The purpose of this article is to discuss the problem of cervical cancer, examine policy solutions, and analyze factors that contributed to the failure of human papillomavirus (HPV) vaccine requirement legislation in Kentucky. During 2007, a Kentucky representative introduced legislation that would require HPV vaccination for all middle-school girls but allow parents to opt out for any reason. Evidence suggests that an HPV school requirement law would result in more Kentucky children being vaccinated than if there were no requirement law. However, this policy solution faced multiple factors that inhibited its ability to survive. Future proponents of HPV vaccine school requirement legislation can draw implications from Kentucky's experience. By building public support, undergoing a softening up period, and presenting a united, vocal front, proponents may be more likely to pass HPV vaccine legislation in the future.
Abma, J.C., Martinez, G.M., Mosher, W.D., & Dawson, B.S. (2004). Teenagers in the United States: Sexual activity, childbearing, and contraceptive use, 2002. Vital Health Statistics , 23, 1-48.
2.
Averhoff, F., Linton, L., Peddecord, K.M., Edwards, C., Wang, W., & Fishbein, D. (2004). A middle school immunization law rapidly and substantially increases immunization coverage among adolescents. American Journal of Public Health, 94, 978-984.
3.
Bosch, F.X., Manos, M.M., Munoz, N., Sherman, M., Jansen, A.M., Peto, J., et al. (1995). Prevalence of human papillomavirus in cervical cancer: A worldwide perspective. International Biological Study on Cervical Cancer Study Group. Journal of the National Cancer Institute , 87, 796-802.
4.
Brown, D. (2006, June 30). HPV vaccine advised for girls. Washington Post.
5.
Dederer, C. (2007, February 18). Pitching protection, to both mothers and daughters. New York Times.
6.
Dempsey, A.F., Zimet, G.D., Davis, R.L., & Koutsky, L. (2006). Factors that are associated with parental acceptance of human papillomavirus vaccines: A randomized intervention study of written information about HPV. Pediatrics, 117, 1486-1493.
7.
Dunne, E.F., Unger, E.R., Sternberg, M., McQuillan, G., Swan, D.C., Patel, S.S., et al. (2007). Prevalence of HPV infection among females in the United States. Journal of the American Medical Association , 297, 813-819.
8.
Family Foundation of Kentucky. (2007a). A new, liberal House for 2007. Retrieved March 5, 2008, from http://www.tffky.org/newsletter_special.htm
9.
Family Foundation of Kentucky. (2007b). House Bill 345- Mandatory HPV vaccine. Retrieved March 20, 2007, from www.tffky.org/legislation
10.
Franco, E.L., & Harper, D.M. (2005). Vaccination against human papillomavirus infection: A new paradigm in cervical cancer control. Vaccine, 23, 2388-2394.
11.
Gerth, J. (2007, February 18). Job rating climbs; likeability low . Louisville (KY) Courier-Journal.
12.
Gibbs, N. (2006, June 21). Defusing the war over the "promiscuity" vaccine. Time. Retrieved March 28, 2008, from http://www.time.com/time/nation/article/0,8599,1206813,00.html
13.
Greer, C.E., Wheeler, C.M., Ladner, M.B., Beutner, K., Coyne, M.Y., Liang, H., et al. (1995). Human papillomavirus type distribution and serological response to HPV type 6 virus-like particles in patients with genital warts. Journal of Clinical Microbiology, 33, 2058-2063.
14.
Home School Legal Defense Association. (2007 ). Kentucky bill requires immunization for pre-teen girls. Retrieved January 31, 2007, from www.hslda.org
15.
House bill 345. (2007). An act relating to cervical cancer immunizations. Kentucky General Assembly.
16.
House Health & Welfare Committee Meeting. ( 2007, February 8). Kentucky General Assembly. Retrieved March 1, 2007, from Kentucky Educational Television Web site: http://www.ket.org/legislature/archives.php?session=wgaos+008
17.
House Health & Welfare Committee Meeting. ( 2007, February 15). Kentucky General Assembly. Retrieved March 1, 2007, from Kentucky Educational Television Web site: http://www.ket.org/legislature/archives.php?session=wgaos+008
18.
House Chambers. (2007, February 22). Kentucky General Assembly. Retrieved March 1, 2007, from Kentucky Educational Television Web site: http://www.ket.org/legislature/archives.php?session=wgaos+008
19.
Isaacs, B. (2007, January 5). Bill would require that girls be vaccinated against HPV. Lexington Herald-Leader.
20.
Jacobs, R.J., & Meyerhoff, A.S. (2004). Effect of middle school entry requirements on hepatitis B vaccination coverage. Journal of Adolescent Health, 34, 420-423.
Kingdon, J.W. (2003). Agendas, alternatives, and public policies (2nd ed.). New York: Longman.
23.
Kuehn, B.M. (2006). CDC panel backs routine HPV vaccination. Journal of the American Medical Association, 296, 640-641.
24.
Lengerich, E.J., Tucker, T.C., Powell, R.K., Colsher, P., Lehman, E., Ward, A.J., et al. (2005). Cancer incidence in Kentucky, Pennsylvania, and West Virginia: Disparities in Appalachia. Journal of Rural Health, 21, 39-47.
Munoz, N., Bosch, F.X., de Sanjose, S., Herrero, R., Castellsague, X., Shah, K.V., et al. (2003). Epidemiologic classification of human papillomavirus types associated with cervical cancer. New England Journal of Medicine, 348, 518-527.
27.
National Conference of State Legislators. ( 2007). HPV vaccine. Retrieved April 2, 2008, from http://www.ncsl.org/programs/health/HPVvaccine.htm#hpvlegis
28.
Orenstein, W.A., & Hinman, A.R. (1999). The immunization system in the United States: The role of school immunization laws. Vaccine, 17(Suppl 3), S19-24.
29.
Raine, T.R., Harper, C.C., Rocca, C.H., Fischer, R., Padian, N., & Klausner, J.D. (2005). Direct access to emergency contraception through pharmacies and effect on unintended pregnancy and STIs: A randomized controlled trial. Journal of the American Medical Association, 293, 54-62.
30.
Ries, L.A.G., Harkins D., Krapcho M., Mariotto A., Miller B.A., Feuer E.J., et al. (2006). SEER cancer statistics review, 1975-2003 . Bethesda, MD: National Cancer Institute.
31.
Saslow, D., Castle, P.E., Cox, J.T., Davey, D.D., Einstein, M.H., Ferris, D.G., et al. (2007). American Cancer Society guideline for human papilloma virus vaccine use to prevent cervical cancer and its precursors . CA: A Cancer Journal for Clinicians, 57, 7-28.
32.
Saul, S., & Pollack, A. (2007, February 17). Furor on rush to require cervical cancer vaccine. New York Times.
33.
Schwartz, J.L., Caplan, A.L., Faden, R.R., & Sugarman, J. (2007). Lessons from the failure of human papillomavirus vaccine state requirements. Clinical Pharmacology and Therapeutics , 82, 760-763.
34.
Smoak, N.D., Scott-Sheldon, L.A., Johnson, B.T., & Carey, M.P. (2006). Sexual risk reduction interventions do not inadvertently increase the overall frequency of sexual behavior: A meta-analysis of 174 studies with 116,735 participants. Journal of Acquired Immune Deficiency Syndromes, 41, 374-384.
35.
Ungar, L. (2007a, February 21). 47% oppose mandatory shots. Louisville (KY) Courier-Journal.
36.
Ungar, L. (2007b, November 14). Bill requiring cancer vaccine sparks debate. Louisville (KY) Courier-Journal.
37.
U.S. Cancer Statistics Working Group. (2005 ). United States Cancer Statistics: 1999-2002 Incidence and Mortality Web-based Report. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute.
38.
U.S. Cancer Statistics Working Group. (2006 ). United States Cancer Statistics: 2003 Incidence and Mortality . Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute.
39.
U.S. Department for Health and Human Services & Centers for Disease Control and Prevention. (2006). HPV and HPV vaccine: Information for healthcare providers. Retrieved February 1, 2007, from www.cdc.gov
40.
Vos, S. (2007, February 27). Apology demanded in HPV flap. Lexington Herald-Leader.
41.
Weinstock, H., Berman, S., & Cates, W., Jr. (2004). Sexually transmitted diseases among American youth: Incidence and prevalence estimates, 2000. Perspectives on Sexual and Reproductive Health, 36, 6-10.
42.
Women in Government. (2007). HPV vaccine: What policymakers need to know. Retrieved March 31, 2008, from http://www.womeningovernment.org/prevention/RoleofPolicymakersFAQ.asp
