Texas almost mandated an HPV vaccine before politics got in the way. Now, it has one of the country's highest rates of cervical cancer
In 2007, two governments set into motion a massive public health experiment.
One was the state of Texas, where lawmakers rejected a mandate to vaccinate adolescent girls against human papillomavirus, or HPV, a near-ubiquitous sexually-transmitted infection that causes cervical cancer. For more than a decade since, the number of Texas adolescents vaccinated against HPV has remained low.
On the other side of the globe, Australia, a country with roughly the same size population and economy as Texas, was taking a radically different approach. Public health leaders there rolled out a nationwide program that offered the HPV vaccine to girls for free at their schools. The program, though optional, proved popular, and it later expanded to boys. Vaccine coverage grew rapidly, with up to 80% of teens becoming immunized over the next decade.
Now, twelve years after Texas and Australia first veered onto wildly different courses regarding HPV prevention, their gap in health outcomes has widened demonstrably. Australia is on track to become the first country to eliminate cervical cancer, perhaps within a decade. Texas, meanwhile, has hardly made a dent in its rate of cervical cancer — which remains one of the highest in the United States, with an incidence comparable to that of some developing countries.
Medical experts in both Texas and Australia say the results underscore the effectiveness of widely available vaccines and cancer screenings.
“From the beginning, I think the [Australian] government successfully positioned the advent of HPV vaccination as a wonderful package that had a beneficial effect for the population,” said Karen Canfell, a cancer epidemiologist with the Cancer Council Australia. “It was celebrated for that reason, and it was a great public health success.”
Local cancer experts say Australia seized a golden opportunity Texas missed out on. “They embraced the vaccine at that time, and our fear kind of began around then,” said Lois Ramondetta, a professor of gynecologic oncology at MD Anderson Cancer Center in Houston. “Really, vaccination in general has just gone down the tube since then.”