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Requiring Human Papillomavirus Vaccine for Immigrant Women

Hachey, Krista J.1; Allen, Rebecca H. MD, MPH2; Nothnagle, Melissa MD3; Boardman, Lori A. MD, ScM4

doi: 10.1097/AOG.0b013e3181baecaa
Current Commentary

The Centers for Disease Control and Prevention Advisory Committee on Immunization Practices recommends human papillomavirus (HPV) vaccination of 11- to 12-year-old girls, with catch-up vaccination for girls and women aged 13 to 26 years. Although compulsory HPV vaccination is not currently mandated for any U.S. population, immigrant women aged 11–26 years are now required to receive the first injection of the vaccine (the full series consists of three doses) as a result of the 1996 Illegal Immigration Reform and Immigrant Responsibility Act. According to this law, immigrants applying for visas to enter the United States or to adjust their immigration status must receive the inoculations that the Advisory Committee on Immunization Practices recommends for U.S. residents. In the case of HPV, this law represents not only an undue burden on immigrant women, but also raises scientific and ethical questions regarding the benefit of vaccination in this population. Given these issues, immigrant women should not be required to provide documentation of HPV vaccination at the time of visa application or adjustment of immigration status.

Rather than mandating vaccination, the United States should allow immigrant women to make informed consent decisions regarding the human papillomavirus vaccine.

From the 1Warren Alpert Medical School of Brown University, Providence, Rhode Island; 2Department of Obstetrics and Gynecology, Women and Infants’ Hospital, Providence, Rhode Island; 3Department of Family Medicine, Memorial Hospital of Rhode Island, Providence, Rhode Island; and 4University of Central Florida College of Medicine, Orlando, Florida.

Corresponding author: Rebecca H. Allen, MD, MPH, 101 Dudley Street, Providence, RI 02905; e-mail:

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2009 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.