Mandatory HPV Vaccine Moves Forward in Iowa

Lynda Waddington

Only two steps remain in Iowa's legislative quest to require insurance companies to provide coverage of vaccinations for the human papillomavirus, the major cause of cervical cancer.

Only two steps remain in Iowa's legislative quest to require insurance companies to provide coverage of vaccinations for the human papillomavirus, the major cause of cervical cancer.

The proposed bill was passed by an 81-16 vote of the Iowa House last week and referred to the Senate Human Resources Committee. All 16 House members opposing the measure were Republicans, six of them women.

Tuesday morning, the Senate committee, chaired by Assistant Majority Leader Joe Bolkcom, D-Iowa City, approved the measure and sent it on to the full Senate floor. The bill will need to pass through the Senate — something that is considered likely — and will need to be signed by Gov. Chet Culver. The law would take affect for third-party payment provider contracts, policies or plans delivered, continued or renewed in the state after Jan. 1, 2009.

"Cervical cancer is preventable," Bolkcom said. "The HPV vaccine is the best defense. This bill will ensure that health insurers make the HPV vaccine available and affordable to Iowa women. I expect the Senate to approve this bill soon."

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The bill, the successor to HSB 566, is supported by the Iowa Osteopathic Medical Association, Child and Family Policy Center, the Iowa Academy of Family Physicians, the Family Planning Council of Iowa, the Iowa Coalition Against Domestic Violence, Planned Parenthood of Greater Iowa, the Iowa Medical Society and the American Cancer Society. It is opposed by Golden Rule Insurance, the Iowa Christian Alliance and Iowa Right to Life.

For the most part, insurance companies — many of which already provide coverage for the vaccine — have remained neutral about the bill.

"Really this is about the state making a long-term commitment to women," said Kyle Carlson, staff attorney for PPGI. "This is the state saying that it is going to prevent cervical cancer as a matter of policy rather than leaving it to market forces."

Genital HPV infection is a sexually transmitted disease that is caused by human papillomavirus, a group of viruses that includes more than 100 different strains. The disease is spread by genital contact. All types of HPV can cause mild Pap-test abnormalities that do not have serious consequences. Roughly 10 out of the 30 identified genital HPV types can lead to development of cervical cancer.

In June 2006, the first vaccine developed to prevent cervical cancer and other diseases in females caused by HPV was recommended by the Centers for Disease Control and Prevention. The vaccine protects against four HPV types, which altogether cause 70 percent of cervical cancers and 90 percent of genital warts. The vaccine was subsequently approved by the Food and Drug Administration for use in girls and women between the ages of 9 and 26. The vaccine is given through a series of three shots during a six-month period.

While there is no doubt the vaccination could save the lives of girls if it is provided before they become sexually active, social conservatives have argued that immunizing teens could encourage sexual activity and provide a false sense of protection against other sexually transmitted infections.

"I think we can reassure [those who worry about promiscuity] that there isn't a cause-effect relationship," said Dr. John Seffrin, chief executive officer of the American Cancer Society. "To put it in another way, the threat of getting cancer has not prevented people from engaging in sexual activity. More importantly, we've found that if you want people to take up an effective measure, you don't ram it down their throat. You provide it and educate people."

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