A proposal to require all entering seventh-graders in New York State to receive the HPV vaccine is stirring up opposition among some parents and school administrators.
Critics say there's no reason to vaccinate children that age against a disease that primarily is spread through sexual contact and that, further, a state-imposed mandate takes away parental choice.
But advocates say the vaccine is recommended by physicians and public health officials and it's demonstrated to prevent both HPV and a number of cancers linked to the virus.
"This vaccine is highly scrutinized. We know it's very, very safe," said Dr. Gale Burstein, the Erie County health commissioner. "It's highly effective."
Democrats have introduced the HPV vaccine bill in the State Legislature each year for about the last decade. It hasn't gone anywhere yet and it's not clear whether the bill has a better chance of becoming law in the 2020 legislative session.
But lawmakers this year did approve a measure eliminating the religious exemption for most state-required vaccines, and that development appears to be spurring vaccine opponents to act.
An anti-vaccine group earlier this month organized a series of protests in Buffalo and across the state, with parents pulling children from school and demonstrating outside legislators' offices. And one area school superintendent is urging lawmakers to vote against the HPV vaccine bill.
"The legislation is ill-conceived and, if passed into law, would have a detrimental effect on many families in the Clarence Central School District," Superintendent Geoffrey M. Hicks wrote in a letter to members of the Assembly and State Senate who represent Clarence.
The human papillomavirus, or HPV, is the most common sexually transmitted infection in this country, according to the Mayo Clinic, with about 14 million people getting infected each year.
It primarily spreads through sexual contact but it also can be transmitted through kissing, health officials said.
"This is a very, very common infection," Burstein said.
Certain strains of HPV can lead to cancer, including about 70% of all cases of cervical cancer. HPV infections also can lead to other genital and anal cancers in women and penile and anal cancers in men, as well as oral and throat cancer.
About 35,000 new cancer cases related to HPV are diagnosed each year, said Dr. Dennis Kuo, chief of the division of general pediatrics at the University at Buffalo and a physician with UBMD Pediatrics.
Experts from the U.S. Centers for Disease Control and Prevention, Roswell Park Comprehensive Cancer Center, the Erie County Health Department and other organizations say the HPV vaccine is a safe and effective way to prevent HPV infections and the virus-related cancers.
Because it doesn't work to treat an existing HPV infection, physicians and health officials recommend girls and boys get the vaccine before they are exposed to the virus – ideally before they become sexually active.
The state already mandates another vaccination for an infection that can be spread through sexual contact – hepatitis B – Burstein said.
"This is a prevention vaccine, like all our other vaccines," she said.
The CDC reports the vaccine can safely be given to children as young as 9 but recommends all boys and girls receive the vaccine at 11 or 12.
More than 100 million doses of the vaccine have been given in this country, among over 270 million doses worldwide, Kuo said, and it has been extensively studied for safety and effectiveness.
Virginia, Rhode Island and Washington, D.C., require the HPV vaccine and Hawaii will, beginning next year, he said, but vaccination rates remain stubbornly low. The CDC reports a vaccination rate for HPV of 49% among 13- to 17-year-olds in the state outside of New York City.
"I routinely recommend the vaccine," Kuo said in an email. "The vaccine prevents cancer."
Assemblywoman Amy R. Paulin and other legislators have sponsored legislation going back at least a decade that would add the HPV vaccine to New York's vaccine schedule.
"If you vaccinate young people, you can hopefully eradicate cancers, just like we were able to eradicate the other diseases on that vaccine schedule,"said Paulin, a Democrat from Westchester County.
Many foes of the HPV vaccine bill oppose any vaccine requirements. They say vaccines haven't been proven safe, contain potentially harmful ingredients and cause dangerous side effects in children.
They don't trust public health officials or government agencies when they attest to the vaccines' safety and effectiveness.
"It is not safe," said Tim Eisenhauer of South Buffalo, a member of a statewide anti-vaccine organization.
He is a father of three young-adult children, two of whom he stopped vaccinating after he said they showed signs of autism. The CDC reports that there is no link between vaccines and autism.
Vaccine opponents suffered a blow earlier this year when the State Legislature approved – and Gov. Andrew Cuomo signed into law – a measure ending the religious exemption for vaccines required for school-age children in the state. Many parents pulled their children from school and began homeschooling them in response.
If this legislation is approved, parents would be required to get the HPV vaccine for their children entering seventh grade – or the children can't attend school.
Jina Gentry of Amherst has four children ranging in age from 20 months to 7 years and none has ever received a vaccination.
She objects to vaccines for safety concerns and on religious grounds, and she removed her two oldest children from school after the law changed.
"God gave me them to guide and to protect and bring up," Gentry said of her children. "And I believe the government is overstepping in this."
In addition to general anti-vaccine views, some opposition is centered on the HPV vaccine itself.
Critics wonder why children as young as 9 years old need a vaccine that prevents a sexually transmitted disease.
Gentry, for one, believes in abstinence before marriage and said parents should be able to choose whether their children receive the HPV vaccine.
Some local school officials also oppose the legislation.
Hicks, the Clarence schools superintendent, said the HPV vaccine doesn't meet the threshold for a mandated vaccine because the virus isn't an "epidemic infectious disease among school-aged children" and isn't easily communicated from subject to subject in a school setting.
He said the district has heard from a number of parents objecting to the HPV vaccine requirement.
"I urge you not to dismiss the concerns of those worried about both the rationale for mandating HPV vaccinations and the serious governmental overreach that interferes with parental ability to make informed medical choices for their children," Hicks wrote to the lawmakers. Neither Hicks nor Clarence School Board President Michael Fuchs responded to messages seeking further comment.
Buffalo Public Schools already are dealing with the repercussions of the elimination of the religious exemption, which required school districts to bar from class students who weren't caught up on their vaccinations, said Tonja Williams, associate superintendent for student support services.
The district isn't publicly opposing the bill and will comply if it becomes state law, Williams said.
"We just do our very best to implement any mandate," she said.
Frontier Superintendent Richard J. Hughes said this is another example of state officials making decisions and forcing local school districts to put those policies into effect – often over the objections of parents.
"Schools have been put in the middle," said Hughes. He urged the State Legislature to "slow the train a little bit" and focus on bigger issues such as the state's $6 billion budget hole.
Paulin and Burstein said they expected criticism from parents and anti-vaccine organizations but the statements from some school officials were discouraging given the importance of this public health issue.
"I do not expect to get opposition from superintendents or school board members. I expect them to be educators, and that is extraordinarily disappointing," said Paulin, the assemblywoman.
A group based in Albany organized protests held across the state outside the offices of state legislators, including that of state. Sen. Tim Kennedy, D-Buffalo.
"We are not going away, period," said Eisenhauer, one of the organizers.
Kennedy voted to end the religious exemption for vaccines but he is still reviewing the HPV vaccine bill and has serious concerns about the proposal, according to a spokeswoman.
"As a father of three, I believe we need to prioritize the health and well being of all children across New York through responsible, thoughtful, and most importantly, fact-based decision-making," Kennedy said in a written statement.