title: Early policy responses to the human papillomavirus vaccine in the United States, 2006-2010.
abstract: OBJECTIVE
  To examine the policies state governments pursued and enacted across the United States in the 5-year period after the U.S. Food and Drug Administration licensed the human papillomavirus (HPV) vaccine in 2006, including the timing and number of bills introduced, the policies proposed, and the legislative success of HPV vaccine policy proposals.
  
  
  METHODS
  Content abstraction and analysis of state-level HPV vaccine-related bills across the 50 states and the District of Columbia introduced between 2006 and 2010.
  
  
  RESULTS
  All but five states (Alaska, Delaware, Idaho, New Hampshire, and Wyoming) introduced HPV vaccine bills between 2006 and 2010. Two-thirds of all bills were introduced in 2007. In all, 141 bills were introduced and 23% or 32 bills were enacted. Of the bills that were enacted, 43.8% provided information for parents and schools about the vaccine; 37.5% provided public financing for HPV vaccines; 34.4% were classified as other policies; 25% created awareness campaigns; 25% required private insurance coverage of the HPV vaccination; 12.5% included voluntary vaccination, and 9.4% mandated vaccination for school entry. One bill reversed prior mandatory vaccination policies. Overall, 91% of enacted HPV vaccine bills did not refer to mandated vaccinations but adopted alternate policy strategies in response to the availability of the new HPV vaccine.
  
  
  CONCLUSIONS
  Nationwide, states responded to the new HPV vaccine by introducing policies designed to increase the availability of information about the vaccine, provide funding, and regulate private insurance coverage rather than require vaccination for school entry.
authors.affiliation: Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, New York. Electronic address: ml3111@columbia.edu.
authors.forename: Miriam J
authors.initials: MJ
authors.lastname: Laugesen
authors.affiliation: Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan.
authors.forename: Ritesh
authors.initials: R
authors.lastname: Mistry
authors.affiliation: National Center for Organization Development, Veterans Health Administration, Cincinnati, Ohio.
authors.forename: Kelley A
authors.initials: KA
authors.lastname: Carameli
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Kurt M
authors.initials: KM
authors.lastname: Ribisl
authors.affiliation: Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California.
authors.forename: Jack
authors.initials: J
authors.lastname: Needleman
authors.affiliation: Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California.
authors.forename: Roshan
authors.initials: R
authors.lastname: Bastani
mesh_terms: D000293:Adolescent; D005260:Female; D006284:Health Plan Implementation / Q000458:organization & administration; D006291:Health Policy; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D006801:Humans; D017589:Immunization Programs / Q000331:legislation & jurisprudence*; D008297:Male; D030361:Papillomavirus Infections / Q000517:prevention & control*; D053918:Papillomavirus Vaccines; D012189:Retrospective Studies; D015229:Sexually Transmitted Diseases, Viral / Q000517:prevention & control; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000331:legislation & jurisprudence*
chemical_list: D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D053918:Papillomavirus Vaccines
keywords: Adolescent health; Anal cancer; Cervical cancer; Child health; Genital warts; Health policy; Human papillomavirus (HPV); Human papillomavirus vaccine; Sexually transmitted diseases; Vaccines