Since the Federal Drug Administration approved the HPV vaccine last summer, there have been varied reactions to this important breakthrough. Recently, several states have lined up with legislation to make the vaccine mandatory or to provide it at no cost. In honor of January being National Cervical Health Awareness Month, here's an update on HPV vaccine news around the world.

Yesterday the Washington Post reported that the D.C. Council is considering a bill that would make it mandatory for girls younger than 13 to be vaccinated against cervical cancer. One of the reasons for this proposal is the high rate of cervical cancer in Washington, D.C. Not only do we have HIV rates higher than the rest of the country, but 13.5 per 100,000 D.C. females have cervical cancer (compared to the national average of 8.8 per 100,000). The District joins other states with bills that would mandate HPV vaccination for girls by the 6^th grade: Kentucky, California, and Texas. A similar bill in Michigan passed the Senate last year, but didn't make it through the House and then died when the legislature adjourned for the holidays.

Critics use the same arguments against the HPV vaccine that they apply to comprehensive sexuality education, condoms, emergency contraception and other prevention methods – that it would encourage promiscuity and not protect against sexually transmitted infections (see the links above for facts about these tired silly arguments). An editorial in The Los Angeles Times protests that there is no evidence the HPV vaccine will lead to increased sexual activity "any more than there is evidence that giving people tetanus shots encourages them to step on rusty nails." There are also concerns about the cost of the vaccine, which must be administered in 3 doses; each shot costs around $120-200.

Other states are addressing this last criticism by proposing voluntary vaccinations at no cost to girls and women in a certain age range. This month, New Hampshire became the first state to offer free cervical cancer vaccinations to girls and women ages 11 to 18. Even the conservative governor of South Dakota (Remember him- the one who tried to enact a total ban on abortion last year?) announced this week that the state will provide free HPV vaccines to girls and women in the same age range as New Hampshire, using state and federal funds.

Beginning in April, Australia will also join the ranks of governments providing free HPV vaccines – though their specifications are for girls and women ages 12 to 18. This is commendable, especially considering the fact that the incidence of cervical cancer in that country is much lower than the United States: 270 Australian women die each year from cervical cancer, compared to 3,900 American women – which still doesn't even come close to the large number of women who die from cervical cancer in developing countries. United Nations agencies have called for funding to provide the HPV vaccine to women in developing countries; last month public health officials met in London for a two-day conference discussing ways to make the vaccine available to those women.

For more information, check out these resources:

• The Kaiser Network hosted an "Ask the Experts" on the HPV vaccine (the transcript is not yet available as of Thursday morning, but check their website – it should be up soon)
• OurBodiesOurBlog has a nice roundup of HPV news in the U.S., including a link to NPR's coverage