Brown signs bill letting CA minors get STD vaccine, and PEP/PrEP?
Oct 9 2011
SACRAMENTO, Calif. -- Gov. Jerry Brown has waded into the national debate over child vaccinations for sexually transmitted diseases, signing into law a bill allowing children as young as 12 to get vaccinated without their parents' consent.
Brown announced Sunday that he had signed AB499, which lets minors get vaccinated against a virus known as human papilloma. Also known as HPV, the virus is a precursor to a leading cause of cervical cancer.
Under the bill signed by Brown, children will also be able to get other STD prevention treatments, including new medicines that help prevent HIV infection if given within 72 hours of exposure.
Supporters, including public health officials, say the law will keep up with new prevention treatments and help slow the spread of disease among minors.
Opponents, including religious leaders, pro-family organizations and Republican lawmakers, say it undermines parents' right to be involved in their children's medical decisions.
Randy Thomasson, president of SaveCalifornia.com, worried the law will deceive preteen girls into a false sense of security, leading them to think they can freely engage in sexual activity without risk. He also accused Brown of interfering with parents' ability to make decisions for children not yet old enough to vote or drive.
The choice has been a hot topic recently in the Republican presidential race.
Republican presidential candidate Michele Bachmann used a GOP debate to attack Texas Gov. Rick Perry for issuing a 2007 executive order mandating the HPV vaccine for young girls. That mandate was overturned by Texas lawmakers, but Perry argued that supporting the vaccinations means supporting life.
California lets minors seek diagnosis and treatment for STDs without parental consent, but they cannot get vaccinated without parental approval. The state already lets teens get confidential care for contraception, pregnancy, mental health problems and drug abuse.
HPV is the most common sexually transmitted disease. The bill's author, Assemblywoman Toni Atkins, D-San Diego, said it has become the world's second leading cause of cancer deaths among women, killing more than 400 Californians in 2008, the latest year for which statistics were available.
Two vaccines are available and most effective if given before a person becomes sexually active. One is licensed as Gardasil by Merck and the other is Cervarix, manufactured by GlaxoSmithKline.
Opponents note that minors cannot get a tattoo or body piercing without their parents' approval in California. They argued it is even more vital for parents to be involved in their childrens' medical care.
Supporters say teenagers and preteens often feel they cannot talk to their parents or guardian.
Law gives minors right to get HPV shots
Gov. Jerry Brown has signed legislation that gives children 12 or older the right to obtain preventive treatment for sexually transmitted diseases without parental consent, including an HPV immunization for cervical cancer.
Brown did not explain his reasoning in the announcement Sunday.
Assembly Bill 499 was carried by Assemblywoman Toni Atkins, D-San Diego. She said the legislation addresses a loophole in the law that forbids prevention steps by doctors but allows minors under 18 to undergo abortions and post-infection treatment for sexually transmitted diseases without the approval of parents or a guardian.
"They are already able to get diagnosis and treatment, but they have not been able to get preventive treatment," Atkins said. "This closes that gap so that practitioners who are already seeing people in their clinics and doctors offices can address these issues with their clients."
Many in the medical field and advocates for minors agree parental consent is ideal. But they say in some cases sexually active minors without a strong relationship with their parents may be too frightened to seek approval and risk their health.
Critics counter the measure is an unwarranted intrusion into parental rights, worry about the safety of certain immunizations and contend that drug makers are behind the law because they stand to profit.
Poway resident Becky Estepp, a mother of boys aged 11 and 13, said she worries about the transfer of authority from parents to the state.
"These vaccines are not magic," said Estepp, whose oldest son had a bad reaction to a vaccine as an infant and is autistic. "They come with risks, and I don't think a 12-year-old has the critical thinking skills in order to assess the risk-benefit analysis."
Estepp said an online report on three vaccines available to minors without parental consent showed some 64,000 adverse events and between 100 and 200 deaths. "This is all about risk," she said.
Under the new law, drug companies, which have been granted far-reaching liability protections from the courts, would likely flood the market with more vaccines, said Estepp, director of communications for the Elizabeth Birt Center for Autism Law and Advocacy.
Among other things, the measure will allow young girls on their own to be vaccinated for the human papilloma virus.
Most of those infected with strains of HPV experience little, if any, symptoms. But some strains could cause cervical cancers that can be fatal if untreated, according to the federal Centers for Disease Control and Prevention.
Mandatory vaccinations of the brand-name drugs Cervarix or Gardasil have drawn protests nationally among those opposed to government-forced immunizations and fears of serious side effects.
Atkins' measure has drawn the ire of the California Catholic Conference, Catholics for the Common Good and SaveCalifornia.com, an organization that advocates on behalf of families.
"AB 499 further endangers minors who are foolish enough to be sexually active, when abstinence-only education would work effectively to protect them," said Randy Thomasson, president of SaveCalifornia.com. "This is bad public policy. Annual pap tests, starting at age 21, actually protect women from the risk of cervical cancer much more than a series of Gardasil shots, which has only a temporary effect."
The new law was supported by ACT for Women and Girls, the California STD Controllers Association, the American Congress of Obstetricians and Gynecologists in California and the American Academy of Pediatrics in California. It will take effect Jan. 1.
"Pediatricians support parental-teen communication, and in a perfect world, all youth would be able to speak openly with their parents or guardians about every health care decision," said Kris Calvin, chief executive of the pediatric group. "Unfortunately, that is not always the case. The ability to consent to the HPV vaccine, which prevents certain types of cancer, or to obtain preventive care for HIV within 72 hours after exposure, are now possible for a teen under AB 499. It is not often that a bill will most certainly save lives. AB 499 will."
HPV is the world's second-leading cause of cancer deaths among women and was blamed for more than 400 fatalities in California in 2008, the latest year for which statistics were available. In men, cancer due to HPV has overtaken cancers due to tobacco use for oral, head and neck cancers.
The California Department of Health and the Centers for Disease Control has said the vaccination is safe and that any side effects are minor. Still, it has remained a controversial topic.
Recently, Texas Gov. Rick Perry was forced to defend himself for issuing an executive order that mandated HPV vaccines for young girls. The 2007 order was later overturned, but Perry said in a GOP presidential debate that his actions amounted to supporting life.
California will join Alabama, Arkansas, Kansas, Montana, and other states in closing the gap in the law.
"The people who tend to question it are probably the media, etc. because it's a newsworthy topic for you," Atkins said. "The issue is that you are dealing with people under the age of 18. The recommendation is for parents to be aware of this for their young girls and young boys and I think, probably, the group of young people that are going to be seeking care are already seeking care for things like diagnosis and treatment."