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January 18, 2012

Mandatory HPV Vaccination—Reply

Author Affiliations

Letters Section Editor: Jody W. Zylke, MD, Senior Editor.

Author Affiliations: O’Neill Institute for National and Global Health Law, Georgetown University Law Center, Washington, DC (gostin@law.georgetown.edu).

JAMA. 2012;307(3):252-255. doi:10.1001/jama.2011.2021

In Reply: This collection of 3 letters in response to my Commentary vividly demonstrates the political and social divisiveness of HPV vaccination, which sets it apart from most childhood immunizations. Each letter is thoughtful, and yet all 3 letters come to distinctly different policy conclusions. Drs Gilkey and Brewer find that health system factors such as cost and enhanced access are more effective than mandates; Dr Berger and colleagues urge immediate state adoption of HPV mandates with limited opt-outs; and Drs Tomljenovic and Shaw reject HPV mandates as a flawed policy. Each letter expresses strong agreement with my view, “Above all, health policy must be driven by science,” and yet each draws different conclusions based on the available scientific evidence. How is this possible?