several e-mails opposing the measure, sponsored by Rep. Karen Morgan (D). Gayle Ruzicka, president of the conservative group Utah Eagle Forum, said she was uncomfortable with an education campaign that targeted girls as young as nine. The Utah Scientific Vaccine Advisory Committee, which sets vaccine requirements for students in the state, has no plans to require the vaccine, the Tribune reports (Salt Lake Tribune, 2/7).
• Washington: Officials hope to provide no-cost HPV vaccines for every girl in the state, but Gov. Chris Gregoire (D) said girls will not be required to be vaccinated, the Spokane Spokesman-Review reports (Roesler/Aleccia, Spokane Spokesman-Review, 2/6). Gregoire at a news conference last week said, "I was reticent to dictate when I think there is a lot of public education that needs to go on," adding, "To go out and start just saying everybody mandatorily has to have this is a little bit troublesome for me" (AP/Vancouver Columbian, 2/6). The state plans to spend $26 million between the 2006 supplemental budget and the 2007-2009 budget proposed by Gregoire on HPV and rotavirus vaccines. Washington State Department of Health spokesperson Tim Church said the state plans to buy 143,000 HPV vaccine doses annually, or enough to vaccinate 47,000 girls. Secretary of Health Mary Selecky last week said she hopes doses of Gardasil will be available by late spring (Spokane Spokesman-Review, 2/6).