The Illinois Opinion Monitor looks at feelings toward mandatory shots for adolescent girls to vaccinate against human papillomavirus (HPV).

URBANA - A survey of Illinoisans indicates some public support for a government program to vaccinate girls against human papillomavirus (HPV), but that support would drop if the shots were mandatory. The Illinois Opinion Monitor survey also found that the majority of a panel of health policy experts would support such a program only if it is voluntary.

Human papillomavirus is a primary cause of cervical cancer that is usually transmitted sexually. The Centers for Disease Control and Prevention recommended in 2006 that 11- and 12-year-old girls receive the vaccine and by the end of last year about half the states, including Illinois, had seen legislation introduced that would mandate HPV vaccine programs in their schools. These efforts were made despite arguments that the clinical studies that led to approval of the vaccine were flawed and that the probability of harmful side-effects was not yet understood.

The governor of Texas issued an executive order last year that would have required vaccination of sixth-grade school girls as of September 2008, but that order was foiled by the overwhelming passage of legislation that bars the state from ordering any vaccinations by 2011. The Illinois Opinion Monitor, which is administered by the University of Illinois Institute of Government and Public Affairs, was conducted before the April legislative action.

In January, the 998 respondents to the Opinion Monitor survey were asked question that referred to the original Texas program. Depending on the answer, a follow-up question was asked that introduced one counter-argument:

Table 1. HPV Questions
Beginning in September 2008, Texas girls ages 11 and 12 will automatically be vaccinated against HPV, a sexually transmitted virus that can cause cervical cancer. Parents who object can file an affidavit to exclude their daughters from vaccination. Should Illinois implement a similar program?

Yes 48.3 %
No 35.6 %
Don't know 16.1 %

If YES: Would your answer change if some doctors argued that it is too early to know if this is an effective vaccine?

Yes 44.4 %
No 37.6 %
Don't know 18.1 %

If NO: Would your answer change if the program were not mandatory (that is, if parents were required to opt in, not opt out)?

Yes 44.9%
No 46.0%
Don't know 9.1%
N=998

The survey did not show majorities locked into either support or opposition, and the results indicated sizeable numbers were willing to change their position when confronted with only one modification or rebuttal. The proportions that changed from Yes to No and vice versa were about the same, but fewer of the initial Yes respondents were certain they would not change away from Yes. If we thus break down our respondents according to the combined questions, we have the following distribution:

Table 2. Overall Breakdown of Respondents

The initial response to the vaccination program is more positive than negative, but there is clear polarization. The 27 percent at the top of the scale either stick with their support or waffle on whether or not doctor doubts could shift their view; only 20 percent dug in their heels in opposition or were not sure they could switch to support if the program were voluntary. With most respondents lying in between, the survey indicates both opponents and proponents of the vaccination programs would have ground to cover if they hope to win the public-opinion battle in Illinois.

Since early 2007, we have been assembling a panel of experts in various policy areas who are willing to answer periodic surveys. Some of those who were chosen for expertise in health policy were asked the following question in the fall of 2007.

The experts surveyed are not a random sample from any identifiable population and, because of the low number in the sample, their responses are merely suggestive of the opinions of some hospital administrators and members of groups with an interest in health care.

The results of the survey suggest that if proponents of the vaccinations are to succeed in imposing a program, they would be wise to make it voluntary, allowing parents to opt-in rather than out. The Opinion Monitor also suggests that any proposal would bring a robust debate on the health merits of the vaccine, and on the philosophy motivating public vaccination against sexually transmitted disease, particularly when administered to young children.