HPV VACCINE

Senate Bills 1416 & 1417 (Substitutes H-1)

Sponsor:  Sen. Bev Hammerstrom

House Committee:  Health Policy

Senate Committee:  Health Policy

Complete to 11-13-06

A SUMMARY OF SENATE BILLS 1416 AND 1417 (PROPOSED SUBSTITUTES H-1)

Senate Bill 1416 would amend the Public Health Code to 1) require a child entering the sixth grade to have been immunized with the human papillomavirus (HPV) vaccine or present a statement of exemption; 2) require the consent of a parent or guardian before a child received the HPV vaccine; 3) require a review of the list of childhood immunizations required for school entry or registration to a preschool to determine if additional vaccinations should be added or current ones removed; and, 4) require changes to the list be reported to the Legislature. 

Senate Bill 1417 would amend the Revised School Code to require the physician statement regarding the immunizations a child had received to include the HPV vaccine.  A more detailed description follows.

Senate Bill 1416

The bill would add a new section to, and amend other sections of, the Public Health Code (MCL 9205b et al.).  The bill would require the Department of Community Health to consult with the Michigan Advisory Committee on Immunizations on all of the following:

·                    A review of the list of childhood immunizations required for school entry or registration to a preschool program of group residence or care to determine if the list should be revised to include additional vaccinations that have been approved by the federal Food and Drug Administration or if vaccinations should be removed.

·                    Identifying and disseminating materials containing information regarding the risks associated with diseases for which immunizations are recommended and the availability, effectiveness, and potential risks of the vaccinations to protect against those diseases.

The department would have to report to the legislative standing committees on health issues, on or before March 1 of each year, any changes that had been made or were being considered to the list of childhood immunizations and any materials that had been identified or disseminated under the bill's provisions during the previous year.  The department would also have to notify members of those legislative standing committees of the day and time that meetings of the Michigan Advisory Committee on Immunizations would be held to discuss items required under the above provisions.  The notifications would have to be made in advance so that members could attend if they so wished.

Currently, a health care provider administering an immunizing agent to a child must present the person accompanying the child with a written certificate of immunization, or make an entry of the immunization on a certificate in the person's possession.  The certificate has to indicate the diseases or infections for which the child has been immunized, the number of doses given, the dates when administered, and whether further immunizations are indicated. The bill would require, beginning with the 2008-2009 school year, the department to include the human papillomavirus (HPV) vaccine in the certificate.

The bill would also require a health care provider, before administering an immunizing agent to a child, to provide the parent, guardian, or person in loco parentis of the child with the most recent vaccine information statement and obtain the consent of the parent, guardian, or person in loco parentis of the child to administer the HPV vaccine.

Furthermore, a parent, guardian, or person in loco parentis of a child entering the sixth grade would have to present to school officials, at the time of registration or not later than the first day of school, a certificate of immunization that beginning with the 2008-2009 school year included the HPV vaccine or statement of exemption under Section 9215. 

Lastly, the code requires the department to promulgate rules to implement the expansion of the Childhood Immunization Registry to include the reporting and recording of additional information such as lead screening performed on children.  The bill would add to this the administration of the HPV virus.

(Section 9215 specifies that a child is exempt from the required immunizations if a physician certifies that a specific immunization would be or could be detrimental to the child's health or if a parent or guardian objects in writing based on religious convictions or other objection to immunization.)

Senate Bill 1417

The bill would amend the Revised School Code (MCL 380.1177).  Currently, before a child enrolls in a public or nonpublic school for the first time or enrolls in grade 6 for the first time, the code requires a signed statement from a physician that the child had been tested for and immunized or protected against diseases specified by the director of the Department of Community Health, a signed statement by the parent or guardian to the effect that the child was not immunized due to religious or other objections to immunizations, or a signed statement from a physician that the child is in the process of complying with all immunization requirements.

The bill would add that beginning with the 2008-2009 school year, the physician statement regarding the immunizations a child had received would have to include the HPV vaccine.

The bill is tie-barred to Senate Bill 1416.

FISCAL IMPACT:

Senate Bill 1416 (H-1) may have fiscal implications for the Department of Community Health and for immunization services funded by the state.  The bill increases responsibilities of the Department regarding the list of required vaccinations for school children, information materials regarding vaccinations, and notifications and an annual report to the Legislature.  This may increase staffing needs if these functions cannot be performed with existing personnel and resources.

The cost of the vaccine is $360 for a full series of 3 vaccines per person.  For insured children, this cost is likely to be covered in most cases due to recent approval as a recommended vaccine by the Centers for Disease Control.  A November 1, 2006 news release by the manufacturer of this new vaccine states that the federal Vaccines For Children (VFC) Program has added this vaccine to its contract which provides free vaccines to providers for uninsured, underinsured, and Medicaid-eligible children.  There may be state costs related to the bill for immunizations supported by state funds, including children of state employees, and other children eligible to receive free or reduced-cost vaccinations under DCH immunization programs, but not under the VFC program.

Over the long term, the use of the vaccine will reduce state and other public and private sector health care costs for cervical cancer cases as the number of cases declines.  In 2003, 399 new cases of cervical cancer were diagnosed in Michigan.  Deaths from cervical cancer in 2003 were recorded at 104.

Senate Bill 1417 (H-1) would have no fiscal impact on state or local government.

                                                                                           Legislative Analyst:   Susan Stutzky

                                                                                                  Fiscal Analyst:   Susan Frey

                                                                                                                           Bethany Wicksall

This analysis was prepared by nonpartisan House staff for use by House members in their deliberations, and does not constitute an official statement of legislative intent.