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Member Research & Reports

Member Research & Reports

Arizona Report on Human Papillomavirus and Mandatory Immunization Laws

A research team led by the University of Arizona Mel and Enid Zuckerman College of Public Health reviewed the effectiveness of mandatory immunization laws and the Human Papillomavirus (HPV). Their findings are published in Public Health Reports.

[Photo: Ms. Leila Barraza]

HPV is a sexually transmitted virus that infects an estimated 14 million Americans annually. The Centers for Disease Control and Prevention recommended in 2007 that all females receive an HPV vaccine at 11–12 years of age so that protection is gained before exposure to the virus is likely to occur. The current recommendations include all adolescents and the vaccine is also recommended for unvaccinated women through 26 years of age, heterosexual males through 21 years of age, and men who have sex with men through 26 years of age.

Vaccine requirements for school entry are a proven method for increasing child immunization rates and decreasing the incidence of vaccine-preventable diseases (VPDs). Laws vary, however, because each state establishes its own vaccine requirements for school entry. All states provide exemptions from vaccination for medical reasons: as of July, 47 states provided religious exemptions and 18 states allowed exemptions for personal beliefs. States with exemptions for personal beliefs have higher rates of unvaccinated children and higher incidence rates of VPDs.

Ms. Leila Barraza, assistant professor of public health policy at the UA Zuckerman College of Public Health, and colleagues reviewed HPV vaccination requirements for school entry that were successfully implemented in Virginia in 2008 and the District of Columbia in 2009; Rhode Island’s regulation became effective in 2015.

Coverage estimates for HPV vaccination are low despite evidence of the vaccine’s effectiveness and safety. This large pool of unvaccinated adolescents in the United States means that considerable public health benefits are not being realized; many vaccine-preventable cancers caused by HPV will occur. Although numerous jurisdictions have faced difficulty passing an HPV vaccination mandate for school entry, now is an opportune time to move forward. Experts suggest that attempts to mandate the HPV vaccination failed because such attempts were made too closely after FDA approval and the ACIP recommendation. Ten years later, ample evidence supports the safety and effectiveness of HPV vaccines. Mandating HPV vaccination for school entry is a move that will protect the public’s health by preventing HPV-related morbidity and mortality.