Compulsory vaccination has a legitimate place in our health care system. But why should the government restrict its vaccinations to the victims? Why not include the carriers?

To the Editor:

I was surprised to see how quickly you expressed support of the proposed mandatory HPV vaccination policy in Texas, stating that the Merck vaccine is “highly effective” (editorial, Feb. 6).

The vaccine has not been proved to reduce cervical cancer. It is moderately effective at preventing certain pre-cancerous changes. There is no long-term safety or effectiveness data.

Most deaths from cervical cancer in this country are in women who are not adequately screened (with a simple Pap smear). In Texas, underscreening in African-American and Hispanic women probably accounts for their disproportionately high rates of cervical cancer.

These adult women need access and coverage for screening. Unfortunately, there is no lobby for the Pap smear.

Deborah Kamali, M.D.
San Francisco, Feb. 6, 2007
The writer is an associate professor of obstetrics, gynecology and reproductive sciences at the University of California at San Francisco.

Requiring a Vaccine for Young Girls