New Hampshire Provides Gardasil At No Cost To Girls Ages 11 To 18; Experience 'Contrasts Sharply' From Other States

Main Category: Cervical Cancer / HPV Vaccine
Also Included In: Pediatrics / Children's Health
Article Date: 17 May 2007 - 9:00 PST

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The New York Times on Saturday examined the high demand for Merck's human papillomavirus vaccine Gardasil in New Hampshire since the state began its voluntary vaccination program (Belluck, New York Times, 5/12).

Gardasil in clinical trials has been shown to be 100% effective in preventing infection with strains 16 and 18, which together cause about 70% of cervical cancer cases, and about 99% effective in preventing HPV strains 6 and 11, which together with strains 16 and 18 cause about 90% of genital wart cases, among women not already infected with these strains. FDA in June 2006 approved Gardasil for sale and marketing to girls and women ages nine to 26, and CDC's Advisory Committee on Immunization Practices later that month voted unanimously to recommend that girls ages 11 and 12 receive the vaccine, which is given in a three-shot series (Kaiser Daily Women's Health Policy Report, 5/10).

New Hampshire's program, announced in November 2006 by the state Department of Health and Human Services, plans to provide Gardasil at no cost to girls and women ages 11 to 18 as part of a state program that offers immunizations to minors (Kaiser Daily Women's Health Policy Report, 12/1/06). According to Jose Montero, a state epidemiologist, New Hampshire is spending $4.9 million on Gardasil this year, which is 28% of the state's immunization budget. Half of the financing is from federal money and the other half is from private insurers, Montero said.

New Hampshire since January has distributed 14,000 doses of Gardasil and is trying to obtain more for physicians that have waiting lists for the vaccine, the Times reports. The state's biggest insurer, Anthem Blue Cross and Blue Shield, beginning in July will no longer cover Gardasil and other vaccines for people ages 11 to 18 because they are eligible to receive it at no cost through the state, Anthem spokesperson Chris Dugan said. Dugan added that Anthem pays into the state program and that other private insurers also are expected to stop covering Gardasil for the age group. Girls and women who are younger than age 11 or older than age 18 must pay out of pocket or though insurance to receive the vaccine, and some families of girls ages 11 to 18 have chosen to pay for Gardasil rather than be placed on a waiting list.

According to the Times, New Hampshire has avoided the "backlash" experienced by many of the more than 20 states that have considered HPV vaccination requirements. Virginia is the only state to pass a law mandating vaccination, but it will allow parents to refuse to have their daughters vaccinated, the Times reports. Greg Moore, a spokesperson for the state's Department of Health and Human Services, said the state has not experienced "significant controversy because there was never a discussion about whether to make [Gardasil] mandatory."

Other states, including South Dakota and Washington, have approved voluntary programs that offer the vaccine at no cost. South Dakota in January began offering Gardasil to girls ages 11 to 18 with $1.7 million in state funds and $7.5 million in federal funds. South Dakota Health Secretary Doneen Hollingsworth said the state has provided nearly 20,000 doses of the vaccine. Hollingsworth said that there has been a "tremendous amount of interest" in Gardasil adding that she has not heard "anything about anybody running out" of the vaccine. The Washington Legislature recently approved $10 million to provide vaccinations for 94,000 girls during the next two years (New York Times, 5/12).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.