CDC Officials Unaware Recommendation On HPV Vaccination Would Lead To Immigration Mandate

Main Category: Cervical Cancer / HPV Vaccine
Article Date: 02 Oct 2008 - 7:00 PDT

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CDC officials said they were unaware that the agency's recommendation for young women to receive Merck's human papillomavirus vaccine Gardasil would lead to an immigration policy requiring immigrant women ages 11 to 26 to receive the vaccine, and an unnamed government official said the requirement might be reviewed, the Wall Street Journal reports (Jordan, Wall Street Journal, 10/1). The vaccine, approved by FDA two years ago and recommended by CDC's Advisory Committee on Immunization Practices, prevents transmission of HPV strains responsible for 70% of cervical cancer and 90% of genital warts (Daily Women's Health Policy Report, 9/30).

A 1996 immigration law states that any vaccination recommended by the U.S. government for its citizens becomes a required one for greencard applicants; Gardasil was added to an updated list of immigration vaccines in July and the policy went into effect Aug. 1. A spokeswoman for U.S. Citizenship and Immigration Services said the policy reflects "a statutory requirement" and is based on recommendations made by CDC.

However, some immigration advocates, physicians and experts said the policy is excessive and unfair to immigrants because of the high cost of the vaccine and research that questions its effectiveness. A CDC spokesperson said the experts on the immunization committee did not realize the decision would affect tens of thousands of immigrants. Jon Abramson, who was chair of ACIP when the recommendation was made, said requiring immigrants to receive the vaccine never was intended. If ACIP "had known about" the immigration requirement, the committee "would have said it's not a good idea," Abramson said, adding that HPV is a sexually transmitted infection and is "not something that endangers kids in a school setting or puts your population at risk."

Immigration advocates also are concerned about the cost of the vaccine for immigrants who already pay more than $500 in application fees. Gardasil requires a three-dose regimen, which costs $360, and the policy requires women 11 to 26 to get one dose of the vaccine, which costs around $120. Tuyet Duong, a senior staff attorney at the Asian American Justice Center, said the requirement is "outrageous" and is "creating an economic barrier" for female immigrants.

The U.S. government requires 14 vaccines for immigration, 13 of which are aimed at combating infectious diseases that are transmitted by respiratory routes and considered to be highly contagious. Gardasil is the only STI on the list. A spokesperson for Merck in a statement said that the company was unaware of the policy, adding that the company "did not lobby for this provision in any way" (Wall Street Journal, 10/1).

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