Senator Eliot Shapleigh - El Paso, Texas

Dr. Raymond H. Kaufman

On Feb. 2, Gov. Rick Perry signed an executive order mandating that all Texas girls be vaccinated against the human papillomavirus (HPV) before entering the sixth grade. With this move, Texas becomes the first state to mandate this vaccine and a leader in the movement to protect our girls and women from a horrific yet preventable disease.

Virtually all cervical cancer cases are related to infection with HPV. By age 50, 80 percent of women will have been infected with HPV.

There are more than 100 types of the HPV virus; it is the most common sexually transmitted infection in the country. At any given time, 30 to 50 percent of sexually active men and women are infected. At least 20 million people in the United States already have it. In studies of young college students, almost 40 percent were found to be infected within 12 months of having sexual intercourse for the first time. By the time young people reach the 12th grade, 60 percent of them have had sexual intercourse. To achieve the maximum benefit from the vaccine, it should be given before the onset of sexual activity.

In most cases, the virus disappears because of the body's immune defenses. But in 5 to 10 percent of individuals, the virus can lead to abnormal cell growth. These changes may progress to invasive carcinoma, a lethal disease if not promptly treated. Most women have no symptoms in the pre-invasive stage of the disease. The diagnosis is made on the basis of a Pap smear.

Unfortunately, Pap smears sometimes do not detect precancerous changes, and some women do not have tests performed regularly. Preventing infection with HPV is by far the best defense, and the vaccine does just that.

The federal Centers for Disease Control and Prevention has backed recommendations for the routine vaccination of 11- to 12-year-old girls. Vaccination can begin as early as age 9; routine vaccination also can be given to 13- to 26-year-old females. Females who are sexually active should still be vaccinated, though they will not be protected if they have already been exposed to the types of HPV the vaccine protects against. Women who get the vaccine should continue to have an annual Pap smear after becoming sexually active.

Mandating the HPV vaccine ensures that more girls will receive a potentially life-saving vaccine. Many families might object to vaccination on the grounds that their daughters are not sexually active. However, when a woman marries, her male partner might be infected.

Insurance companies, the Children's Health Insurance Program, Medicaid and the Texas Vaccines for Children Program cover mandated vaccines. Parents who object to mandatory vaccinations, including the HPV vaccine, still have the right to opt out for religious reasons or objections of conscience. In his executive order, Perry even included the option of initiating this process online. Parents' right to decide whether to vaccinate their children has not been taken away.

We must embrace this opportunity. We need to allow science and medicine to guide our decisions. That means listening to medical experts and organizations, many of which have officially recommended that young girls receive this vaccination years before beginning sexual activity. To do otherwise is irresponsible and detrimental to the future of our girls