The HPV vaccine is a ‘lifesaver,’ but too many kids aren’t getting it. It’s time for a mandate.

One day in the mid-aughts, I was sitting in my office in the New Jersey Department of Health in Trenton when I received a call from a business reporter for a local newspaper. At the time, I was the chief government epidemiologist in the state and responsible for promulgating vaccination requirements for school attendance.

The reporter was interested to know whether the state was planning to require adolescent schoolchildren to receive a new vaccine being developed by Merck pharmaceuticals to prevent infection with the human papilloma virus (HPV) that causes cervical and other cancers.

It was the first time I had heard about this vaccine.

I responded by stating I was not in support of a school mandate because this sexually transmitted infection was unlikely to be transmitted in a school setting, and the opposition to a proposed mandate would be intense.

In the nearly 20 years since that time, my opinion has changed.

The HPV vaccine is, in short, a lifesaver.

The HPV vaccine is, in short, a lifesaver. By preventing several types of cancer, it can save thousands of U.S. lives each year. But too many children aren’t getting it.

My change of heart was solidified after I read that the Centers for Disease Control and Prevention plans to cut funding for states’ childhood vaccination programs, and a June news release from the New Jersey Department of Health that said the number of HPV-related cancers is rising in the state.

As a result, I now believe that HPV vaccination should be added to the list of required vaccines for children, specifically adolescents, attending schools.

Here’s why I believe such a dramatic step is necessary.

First, the most recent vaccination data show that the number of teens getting the vaccine has slowed, or even declined, over the last few years, and is much worse than other routine and required childhood vaccines. In New Jersey, for instance, the rate of the first HPV vaccine dose has decreased since 2020, and only slightly more than half of N.J. teens are fully vaccinated against HPV. Pennsylvania’s rate — 69% — isn’t much better.

Second, the FDA-approved HPV vaccine, which now contains nine infectious strains of the virus, has been shown over the years to prevent not just cervical cancer, but also a wide range of cancers and precancerous lesions and no new serious adverse events. And rates of HPV infection and early cancers tied to the virus are falling since the vaccine was first deployed.

Third, the administration of the vaccine has become simpler, going from a three-shot series to a two-shot series, if starting before the 15th birthday. And there are initiatives and ongoing global studies that could support a one-dose vaccine policy in a few years, which would further simplify the vaccine schedule and thereby prevent more cancers in the U.S. and globally.

If New Jersey and Pennsylvania were to create an HPV vaccine school mandate, they wouldn’t be the first: Virginia, Hawaii, Rhode Island, and the District of Columbia have already done so.

» READ MORE: I’m a physician over age 50 and I’m not getting my second COVID booster yet. Here’s why. | Opinion

So what’s stopping other jurisdictions from moving forward with new regulations? For one, there is general resistance to childhood vaccination among a large segment of the population, which hasn’t been helped by the COVID-19 pandemic. Requirements for COVID-19 vaccination among adults have caused a backlash on mandates for any population, including school-age children.

A longer running objection to HPV vaccine mandates is that vaccinating teenage children will lead to increased sexual activity, a myth that has been debunked through repeated studies.

So, what does it take to get a school mandate in place? Well, it depends on the jurisdiction, but essentially, it takes a state law and/or regulations, political support, and time.

All states have supporting laws that allow for mandates. In some, it requires legislative action. In others — including Pennsylvania and New Jersey — it can happen through regulations, via the state department of health. But even in states that permit mandates through a regulatory process, the legislature can pass laws that supersede this process.

As a result, a mandate needs political support from the governor, the departments of health and education, the presiding legislative bodies, and public health care professionals. This was the case in 2007 when New Jersey was the first state in the nation to require influenza immunization for preschool-age children.

Adopting a school mandate for vaccination is not for the fainthearted. It requires supportive scientific evidence, political will, committed leadership, and perseverance against expected significant opposition. But the fight is worth it to protect our children.

We have a safe way to prevent them from developing cancer and other related conditions as they grow and mature into adults. It’s our obligation and responsibility as elected officials, public health professionals, health advocates, parents, and caregivers to use the tools we have to prevent disease in our children before it’s too late. We just need the courage to make it happen.

Eddy Bresnitz is a physician and former deputy commissioner for Public Health Services in the New Jersey Department of Health, where he was also the state’s chief epidemiologist. From 2008 to 2020, he was the global medical director for adult vaccines at Merck, during which time Merck’s position was to be neutral on state mandates. He retired from Merck several years ago and no longer owns individual stocks in the company. dreddybres@gmail.com