Statement of Dr. Jon Abramson, Chair of the Centers for Disease Control to the Committee

March 28, 2007

Per your request the following are my own reasons for not supporting the notion that HPV vaccine should be mandated at this point in time:

1) HPV, unlike the other vaccines that states currently mandate as a requirement for attending public school, is not highly contagious in the school setting (i.e., unlike measles, chickenpox and other highly contagious diseases the risk of acquiring HPV in the school setting is low).

2) HPV is an expensive vaccine. At this time even some children who are VFC-eligible can not get the vaccine. Additionally, there are a substantial number of children that are not part of the VFC program and whose families do not have insurance that covers the HPV vaccine. Many of these families can not afford to pay for the vaccine out of pocket. Unless the state that is mandating the vaccine has designated the monies to pay for all these children to get the vaccine than the only option is for the children to not be allowed to attend school or to allow all of these families to claim a personal exemption. Both of these options have major negative repercussions including disruption of the education of the child or creating a much easier exemption process than currently exists for other mandated vaccines and this will likely spill over into some parents demanding the same for the other currently mandated vaccines that prevent highly contagious diseases.

3) FDA approval of this vaccine has only occurred in the last year and the official recommendation from the CDC to use this vaccine in females 11 - 26 years of age only occurred this month. Thus, there has not been sufficient time to see if a high percentage of the population for whom the vaccine is recommended will use it without the implementation of a mandate.

Jon S. Abramson, MD
Weston M. Kelsey Professor
Chair, Department of Pediatrics
Wake Forest University School of Medicine
Medical Center Blvd
Winston-Salem, NC 27157

phone- (336)716-2512
fax- (336)716-9699
email- jabrams@wfubmc.edu