Researchers at Harvard University School of Public Health examined state, legal, and policy approaches to promote vaccination of preteen girls for human papillomavirus.
Dates of Project: 2007 to 2010
Description: In June 2006, the Federal Drug Administration approved the first human papillomavirus vaccine, and the Centers for Disease Control and Prevention recommended routine vaccination of girls ages 11 to 12. The recommendation sparked debate about whether and how to use laws, regulations, and policies to encourage uptake of the vaccine.
To inform ongoing policy-making and future decisions about the human papillomavirus vaccine and other vaccines, more information was needed on the role of public health law and the effectiveness of specific policy approaches in this arena.
The researchers conducted interviews with 73 key informants in six states engaged in legislative and policy deliberations concerning the human papillomavirus vaccine. They also reviewed relevant documentary materials and conducted a literature review.
Key Findings: As reported in the New England Journal of Medicine, at least eight distinct factors impeded the adoption of school-entry mandates for the human papillomavirus vaccine or, in one case, led to the adoption of a weak mandate. They included the newness of the vaccine, the sexually transmitted nature of human papillomavirus, and the noncontagiousness of human papillomavirus.
As reported in the American Journal of Public Health, the vaccine manufacturer, Merck, played several different roles in the policy-making process, including serving as an informational resource to legislators and health department officials, and lobbying and presenting policy alternatives to legislators. Stakeholders viewed roles focusing on information provision as appropriate, but held less positive views of the company’s aggressive and early lobbying for school-entry mandates.
In the Journal of Health Politics, Policy and Law, the team reported that state legislatures, rather than administrative processes within health departments, dominated the policy activity related to the human papillomavirus vaccine.
“Actions that are too aggressive or that lack transparency can undermine the prospects for legislation that foster acceptance of new vaccines.”—the researchers.