WASHINGTON, June 9 (UPI) -- This week the Food and Drug Administration approved a vaccine to prevent cervical cancer in women. In an odd way, the announcement highlights what may be wrong with government policy on another vaccination, the very first one children receive.
The FDA's approval of Gardasil is intended to block human papillomavirus, or HPV, the most common sexually transmitted disease and one that causes almost all cases of cervical cancer. The agency approved the vaccine for girls beginning at age 9 to protect them before they become sexually active.
Some cultural conservatives oppose making the shots mandatory for public-school attendance because of what they fear is an implicit endorsement of pre-marital sex. That's an issue an advisory committee of the Centers for Disease Control and Prevention -- and ultimately, each of the 50 states -- will have to grapple with.
Regardless, the decision to wait till the cusp of adolescence to give the shot seems sensible -- and drives home the contrary approach that the CDC has taken with the hepatitis B vaccination mandated for every newborn child.
To listen to some public-health officials, you'd think the nation was in the grip of an incipient Hep B epidemic lurking in the nation's hygienically challenged daycare centers -- an epidemic contained solely by vaccination on the day of birth.
In fact, hepatitis B is overwhelmingly a disease of sexual contact and intravenous, illegal drug use. Except in cases where the mother tests positive for Hep B, the risk to children vs. the risk of such an early vaccination seems questionable in the eyes of many critics of CDC immunization policy.
Over the course of the past year, as I've reported on concerns that vaccines may be linked to a huge increase in autism diagnoses beginning in the 1990s, the hepatitis B vaccination at birth stood out; the vaccination was first recommended in 1991.
At least two doctors tell me their faith in the government's entire childhood immunization schedule was shattered by the CDC's insistence that every newborn needs a Hep B shot as an urgent matter of public health.
"It is universally accepted that such mandate was forced upon our children only because they were 'available,' while efforts to vaccinate high-risk adults had repeatedly failed," Dr. F. Edward Yazbak testified in 2001 before the Massachusetts House of Representatives.
"The continued mandate of this vaccine with all its problems may result in parents losing faith in vaccine programs in general, and opposing all vaccinations, many of which we know are necessary and effective," he said.
The National Vaccine Information Center, which supports parental choice and awareness of immunization hazards, raises similar issues. "Unlike other infectious diseases for which vaccines have been developed and mandated in the U.S., hepatitis B is not common in childhood and is not highly contagious," the NVIC says.
"Hepatitis B is primarily an adult disease transmitted through infected body fluids, most frequently infected blood, and is prevalent in high risk populations such as needle using drug addicts; sexually promiscuous heterosexual and homosexual adults; residents and staff of custodial institutions such as prisons; health care workers exposed to blood; persons who require repeated blood transfusions and babies born to infected mothers."
Dr. Mayer Eisenstein, medical director of the family-practice Homefirst Medical Services in Chicago, told the Illinois Legislature in 1997 that mandating Hep B for newborns was absurd.
"The idea of giving this vaccine to a one-day old baby, a newborn, is preposterous. There is no scientific evidence for this. In fact, I called up the manufacturer and I had (a representative) come to St. Mary of Nazareth Hospital, where I am Chairman of the Department of Medicine, and I asked him: 'Show me your evidence on one-day old infants as to side effects (from the hepatitis B vaccine)' -- we have none. Our studies were done on 5 and 10 year olds.
"As a father, grandfather, a physician, as a lawyer, I want the option of not giving it to my children unless I believe the scientific evidence is there."
Yet waiting until genuine risk looms -- via sexual activity, intravenous drug use or a healthcare job -- has been rejected out of hand. That view was confirmed earlier this year by both the CDC and the American Academy of Pediatrics, whose members administer the vaccines.
"The Academy has endorsed CDC recommendation for hepatitis B vaccine, 'A Comprehensive Immunization Strategy to Eliminate Transmission of Hepatitis B Virus Infection in the United States,'" the AAP said in a news release.
"The CDC recommends that all newborns receive a birth dose of hepatitis B vaccine before leaving the hospital unless a physician provides a written order to defer the birth dose."
Compare that to waiting till age 9 for the new Gardasil vaccine. While the reasonable concerns of some parents are yet to be resolved, this already stands in stark contrast to the public health establishment's hepatitis B hammerlock on the nation's newborns.
True, the mercury-based preservative thimerosal that some believe is behind the rise in autism has been removed from Hep B and other routine childhood vaccines. But the issue of whether children are getting an unnecessarily early and heavy load of vaccines -- and whether that could explain the rise in autism or chronic illnesses like asthma -- remains squarely on the table, at least to this observer.
In years to come, I suspect, the Hep B shot at birth may be regarded as a case study in doctors gone wild.