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Gardasil Requirement for Immigrants Questioned

Sep 18, 2008 | Parker Waichman Alonso LLP

Since Gardasil came on the market, Merck & Co. has been pushing for it to be made mandatory for young women in the U.S.   Now that has happened - at least in regards to one group of women.   Nearly unnoticed, the U.S Citizenship and Naturalization Service has changed its vaccination policy, and is now requiring that immigrant girls and women, ages 11 through 26, be immunized for the Human Papillomavirus  (HPV) if they want to apply for citizenship.  Gardasil is the only HPV vaccine currently approved for use in the U.S.

The U.S. Citizenship and Naturalization Service added the HPV vaccination requirement in July, when it revised the Centers for Diseases Control's (CDC)  Technical Instructions to Civil Surgeons for Vaccination Requirements.  The Service is also requiring immigrants applying for citizenship to be vaccinated against hepatitis A, rotavirus, meningitis and chicken pox.  But those are highly contagious disease, while HPV is not.

The new regulation is causing quite a bit of controversy because current U.S citizens are not required to have the Gardasil vaccine.  "If the government is trying to take care of everyone, they should be doing it also with the citizens," Ginky-Lee Torres, an immigration lawyer, told a North Carolina TV station.

Even the CDC - which recommends Gardasil for girl and women ages 11 to 26 - has not advocated mandatory vaccination for anyone.  Dr. Jon Abramson, chairman of the CDC's advisory committee on immunization practices said in February 2007 he opposed mandatory vaccination because  sexually transmitted HPV is not a contagious disease like measles.  Abramson also cited the cost of Gardasil as another reason for his opposition.

Immigrant advocates are also concerned that  Gardasil's high cost would be a burden to immigrants who do not have health insurance.  At $162 per shot, the 3-dose Gardasil vaccine is the most expensive vaccine on the market.

And finally, there are serious concerns about the safety of Gardasil.  There have been 9,749 adverse reactions following Gardasil and 21 reported deaths since 2006.   Those side effects, which were reported to the Vaccine Adverse Event Reporting System (VAERS) included 10 miscarriages, 78 severe outbreaks of genital warts and six cases of Guillain-Barré syndrome, an autoimmune disorder that can result in paralysis.