October 7, 2008

Gardasil Vaccine Requirement for Immigrants Causes Controversy

In order to obtain lawful permanent resident status, the U.S. Citizenship & Immigration Services (USCIS) requires foreign nationals to undergo a medical examination and submit a medical certificate completed by an authorized physician, which confirms that they have all age-specific vaccinations and that they do not have any communicable diseases. The list of required vaccinations, based on recommendations made by the Centers for Disease Control (CDC), is designed to prevent the transmission of highly infectious diseases.

On February 2, 2008, the CDC recommended that Gardasil, the vaccine that helps prevent four types of human papillomarvirus (HPV), including two believed to cause 70 percent of all cervical cancer cases, be given to females ages 11 to 26 in the United States. Unlike the 13 other diseases for which the USCIS requires vaccinations, HPV is the only sexually transmitted disease. Although the CDC Advisory Committee for Immunization Practices has stated that it never meant for the vaccine to become mandatory for young female immigrants, the USCIS made the vaccine a requirement when it published its updated list of vaccine requirements in July 2008.

The HPV vaccine requirement has caused controversy for a number of reasons. First, the vaccination, which is administered in a three-dose regimen over a six month period, is one of the most expensive vaccines on the market, costing approximately $360. Second, the medical community has not come to a consensus on the efficacy or safety of the vaccine as published studies have reported that the vaccine is not cost-effective for older females who may have already been exposed to HPV prior to receiving the vaccinations; women who receive the vaccination must continue to have annual Pap screenings as they could contract a form of HPV not prevented by the vaccine; and adverse effects, such as seizures and pain, have been reported.

A number of complaints have been filed with the USCIS about the vaccine and some young women are requesting a waiver from the vaccination requirement on religious or moral grounds. GT will continue to monitor the situation and will provide any changes or updates that they become available.