State rep plans vaccine bill

Missouri state Rep. Sam Page, D-Creve Coeur, said last week he is going to introduce a bill that would require health insurance companies in the state to pay for Gardasil, the vaccine that protects women from several strains of the human papillomavirus or HPV. The state would provide the vaccine to women who don't have insurance.

The bill follows another Page filed in February that would require HPV vaccinations for girls in middle school. Parents could decide against vaccinating their children for medical or religious reasons, under the legislation.

"The legislation will also have schools distribute information to educate parents about the vaccine at the time their daughter receives her other immunizations before entering the sixth grade," said Page, a medical doctor. "Parents can then make an informed decision to have their children vaccinated."

The HPV vaccine, which is administered in three doses over a six-month period, became available for females ages 9 to 26 in June. Gardasil protects them from the four HPV strains that cause 90 percent of warts and the strains that cause 70 percent of cervical cancer.

According to the Centers for Disease Control and Prevention, one in four U.S. women ages 14 to 59 is infected with HPV. There are about 100 types of HPV, but the most dangerous and painful are contracted through sexual contact. Research indicates the virus increases a woman's likelihood of developing cervical cancer.

Diane L. Wilson dlwilson@semissourian.com This vial of Gardasil, at the Midwest Obstetrics and Gynecology, is the approved HPV vaccination to help prevent cervical cancer.

Since Gardasil became available at Southeast Missouri State University last fall, health officials at the Center for Health and Counseling have been providing information about the vaccine to female students. "We're trying to become informers because there certainly is a lot of HPV present," said Ann Frey, a registered nurse at the center.

Frey said 24 doses of the vaccine have been administered to female students at Southeast since it became available and some have started the series of vaccinations with their family physicians. Southeast has about 5,000 female undergraduates.

She believes others are holding off on getting Gardasil because of the cost, $450 to $720 for three doses. Most insurance companies don't cover the vaccine or only cover part of it, Frey said.

Southeast students Brandy Borgfield, 24, of Cape Girardeau and Jessi Glueck, 21, of Scott City have reservations about the vaccine.

"Even if the FDA has approved it, what if five years down the road it leads to health problems or some kind of disease other than HPV? I think it has a lot of issues they haven't discovered yet," Glueck said.

Borgfield has a problem with making the vaccine mandatory for girls as young as 9 years old.

"It seems the push right now is mainly focused on the young girls," she said. "When you see the commercials for the vaccine, what do you see? You see little girls jump-roping -- you don't see the college-aged females walking on campus, you see kids. I don't think they're reaching out to the right people."

Texas Gov. Rick Perry announced last February that sixth-grade girls in the state will be vaccinated, but his order could be overturned by the legislature. Lawmakers in Virginia and New Mexico have voted to require the vaccine for middle-school girls and now await their governors' approval. Legislators in 19 other states have considered similar mandates.

Younger girls who are eligible can receive the immunization free through the Vaccines for Children Program at county health departments in Missouri. Medicaid also covers the vaccination costs for women who qualify.

Not an STD vaccine

Nurses at the Cape Girardeau County Health Department have administered about four doses of Gardasil a week since the vaccine became available there several months ago, said registered nurse Mary Jo Stockwell. "I think a lot of people may seem hesitant to get the vaccine because they associate HPV with a sexually transmitted disease," Stockwell said. "They think this is an STD vaccine, and in reality it's not. Even skin-to-skin contact can cause HPV, and that really needs to be understood by people."

Most of the females who have been vaccinated for HPV at the county health department have been in their midteens, Stockwell said.

The vaccine hasn't been as well received as expected at Cross Trails clinics in Cape Girardeau and Marble Hill. CEO Vicki Smith said that could be due to the clinic's lack of advertising of the availability of Gardasil.

Since the clinics received the 300 doses of the vaccine in February, only 13 women ages 17 to 26 have received at least one round of the vaccine.

Dr. Maritza Manrique-Kiniry, an obstetrician-gynecologist at Cape Care for Women, said most of the almost 300 patients who've received the vaccine at her office are 18 years old and younger. Most of the girls were brought in by their mothers.

"I think when you are in a more private setting you can sit down and talk with the patient and really give them information about this," she said. "In a clinic, the patients are still receiving quality care, but the physicians are a lot busier and don't have the time to really stress the importance of the vaccine."

At the annual health fair last fall on Southeast's campus, the Center for Health and Counseling passed out information about Gardasil. "There were a lot of people interested in it, but it's still a fairly new vaccine," Frey said. "Eventually I do think it will be a lot like the other immunizations, and at some point all females will receive the vaccine. It would certainly be good for the general population."

But college students Borgfield and Glueck don't ever plan to get the vaccine. "I didn't have an opinion about the vaccine before I really looked into it," Glueck said. "My main thing is that it's such a new product, and it just seems there are a lot of discrepancies about it. What if it only lasts for five years? Will you have to continue getting boosters every five years for your entire life?"

Borgfield said she would consider getting the vaccine but plans to stay with her boyfriend of six years for the rest of her life. "I think that some people who stick with one partner, it may not be for them," she said. "Most likely if I wasn't in a relationship I would consider it. But my issues are with the younger girls and the mandates to require them to get it."

jfreeze@semissourian.com

335-6611, extension 246