Committee on Family, Health and Human Services Minutes
March 27, 2007
In Attendance: Judy Myers, Chair, Bill Ryan, Marty Rogowsky, Ursula LaMotte,William Burton, Kenneth Jenkins and Tom Abinanti.
In Attendance: CEO: Bill Randolph. Office for Women: Camille Murphy. DOH: Dr. Joshua Lipsman. BOL: Legislator Vito Pinto, Chris Crane, Rick Pezzullo, Sarah O’Brien, Louise Gantress, Diana Toledo, Joanne Sold and Melanie Montalto.
Items Discussed: Human Papilloma Virus and the Gardasil vaccine that prevents infection of four strains of HPV, two of which cause cervical cancer.
Chairwoman Myers called the meeting to order at 10:30 a.m.
Chairwoman Myers introduced the Committee members and speakers, and gave a brief introduction to the importance of the meeting, HPV and Gardasil.
Merck was unable to send a representative but sent several brochures and information for the Committee.
Dr. Adina Keller, a practicing OBGYN and representative from the American College of Obstetrics and Gynecology, read a statement from ACOG regarding HPV and Gardasil. A copy of the statement is on file and available for review.
Dr, Keller stated that there are over 100 strains of HPV, 30 of which infect the genitals. Gardasil prevents 70% of cervical cancer causing strains of HPV and 90% of HPV strains that cause genital warts. She said that vaccination at 11-12 years old is best because it is prior to sexual activity and studies show that the body develops the best antibodies at this age as compared to non sexually active 16 year olds.
Dr. Jose Munoz, the Chief of Pediatric Infectious Diseases at the Maria Fererie Children’s Hospital a the Westchester Medical Center gave a power point presentation on HPV and Gardasil. A copy o f the presentation is on file and available for review.
Dr. Munoz stated that there has been a decline in cervical cancer cases in the United States thanks to ACOG and the ACIP as well as public health policy which encourages pap tests and early screenings. He said early vaccination is important because the vaccine cannot prevent cancer in women who have already been infected with high risk HPV strains.
Dr. Munoz stated that he has never seen a vaccine that at some point did not need a booster. He does not know how long Gardasil will last until it wanes and needs a booster shot.
A discussion ensued regarding the recommended age of vaccination. Chairwoman Myers asked if there are other strains of HPV that cause cervical cancer. Dr. Keller explained that there are, but the results come in groups by high risk and low risk strains so it is hard to pinpoint how many strains cause cancer and at what rate.
Legislator Abinanti asked about vaccinations in boys and stated that he has great concern about vaccines and the possible correlation with autism.
Dr. Keller stated that there is currently no way to test men for HPV and men are the vectors of the virus. They are currently testing the vaccine in men but it is difficult. She said it is necessary to look at the big picture in wiping out the virus and the cancer and vaccinate across the board when that is possible.
Legislator LaMotte asked why there is aluminum in the vaccine. Dr. Munoz said it helps to develop higher antibodies. Dr. Lipsman explained that there are different forms of aluminum and this vaccine has been approved by the FDA, the ACIP and then the CDC. The ACIP and the CDC have recommended the vaccine for use and strongly urge females to get the vaccine. Dr. Lipsman continued to say that everyone is eager to reduce cancer rates and this vaccine appears to be extremely safe and effective. He said the problem is availability and cost.
Legislator Burton asked if there is a timeline on the vaccine for boys. Dr. Munoz and Dr. Lipsman explained there is an excellent system to monitor the virus and vaccine in women through changes in the cervix. There is no way to screen boys other than testing antibody levels. Studies will be done to vaccinate boys but the timeline is unknown.
Legislator Abinanti asked if the vaccine will affect fertility or offspring. Dr. Lipsman said it will probably enhance fertility and immunity in offspring. Dr. Keller explained that there will always be concerns about long term effects of vaccines but we will not know for 20 years and we do not have time to waste because HPV is a world wide epidemic.
Legislator LaMotte asked if it was possible that this was too good to be true. Dr. Lipsman said it is possible but people are living a lot longer than they used to due to public health and vaccines.
Lillian Jones, Regional Director of the American Cancer Society read a statement from the American Cancer Society which is on file and available for review. She stated that the vaccine costs $120 per dose and three doses are required. She said that many insurance companies cover the vaccine with average copays of $72.
The American Cancer Society is in favor of the vaccine and supportive of an educational campaign because adolescents are a hard to reach group, but they do not have a policy on mandating the vaccine. ACS plans to monitor the take up rate of the vaccine.
Legislator Abinanti asked Dr. Lipsman if he thinks it would be better to wait for the results on those who voluntarily vaccinate before mandating it. Dr. Lipsman said we would be doing more harm than good that way.
Vanessa Flynn of POMCO insurance told the Committee that New York State insurance providers are required to follow recommendations of the CDC, which now includes the HPV vaccine.
Jennifer Zando also of POMCO said that POMCO follows the National and New York State insurance Department standards. The CDC recommended the vaccine, so Westchester County plans began covering the vaccine for girls ages 9-19 effective January 1, 2007. She said that the vaccine is one of the more expensive ones and cost is definitely a concern, but POMCO looks at the long term savings when determining their coverage plans and the savings are incredible.
Lisa Winjum from Planned Parenthood stated that education is Planned Parenthoods’ priority. She said that the vaccine is a red light to cancer, not a green light to sexual activity. She said that Planned Parenthood of New York has not taken a position on mandating the vaccine, but national Planned Parenthood supports the mandate as long as it does not create a financial burden for families.
Camille Murphy, Director of the County Office for Women, said she did a small random sample of women and found there was concern about lack of knowledge about the vaccine so they chose not to get it or vaccinate their daughters. She stressed that an educational campaign needs to take place. She also said that Planned Parenthood will do a workshop on HPV and STD’s at the Every Woman’s Conference on May 12th.
Moved by Legislator Abinanti and seconded by Legislator Jenkins the Committee on Families, Health and Human Services adjourned at 12:30 p.m.