On Requiring HPV Vaccines for Immigrants to the U.S.
I first heard a week or so ago that the United States is going to require the HPV vaccine (when age-appropriate) among the mandatory vaccines for those seeking legal permanent residency. I have not been opposed school systems making the vaccine mandatory – with the caveat of generous opt-out provisions – because this action often triggers coverage of the very expensive vaccine which many families could not otherwise choose because they could not afford it. However, requiring the vaccine for immigrants troubles me. There is no opt-out provision that I’m aware of, and as far as I know there is not then the same assistance with the vaccine price as there would be for U.S.-born schoolchildren.
The woc phd blog has a much lengthier discussion of vulnerable populations, but I will add that I am concerned that people who may be at a language disadvantage may not be appropriately informed about this new vaccine. Even if they are adequately informed, they still have no chance to refuse (which U.S. citizens do have – the vaccine is not mandatory for all U.S. residents), and have an additional $300 barrier between themselves and legal residency.
Even when vaccines are mandated for schoolchildren, there is choice involved – parents can get the facts, and then decide. In this case, there is no choice, and a vaccine is being required for a disease that does not pose a tremendous public health threat if immigrants are not vaccinated. I’m not someone who believes all vaccines are bad, but I’m very wary when the requirements go this far, on something so new, and so expensive, and in the targeted population of immigrants.
Feministe also has discussion. woc phd distills concerns down to a profit motive for the vaccine maker and sneaky human subjects testing – give that a read for an interesting perspective. I do still think that many of the concerns about Gardasil (the one currently approved HPV vaccine in the U.S.) have been blown out of proportion by reporters and others who don’t understand the VAERS system (and how to interpret adverse event reports) or the realities of postmarketing surveillance, and I can understand a motivation to improve the health of underserved immigrant populations by potentially preventing a cancer that requires ongoing, reliable access to healthcare for early detection. However, something about requiring this vaccine in order to gain legal residency just gives me the willies.