AAFP Policy Statement Regarding Consideration of the Mandated Use of HPV for School Attendance

Board Chair Approved: February 7, 2007

"The AAFP feels it is premature to consider school entry mandates for human papillomavirus vaccine (HPV) vaccine until such time as the long term safety with widespread use, stability of supply, and economic issues have been clarified."

Background:
The American Academy of Family Physicians (AAFP), along with the Centers for Disease Control and Prevention (CDC) and its Advisory Committee on Immunization Practices and the American Academy of Pediatrics (AAP), have recommendations for the use of human papillomavirus vaccine (HPV) which calls for routine vaccination with three doses of HPV for females 11-12 years of age. The vaccination series can be started in females as young as 9 years of age. Catch-up vaccination is recommended for females 13-26 years of age who have not been vaccinated previously or who have not completed the full vaccine series. These recommendations can be accessed on the Recommended Adolescent Immunization Schedule (1-page PDF file; More information on PDF files), Recommended Adult Immunization Schedule (2-page PDF file; More information on PDF files) and the CDC (Quadrivalent Human Papillomavirus Vaccine; MMWR: 56 [Early Release];1-24).

Recently, there has been increasing state level action considering mandating HPV vaccination with proof of vaccination required for school attendance. Several issues should be considered regarding a mandated school attendance requirement. These include that HPV does not adhere to the public health model for control of infectious disease in a school setting. (e.g. measles, chicken pox); a universal school attendance requirement would come as a sudden significant cost that may not be able to be paid for by patients, state public health departments, and the healthcare system; and assurance of an adequate HPV supply for such a sudden increased demand and ability to administer it.