senate Bill S7315

Provides for the immunization of all children born after January 1, 1996 against the human papillomavirus (HPV)

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Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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  • 12 / May / 2014
    • REFERRED TO HEALTH

Summary

Provides for the immunization of all children born after January 1, 1996 with the human papillomavirus (HPV).

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Bill Details

Versions:
S7315
Legislative Cycle:
2013-2014
Current Committee:
Senate Health
Law Section:
Public Health Law
Laws Affected:
Amd ยงยง2164 & 613, Pub Health L
Versions Introduced in Previous Legislative Cycles:
2011-2012: A699
2009-2010: A778
2007-2008: A5810

Sponsor Memo

BILL NUMBER:S7315

TITLE OF BILL: An act to amend the public health law, in relation to
requiring immunization against human papillomavirus (HPV)

PURPOSE OR GENERAL IDEA OF BILL:

To ensure that immunization against HPV be administered to children in
New York State in the same manner and according to the same time
schedule that other immunizations are currently administered

SUMMARY OF SPECIFIC PROVISIONS:

Section one amends the section heading and subdivisions 2, 3, 5, and 6
of section 2164 of the public health law, as amended by chapter 169 of
the laws of 2006, subdivision 2 as separately amended by chapter 506
of the laws of 2006, by adding human papillomavirus (HPV) to the list
of required immunizing agents, such as those against poliomyelitis,
mumps and measles, to be administered to children in this state.
Section one also adds the HPV vaccine to the list of vaccines for
which: a booster is required; a person in parental relationship to a
child shall request a vaccine if not previously administered; a health
practitioner who administers such immunizing agents shall give a
certificate of immunization to the person in parental relation to a
child who has been vaccinated; a person in parental relation shall be
notified by a principal, teacher, owner or person in charge of the
school that the school has not received a certificate of immunization
or other acceptable evidence of the child's immunization. A form shall
be provided by the school to a person in parental relationship to a
child not yet vaccinated which allows such person to either state a
valid reason for withholding consent to immunize such child or to give
permission to the school to immunize the child. The law currently
permits a religious exemption to mandated immunizations.

Section two amends paragraph (a) of subdivision 7 of section 2164 of
the public health law, as amended by chapter 189 of the laws of 2006,
by adding HPV to the list of immunizations for which a certificate of
immunization is required by a school in order to allow a child to
attend such school in excess of fourteen days. If a student is
transferring from out-of-state or from another country and can show a
good faith effort to get the certificate or other evidence of
immunization, the time period may be extended to thirty days.

Section three amends the opening paragraph of subdivision 8-a of
section 2164 of the public health law, as amended by chapter 189 of
the laws of 2006, by adding HPV to the list of required immunizing
agents for which a certificate of immunization is required in relation
to preventing a child from attending school.

Section four amends paragraph (a) of subdivision 1 of section 613 of
the public health law, as amended by chapter 36 of the laws of 2010,
by adding HPV to the list of communicable diseases against which the
commissioner of health shall develop and supervise the execution of a
program of immunization, surveillance and testing in order to raise to
the highest reasonable level the immunity of children in the state.

Section five provides the effective date.


JUSTIFICATION:

Cervical cancer is the second-leading cancer among women worldwide,
affecting an estimated 470,000 worldwide resulting in 233,000 deaths
annually. In the United States, the American Cancer Society (ACS)
estimates that approximately 11,150 cases of cervical cancer will be
diagnosed this year and approximately 3,670 women will die from
cervical cancer. The American College of Obstetricians and
Gynecologists estimates that in New York approximately 1,000 women are
newly diagnosed with invasive cervical cancer and approximately 300
women die from the disease.

According to ACS, 99.7% of all cervical cancer cases are linked to
human papillomavirus (HPV). The types of HPV that cause cervical
cancer are sexually transmitted. ACS estimates that at least 80% of
sexually active women in the United States will have HPV by age 50,
with most cases acquired soon after individuals have Sex for the first
time. Guttmacher Policy Review, Fall 2006. While the majority of cases
resolve on their own, for women whose body defenses are not sufficient
to clear the virus, cervical cancer can develop later in life (it can
take up to 20 years for an HPV infection to cause cervical cancer).

A vaccine against the types of linked to most cases of cervical
cancer, Gardasil, was approved last year by the United States Food and
Drug Administration. The Centers of Disease Control and Prevention
(CDC) and its Advisory Committee on Immunization Practices (ACIP)
recommended the routine vaccination of girls 11-12 years of age, but
noted that the vaccine can be given to girls as young as 9 up to age
26. When CDC has recommended the vaccination of school-age children,
New York adds such recommended vaccination to the list of vaccinations
required for school entry.

Gardasil is shown to protect against two types of HPV that cause about
70% of cervical cancers and two other types of HPV that cause 90% of
genital warts. The vaccine is given as a series of three shots over a
period of six months. Another vaccine against HPV, Cervarix, was
approved by the FDA in 2009.

Cervical cancer screening, through Pap tests and other detection
technologies, together with the new vaccine now make cervical cancer
one of the most preventable forms of cancers. Further, vaccination
against HPV has the potential to significantly reduce cervical cancer
incidence and mortality within our underserved populations - poor and
rural communities and black and Hispanic communities, which are
disproportionately affected by cervical cancer. In 2006, ACS estimated
that more than half of the women in the United States diagnosed with
cervical cancer had not had a Pap test in the last three years. These
women are disproportionately low income, black and Hispanic who lacked
access to affordable health services.

The vaccine is most effective when given to individuals before they
are infected with HPV through sexual contact. ACIP therefore
recommends that females should be vaccinated before sexual activity.
To significantly reduce cervical cancer deaths in this country and the
world, it is necessary to achieve near-universal vaccination of girls
and young women prior to sexual activity. The most effective way to
achieve rapid and widespread vaccination, as suggested by the


Guttmacher Institute, is by requiring children to be vaccinated prior
to attending school. School-based immunization will also help to close
racial, ethnic and socioeconomic gaps in immunization rates. Because
many individuals have no health insurance coverage or access to
affordable care, a school vaccination program will facilitate
protecting individuals who are or may potentially become disconnected
from health care services.

By requiring vaccination of girls at an early age, before they have
engaged in sexual activity and before they have left school, we have a
greater chance of preventing cervical cancer. ACS reports that surveys
of teens in the United States show that almost one quarter of them
have had sex by the age of 15 and 7096 have had sex by age 18. And,
according to the Guttmacher Institute, school dropout rates begin to
increase as early as age 13. Middle school may therefore be viewed as
"the last public health gate that an entire age-group of individuals
pass through together-regardless of race, ethnicity or socio-economic
status." Guttmacher Policy Review, Fall 2006. This bill will leave to
the department of health to determine the age at which girls will be
required to be vaccinated in light of ACIP recommendations.

Currently, the cost of the vaccine is covered by Medicaid and Medicaid
managed care plans, Child Health Plus and Family Health Plus. The
federal al Vaccines for Children program covers the vaccination of
eligible girls under age 18.

$1.5 million was included in the governor's budget proposal in 2009 to
promote and expand access to the vaccine for low-income teens and
women. Texas recently became the first state to require vaccination of
school girls ages 11 and 12 against HPV and legislation requiring
vaccination in the schools is currently being considered in 18 other
states and the District of Columbia.

PRIOR LEGISLATIVE HISTORY:

A.699, 2011 and 2012 referred to health.
A.778, 2009 and 2010 referred to health.
A.5810, 2007 and 2008 referred. to health.

FISCAL IMPLICATION:

Minimal to the state, offset by future healthcare costs related to the
treatment of cervical cancer.

EFFECTIVE DATE:

This act shall take effect on the first of September next succeeding
the date on which it shall have become a law; provided, however, that
sections one, two and three of this act shall apply only to children
born on or after January 1, 1996.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  7315

                            I N  S E N A T E

                              May 12, 2014
                               ___________

Introduced  by  Sen. HOYLMAN -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the public health law, in relation to requiring  immuni-
  zation against human papillomavirus (HPV)

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. The section heading and subdivisions  2,  3,  5  and  6  of
section  2164 of the public health law, as amended by chapter 189 of the
laws of 2006 and subdivision 2 as separately amended by chapter  506  of
the laws of 2006, are amended to read as follows:
  Definitions;   immunization  against  poliomyelitis,  mumps,  measles,
diphtheria, rubella, varicella, HUMAN PAPILLOMAVIRUS (HPV),  Haemophilus
influenzae  type  b (Hib), pertussis, tetanus, pneumococcal disease, and
hepatitis B.
  2. a. Every person in parental relation to a child in this state shall
have administered to such child an adequate dose or doses of an immuniz-
ing agent against poliomyelitis, mumps,  measles,  diphtheria,  rubella,
varicella,  HUMAN  PAPILLOMAVIRUS  (HPV),  Haemophilus influenzae type b
(Hib), pertussis, tetanus, pneumococcal disease, and hepatitis B,  which
meets  the standards approved by the United States public health service
for such biological products, and which is approved  by  the  department
under such conditions as may be specified by the public health council.
  b.  Every person in parental relation to a child in this state born on
or after January first, nineteen hundred ninety-four and entering  sixth
grade  or a comparable age level special education program with an unas-
signed grade on or after September first, two thousand seven, shall have
administered to such child a booster immunization containing  diphtheria
and  tetanus  toxoids, [and] an acellular pertussis vaccine, AND A HUMAN
PAPILLOMAVIRUS (HPV) VACCINE, which meets the standards approved by  the
United  States  public  health service for such biological products, and
which is approved by the department under  such  conditions  as  may  be
specified by the public health council.
  3.  The  person  in  parental  relation  to any such child who has not
previously received such immunization  shall  present  the  child  to  a

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD04901-03-4

S. 7315                             2

health  practitioner  and request such health practitioner to administer
the  necessary  immunization  against  poliomyelitis,  mumps,   measles,
diphtheria,  Haemophilus  influenzae  type  b (Hib), rubella, varicella,
HUMAN  PAPILLOMAVIRUS  (HPV),  pertussis, tetanus, pneumococcal disease,
and hepatitis B as provided in subdivision two of this section.
  5. The health  practitioner  who  administers  such  immunizing  agent
against  poliomyelitis, mumps, measles, diphtheria, Haemophilus influen-
zae type  b  (Hib),  rubella,  varicella,  HUMAN  PAPILLOMAVIRUS  (HPV),
pertussis,  tetanus,  pneumococcal  disease, and hepatitis B to any such
child shall give a certificate of such immunization  to  the  person  in
parental relation to such child.
  6.  In  the  event that a person in parental relation to a child makes
application for admission of such child to  a  school  or  has  a  child
attending  school  and  there  exists no certificate or other acceptable
evidence of  the  child's  immunization  against  poliomyelitis,  mumps,
measles,  diphtheria,  rubella,  varicella,  HUMAN PAPILLOMAVIRUS (HPV),
hepatitis B, pertussis,  tetanus,  and,  where  applicable,  Haemophilus
influenzae  type b (Hib) and pneumococcal disease, the principal, teach-
er, owner or person in charge of the school shall inform such person  of
the necessity to have the child immunized, that such immunization may be
administered by any health practitioner, or that the child may be immun-
ized  without charge by the health officer in the county where the child
resides, if such person executes a consent therefor. In the  event  that
such  person does not wish to select a health practitioner to administer
the immunization, he or she shall be provided with a  form  which  shall
give  notice  that  as  a prerequisite to processing the application for
admission to, or for continued attendance at,  the  school  such  person
shall  state  a valid reason for withholding consent or consent shall be
given for immunization to be administered by a  health  officer  in  the
public employ, or by a school physician or nurse. The form shall provide
for  the  execution  of a consent by such person and it shall also state
that such person need not execute such consent if subdivision  eight  or
nine of this section apply to such child.
  S  2.  Paragraph  (a)  of  subdivision 7 of section 2164 of the public
health law, as amended by chapter 189 of the laws of 2006, is amended to
read as follows:
  (a) No principal, teacher, owner or person in charge of a school shall
permit any child to be admitted  to  such  school,  or  to  attend  such
school, in excess of fourteen days, without the certificate provided for
in subdivision five of this section or some other acceptable evidence of
the child's immunization against poliomyelitis, mumps, measles, diphthe-
ria,  rubella,  varicella,  HUMAN  PAPILLOMAVIRUS  (HPV),  hepatitis  B,
pertussis, tetanus, and, where applicable, Haemophilus influenzae type b
(Hib) and pneumococcal disease; provided,  however,  such  fourteen  day
period  may  be  extended to not more than thirty days for an individual
student by the appropriate principal, teacher, owner or other person  in
charge  where  such  student  is  transferring from out-of-state or from
another country and can show a good faith effort to  get  the  necessary
certification or other evidence of immunization.
  S  3.  The opening paragraph of subdivision 8-a of section 2164 of the
public health law, as amended by chapter 189 of the  laws  of  2006,  is
amended to read as follows:
  Whenever  a  child has been refused admission to, or continued attend-
ance at, a school as provided for in subdivision seven of  this  section
because  there exists no certificate provided for in subdivision five of
this section or other acceptable evidence of  the  child's  immunization

S. 7315                             3

against  poliomyelitis,  mumps, measles, diphtheria, rubella, varicella,
HUMAN PAPILLOMAVIRUS (HPV), hepatitis B, pertussis, tetanus, and,  where
applicable,   Haemophilus  influenzae  type  b  (Hib)  and  pneumococcal
disease, the principal, teacher, owner or person in charge of the school
shall:
  S  4.  Paragraph  (a)  of  subdivision  1 of section 613 of the public
health law, as amended by section 24 of part E of chapter 56 of the laws
of 2013, is amended to read as follows:
  (a) The commissioner shall develop and supervise the  execution  of  a
program of immunization, surveillance and testing, to raise to the high-
est  reasonable  level the immunity of the children of the state against
communicable diseases including, but not limited to, influenza,  poliom-
yelitis,  measles,  mumps, rubella, haemophilus influenzae type b (Hib),
diphtheria, pertussis, tetanus, varicella, HUMAN  PAPILLOMAVIRUS  (HPV),
hepatitis  B,  pneumococcal  disease,  and the immunity of adults of the
state against diseases identified by the commissioner, including but not
limited to influenza, smallpox, hepatitis and such other diseases as the
commissioner may designate through regulation.   Municipalities  in  the
state shall maintain local programs of immunization to raise the immuni-
ty  of  the  children  and  adults  of  each municipality to the highest
reasonable level, in  accordance  with  an  application  for  state  aid
submitted  by  the  municipality  and approved by the commissioner. Such
programs shall include assurance of provision  of  vaccine,  serological
testing  of  individuals  and  educational efforts to inform health care
providers and target populations or their parents, if they  are  minors,
of  the  facts  relative  to these diseases and immunizations to prevent
their occurrence.
  S 5. This act shall  take  effect  on  the  first  of  September  next
succeeding  the  date  on  which  it  shall have become a law; provided,
however, that sections one, two and three of this act shall  apply  only
to children born on or after January 1, 1996.

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