COLUMBUS - While calling a new vaccine that protects against a virus that causes cervical cancer a "major medical breakthrough," Gov. Ted Strickland said he does not favor making it mandatory.
That puts him at odds with a bill about to be introduced by Rep. Edna Brown (D., Toledo), which would require girls to be vaccinated before they enter the sixth grade, roughly at the age of 11 or 12, unless their parents reject it for medical, religious, or philosophical reasons.
"I think there are problems in trying to make it mandatory, and so that's not where I'm going," Mr. Strickland said.
"I think there are legitimate questions about when it should be administered," he said.
The governor said the state could play a role in making sure the vaccine, which can cost $360 for a regimen of three shots, is available to those who want it but can't afford it.
Gardasil, developed and marketed by Merck & Co., Inc., was approved last year by the U.S. Food and Drug Administration to target four strands of the human papilloma virus.
The virus spreads through sexual contact, can cause genital warts, and is believed to be responsible for 70 percent of cervical cancer deaths.
Mr. Strickland's office said about 500 invasive cervical cancer cases are diagnosed each year in Ohio.
The Centers for Disease Control's Advisory Committee on Immunization Practices has recommended a mandatory age range similar to that included in Ms. Brown's bill.
Ms. Brown said she still plans to introduce her bill this week.
"I'm hoping to share the facts with [the governor], particularly that as many as 10,000 new cases are diagnosed annually [nationally], that there are almost 4,000 deaths, and that this vaccine is effective in preventing the risk of cervical cancer," she said.
"Sometimes the facts can change a person's mind," Ms. Brown added.
She said the bill will include a component to educate children and their parents about the vaccine.
"This is not birth control and it does not encourage sexual activity," Ms. Brown said.
Texas Gov. Rick Perry, a Republican, recently surprised social conservatives by issuing an executive order making Texas the first state to mandate HPV vaccinations for sixth graders.
The vaccine would be administered before the start of the 2008-09 school year.
Under pressure, Merck recently announced it will back off on its aggressive lobbying of states and Congress to mandate the vaccine.
Adding to the suspicions of opponents is the fact that Merck was the maker of the arthritis drug Vioxx, which was pulled from the market last year because of serious safety concerns.
"Mandatory immunization is one of the most sensitive areas of government trust," said David Zanotti, president of the American Policy Roundtable, which opposes mandatory immunization for HPV.
"[The] government can't afford to make a mistake," he said. "When you look at areas like measles, polio, and smallpox, in the past government has gotten it right. Those diseases are communicable diseases in which kids can't help but get it. That's different from a sexually transmitted disease."
Mr. Strickland, a Democrat, said Ohio can help to educate parents about the apparent benefits.
"This is an immunization for preventable deaths," he said.
"Women get this cancer not because of promiscuity. I think we should be celebrating the fact that there's been this breakthrough, and that we now have a cancer that, if the medical claims prove to be accurate, is a cancer that we can defeat largely."
Ohio currently offers the HPV vaccine on a limited basis under its Vaccines for Children, a federally funded program providing free vaccines to children eligible for Medicaid or who lack vaccine insurance coverage.
The Department of Health's acting director, Anne Harnish, has not taken a position on making immunization mandatory, said spokesman Jay Carey.
He noted cost would have to be a factor in such a decision.
"This is an expensive vaccine," he said.
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