This week, the Allegheny County Department of Health, along with Allegheny County Council members, heard testimony in support of and against — but mostly in support — making the HPV vaccine mandatory for children, both boys and girls, ages 11 and 12.
Human papillomavirus, or HPV, is the most common sexually transmitted disease, according to the Centers for Disease Control and Prevention, which along with the American Academy of Pediatrics recommends the three-dose (over a period of six months) vaccine at that age, meaning before kids generally become sexually active.
More than 25 speakers — including doctors, researchers, executives from health-care foundations, high school students, cancer survivors and even a dentist — addressed Dr. Karen Hacker, head of the Allegheny County Health Department, and council members.
Dr. Liz Miller, director of community health at Children's Hospital at Pittsburgh and a professor of pediatrics at the University of Pittsburgh's School of Medicine, called the vaccine mandate "critically important" for "bridging the gap" in parts of Allegheny County where parents might not be educated on HPV, or where access to primary care is less likely.
"The HPV vaccine is frankly a no-brainer," she said.
According to the CDC, in most cases HPV will go away on its own. But when it doesn't, it can cause genital warts and cancers, including cervical cancer, cancer of the vulva, vagina, penis or anus. Cancer caused by HPV can also manifest itself in the throat, tongue and tonsils.
Currently the vaccine is mandatory for school entry in Rhode Island, Virginia and Washington, D.C.
"We have spoken with all three states to better understand their perspectives and experience," Hacker wrote in an email to City Paper
. She says the vaccine is covered by most health-insurance plans and is included in the Affordable Care Act's preventive measures.
John Rhodes, a 50-year-old assistant basketball coach for the Duquesne University Dukes, testified as a throat- and neck-cancer survivor. He called himself a "6-foot-9 walking billboard" for the HPV vaccine. He has been in remission for seven months after being treated for stage-four cancer that settled in his lymph nodes and was caused by HPV.
"My kids are vaccinated," he said. "As a coach and a competitive person, I challenge you [to mandate the vaccine]."
Several doctors shared concern for the pain and complications their patients feel once they are diagnosed with a cancer caused by HPV.
Dr. Umamaheswar Duvvuri, a head- and neck-cancer surgeon at UPMC and the local VA hospital, told the crowd about his 55-year-old male patient from Dubois, Pa., who found a lump on his neck. "I spent the day removing a large portion of this man's tongue," he said. "That could've been prevented."
After the meeting, he explained that he and colleagues will be operating on six patients and treating four others for "oropharyngeal" cancers — head and neck cancers — and that those types of cancers are predicted to rise by 2020.
Sixteen-year-old Sydney Reyes, of Riverview Junior-Senior High School, addressed another common argument against the vaccine — that it will encourage sexual promiscuity in teenagers.
"This assumption can be resolved by having a proper discussion with your teen, not by blocking a vaccination," Reyes said. "Why should we risk a life like this when we really don't have to?"
A few speakers against the vaccine mandate expressed their concerns to the councilors. A parent named Amy Rafferty read a letter from a friend whose daughter allegedly suffered severe hypertonia — muscles spasms — to the point where she couldn't walk anymore after receiving Gardasil, the HPV vaccine from Merck.
James Lyons-Weiler, who formerly worked at the Hillman Cancer Center and who started his own research group entitled the "Institute for Pure and Applied Knowledge," told the crowd he was concerned that the current vaccine would allow for stronger virus strains to attack humans in the future.
Yesterday, Lyons-Weiler posted a 3,000-word essay on his blog denouncing the medical professionals who asked Allegheny County to mandate the vaccine. He also mentioned that he met Rafferty because she organized the local screening of VAXXED
— an anti-vaccine documentary that was kicked off the Tribeca Film Festival schedule, and which City Paper
's film critic Al Hoff said came "across as an infomercial by way of a conspiracy theory for a discredited argument."
Speakers who followed opponents of the vaccine mandate contradicted their arguments.
Hacker says the comments gathered at the hearing will be presented to the board of health in July.
"They wanted us to consider what the public felt [about an HPV-vaccine mandate]," Hacker said by phone today.
If the board decides to recommend a mandate, a public-comment period would follow.
Editor's note: This post has been udpated to include comments from Dr. Karen Hacker.