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New mandate calls for HPV vaccination

Vaccine requirement for seventh graders stirs up mixed reactions among parents, citizens

Staff Writer
Thursday, September 17, 2015

As the school year began this month, incoming seventh graders across the state bought backpacks, shopped for new clothes and dreaded the return of early morning wake-ups. This year, though, a new stop was added to the list — getting vaccinated against human papillomavirus, a sexually transmitted disease that can cause cervical cancer.

The state began requiring the first dose of the vaccine of all seventh graders Aug. 1 after a mandate from the Rhode Island Department of Health. The second dose will be mandated for eighth graders beginning next year and the third for ninth graders the following year.

The mandate was passed in July 2014 after a public hearing in January 2014 to comply with Center for Disease Control recommendations. The age of the mandate is backed by CDC research that indicates the highest immune response when administered at that age, said Joseph Wendelken, spokesperson for RIDOH.

“Our school immunization regulations are one of the reasons why Rhode Island children are among the best immunized in the country,” Wendelken said. “Our school immunization regulations help protect children from serious, vaccine-preventable diseases. In the case of HPV, we are talking about a virus that leads to cancer in both males and females.”

Though Rhode Island law does not dictate that all vaccines recommended by the CDC be required for entry into public schools, RIDOH does incorporate vaccines recommended by the CDC into its school regulations.

But parents across the state have mobilized against the HPV dose, especially the way the measure was enacted.

Members of Rhode Islanders Against Mandated HPV Vaccinations, a group that formed in response to the RIDOH action, argue that the power to issue new health mandates belongs with the legislature and necessitates more public input than the current process allows.

“As a citizen and as a parent, I don’t want to see these kinds of things happening in the future,” said Aimee Gardiner, co-leader of the group. “I want to stand for my family and for all the families in Rhode Island in favor of democratic processes.”

Though Gardiner is not opposed to the vaccination itself and has vaccinated her kids according to previous mandates, she views the decision as one for the legislature. With the RIDOH unlikely to change the mandate, Rhode Islanders Against Mandated HPV Vaccinations is left with two remaining paths: the governor’s office and the legislature itself, she said.

Gov. Gina Raimondo’s office issued a statement Aug. 27 indicating unlikeliness to amend the mandate that read, “These regulations were finalized over a year ago after a public hearing. The Governor recognizes there are concerns about mandatory vaccinations, but the CDC recommends the HPV vaccine as a safe and effective way to help prevent cancer in males and females and save lives.”

The Coventry School Committee passed a resolution last month urging the governor to reconsider her stance on the mandate.

“I personally would never have brought that resolution forward to my committee,” said Katherine Patenaude, chairwoman of the Coventry School Committee and director of the Multidisciplinary Laboratories at the University. She voted to approve the measure based on constituent input, though she said she had “never witnessed this kind of behavior” at the committee meeting.

Patenaude said the only reason people so vehemently oppose this mandate as opposed to others is “because the word ‘sex’ is part of it,” she said, adding,“People don’t want to think about their seventh graders having sex.”

Rhode Island students will not be fully protected against HPV until administration of the vaccine’s final dose, which is not mandated until ninth grade and significantly improves its effectiveness.

The general assembly will likely be more amenable to the cause, Gardiner said, though it will not be in session until January. In the meantime, parents hoping to avoid the vaccination must apply for a medical or religious exemption as provided for in the regulation.

A previous version of this article misstated that Rhode Island law dictates that all vaccines recommended by the Centers for Disease Control be required for entry into public schools. The Herald regrets the error.

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  2. KeepBoysWhole says:

    Rhode Island mandates (and the CDC promotes) the HPV vaccine (Gardasil), while ignoring the strong evidence linking male circumcision to cervical cancer.

    It is not true that circumcision protects men (or women) against cancer-causing HPV. In fact, circumcision makes it harder for the immune system of the penis to naturally clear the infection. The website states: “Of the cervical cancers related to HPV, about 70% are caused by two strains, HPV-16 or HPV-18.” HPV-16 accounts for an even greater majority of HPV-induced vaginal/vulvar cancers, penile cancers, anal cancers and head and neck cancers.

    In the case of HPV-16, male circumcision seems to negatively impact the clearing process. As stated in the peer-reviewed article below: “Time to clearance was significantly shorter among intact men for HPV type 16 (HR 0.56, 95% CI 0.42-0.75). Correspondingly, the probability of clearing an HPV infection was significantly lower among circumcised men compared to intact men. (p < 0.001)." The lower the p value, the more statistically significant the result. p=0.001 means basically means there is a 1 in 1000 probability that this finding is due to statistical chance. These biased researchers don't state this in their conclusions, but this result means that HPV clearing times are shorter – and probability of clearing is higher – for intact men in one of two types that cause 70% of the cancers. The rest of the HPV strains are rare or innocuous. And being circumcised does not protect one from being initially infected by HPV-16 or 18 at all. A more appropriate conclusion is that circumcised men are more likely to harbor HPV-16 and thus more likely (in a given time frame) to transmit it to their partners, thus increasing cervical cancer in females. And like elsewhere in the body, the immune system of the penis fights against HPV viruses, especially HPV-16. Since the mammalian prepuce has existed for 50 million years, it is very likely that it would evolve mechanisms for clearing viruses. The ethical implication is that pro-circumcision policies deprive boys and men of a significant part of their natural immune system, without their consent. And if health officials in Rhode Island and across the nation truly cared about the public health of people, they would immediately declare an end to forced circumcision.

    Source: 2014. BMC Infectious Diseases. Male circumcision and the incidence and clearance of genital human papillomavirus (HPV) infection in men: the HPV Infection in men (HIM) cohort study. Ginesa Albero, Xavier Castellsagué*, Hui-Yi Lin, William Fulp, Luisa L Villa, Eduardo Lazcano-Ponce, Mary Papenfuss, Martha Abrahamsen, Jorge Salmerón, Manuel Quiterio, Alan G Nyitray, Beibei Lu, F Xavier Bosch and Anna R Giuliano. *Xavier Castellsague is a former proponent of pro-circumcision policies.

  3. The founders of the movement to REMOVE the HPV vaccine mandate in Rhode
    Island partnered with the RI Alliance for Vaccine Choice, is dedicated to protecting our medical freedom in Rhode Island. We are currently working with our state legislators to remove the HPV vaccine mandate in Rhode Island.
    Visit our website to view our ‘HPV Parent Information Packet’ and other valuable information.

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