The Journal Gazette
Tuesday, March 15, 2016 4:54 pm

HPV vaccine voluntary, state clarifies in letter

Niki Kelly | The Journal Gazette

INDIANAPOLIS – Bowing to criticism from conservatives, the Indiana State Department of Health has softened a letter recently sent to parents regarding a cancer vaccine for Hoosier girls. 

"ISDH received questions after the first wave of letters started to go out. We reviewed the letter and decided to clarify the language to address those questions," spokeswoman Jennifer O’Malley said.

The concerns were highlighted by the American Family Association of Indiana, whose executive director sent a scathing email to all of its supporters questioning the intrusion by state government into private affairs.

Gov. Mike Pence told The Journal Gazette then that he would review the situation and act.

The original letter was sent to 305,000 Hoosiers in September. The revamped letter is set to go out to 175,000 parents, O’Malley said.

The biggest change is that the first paragraph now makes clear that the human papillomavirus vaccine is recommended by the Centers for Disease Control and Prevention but is not required by the state. 

The initial letter began with a strong statement about protecting Indiana’s citizens from vaccine preventable diseases and never said the HPV vaccine was voluntary.

HPV is a sexually transmitted virus that can cause cervical cancer, genital warts and other medical issues. About 23 percent of Indiana girls ages 13 to 16 have received all three doses of the HPV vaccine, according to federal statistics.

The new letter also prominently points out that the Indiana State Department of Health regularly reviews immunization records reported to the state’s Children and Hoosier Immunization Registry Program, or CHIRP, and includes a link to have a child’s information permanently removed from the registry.

The Indiana University School of Medicine’s Center for HPV Research sent a letter to Pence a few days ago, urging him not to back down on the HPV reminder letter. It was signed by more than 30 professors and medical professionals.

"A long-standing and evi­dence-based practice to en­cour­age vaccination is the use of reminder recall letters addressed to parents and guardians of children who have not initiated or completed the vaccination series," the letter said. "Hoosier parents have been receiving these letters since 2012, and there have been at least three letter cycles sent to parents specifically focused on HPV vaccination."

The group cites the low HPV vaccine rate in Indiana and said "this is of great concern to us as cancer researchers, because the vaccine is both safe and effective."

The center also expressed concern that some who disagreed with the letter focused on the existence of an immunization database.

"This is unfortunate, because the registry is a central component of a comprehensive public health strategy against all vaccine preventable diseases," the letter said. "The concerns are without merit, and merely attempt to unravel important public health advances at the expense of Hoosier health."

A new paragraph in the reminder letter explains how HPV is spread and that it is so common that nearly all sexually active people will get it during their lifetime. Most infections go away on their own, but the virus can lead to cervical cancer in women.

Then the letter includes a paragraph used in the initial letter, citing support from various medical associations for the vaccine and when it is most effective.

Pence’s office stepped in this year against a legislative effort to increase the rate of HPV vaccination to 80 percent.

The measure was defeated in the Indiana House.

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