Democratic Assemblywoman Toni Atkins represents San Diego's 76th district
Cheryl Saenz, MD, a clinical professor in the UC San Diego Department of Reproductive Medicine.
Related Story: Calif. Bill Would Allow Minors To Get HPV Vaccine
CAVANAUGH: This is KPBS Midday Edition. I'm Maureen Cavanaugh. Among the hundreds of bills awaiting governor Jerry Brown's signature or veto is one concerning a national political talking point. AB499, introduced by San Diego assembly woman, Tony at kin, would allow minors to consent to getting the HPV vaccination even without parental approval. During a aren't Republican debate, the HPV vaccine and its side effects got a national airing. Critics say the drug companies are over-selling the vaccine and not being honest about side effects. Joining me to discuss AB499 are my guests, democratic assembly woman Tony Atkins representing San Diego 76th district, and assembly woman Atkins, thank you so much for coming in.
ATKINS: Thank you, Maureen
CAVANAUGH: And doctor Cheryl Sines is a clinical professor at UCSD San Diego department of reproductive medicine. Doctor Sines, welcome
SINES: Thank you, Maureen.
CAVANAUGH: Assembly woman Atkins, can you give me the details of AB499? What would it do?
ATKINS: Basically what it does is close a gab in existing state law that allows minors under the age of 18 to seek diagnosis and treatment of STDs. That's existing law. What my bill, 499 does, would allow these same under age of 18 minors to be able to get access to prevention. And by prevention, we mean access to several things. The vaccine for HPV. And also prove lactic antibiotic use if you have been exposed to HIV or AIDS within the last 72 hours. It closes a gap within law. We don't have the medical advances in technology back then, which is why I'm trying to do this today am
CAVANAUGH: I would suppose the area of controversy outside of the vaccine itself, which is controversial to some people, is that parents may not want their minor children to be able to access this kind of vaccine, to request it, and to be administered an HPV vaccine, and the other preventative medical treatment that you're talking about without getting their permission. What do you say to parents who have reservations about that?
ATKINS: Well, this is the decades-long discussion about issues in which you provide services to young people under the age of 18. What I would say is I wish we lived in a perfect world and I wished that young people would maybe refrain or seek advice from medical professionals and parent approximately figures and relatives before they become sexually active. What we know is that doesn't happen. The and the reason I sponsored this bill is because we see the numbers of young people under the age of 18 with sexually transmitted diseases continuing to increase. While under people under the age of 18 are 25% of the sexually active population at whole, more than half of them are getting sexually transmitted diseases. Soap they're getting gonorrhea, be syphilis, chlamydia, exposure to HIV and AIDS at much higher rates than the general population. And I would say as someone who has coparented, that I want my kid to be safe. And if they're not going to talk to me, I hope they're going to go to a clinic, a physician, a medical practitioner, who will help them be safe.
CAVANAUGH: We have a caller on the line who wants to join the conversation. Sarina is calling from Mission Hills. Sarina, welcome to the program.
NEW SPEAKER: Thank you very much for taking my call. And I am totally against 499 at the very best I'm hoping that the governor will veto on it. At the very least that he have a provision for parents to opt out. Yes, of course, we would all like our children to be safe. But it's not government's business. Any child under the age of 18 cannot get married without parental consent. Any child under the age of 18 cannot joined the armed services without parental consent. This is not the governor's -- the government's business
CAVANAUGH: Sarina, let me get a reaction to your objections to AB499. Assembly woman at skins?
ATKINS: Well, I do understand the emotion behind what she is saying. I again helped raise a young person who's now 25. I think that the issue is public health. Public health and public safety. We know that clinics and medical professionals are required to report any individual that has an STD when they present themselves for treatment. This is a public health issue. And if the largest percentage of people presenting with STDs, which can impact their lives forever and in some cases cause death, I think that is the point in which you discuss whether government gets involved or not from the public health perspective.
CAVANAUGH: Doctor Sines, let me move this conversation to the HPV vaccine, because I think that is one of the most controversial aspects of this legislation if I can put it that way. What diagram does the vaccine prevent?
SINES: There are presently two vaccines on the market. One is called guardisil, and that's produced by America, and the other is server ax, and that's produced by glass co Smith Klein. Guardisil, protects against the viral subtype 6 and 11, which cause most cases of genital warts, and 16 and 18, which cause about 70% of the cervical cancers in this country. Servicer ax, which contains the viral subtypes against 16 and 18 has the same protection against 70% of the cervical cancers in this country. So the hope is that with compliance of vaccination, and right now, the FDA has approved vaccination for the guardisil vaccine, males and females, 9 to 26 years old, the hope is that we could prevent up to 97% of the cervical cancers in this country.
CAVANAUGH: Why do kids who are not sexually active yet need to get a vaccine to stop a sexually transmitted disease?
SINES: This vaccine only works if the patient, male or female, gets the vaccination series prior to exposure to the HPV. So you don't have to necessarily be having sexual intercourse to get HPV. You can have any kind of skin to skin contact with someone that's infected, and that person probe probably has no outward Sines. So the early are we vaccinate, before exposure to HPV, then the better the efficiency of the vaccine. Of
CAVANAUGH: Do we know how effective the HPV vaccines that are on the market now are against either cervical cancer or genital warts or the other kinds of HPV infections that it's supposed to guard against?
SINES: We do. There have been many clinical trials conducted around the world in many different populations. And the protection that's conferred against warts,, the HPV 6 and 11 driven one, would eliminate about 90% of the warts in this country. And it's considered 99 to 100% efficient. With respect to the cervical cancers, where we would eliminate 70% of the cervical dysplasias and cancers, the efficacy of the vaccine series is about 97% before exposure. So incredibly effective
CAVANAUGH: John is calling us from Tierra Santa. Welcome to the program.
NEW SPEAKER: I just wanted to call and disagree with the parent that called earlier. I'm a supporter of this bill. When I was young, I had a good relationship with my parent, but I would have died before I had a conversation with these issues about my parents. And now that I'm a parent, I can easily imagine how this would be a very difficult conversation for one of my kids to have with me. So I think it's good that for all children, but especially children that don't have a good supportive relationship with their parents, have options.
CAVANAUGH: Well, thank you for the call, John. I appreciate it. Jennifer is on the line from normal heights. Hi Jennifer.
NEW SPEAKER: Hi there. I just want to say, I am a supporter of the bill. I have a background, a master's degree in public health. And I just recently suggested to my 19-year-old son that this is something that he wanted to participate in. Be sure that he got that vaccine. So we don't talk about his sex life, but I'm pretty open and know that kids do lots of things that their parents don't know about. And I am -- I found when I heard about the bill, it was like ooh, I'm not sure I want somebody to let my child do something I don't know about. And then I definitely changed my mind on that. And I'm happy that it's open, and I think it's a huge public health issue. So thank you
CAVANAUGH: Lthank you for the call. And thank you for calling, I appreciate TJennifer. Jennifer brings up a subject we don't hear associated with the HPV vaccine very much, and that's boys getting the vaccine. We hear about guarding against cervical cancer. Why would a 19-year-old boy get this vaccine?
SINES: Well, the FDA has approved the guardisil vaccine for boys. At this djustmenture, primary let me for the prevention of warts. But I think it's important to bring up for your listening audience, Maureen, that many other cancers that affect men are actually driven by HPV as well. These include head and neck cancer, oral cancers, rectal cancers. About 70% of that, are HPV driven. So again, we would expect to see a decrease in the frequency of those cancers if people vaccinate
CAVANAUGH: There has been a lot of controversy about how safe this vaccine might be. There are reports there have been deaths associated with the vaccine after young people get it. Some people claim 1 or 2 children have died. Do we have any proof of that?
SINES: Well, whenever a vaccine comes onto the market, the CDC as well as the FDA all keep track in a vaccine registry of adverse events that happen to people after they've received the vaccine. And what they do is they compare the frequency of those adverse events in the vaccine, and the vaccinated people against people that are not vaccinated. Because I'm -- adverse events are going to happen to anybody throughout the course of their life. And there's been no difference in the frequency of these adverse events in the vaccinated population versus the nonvaccinated population. So no, we really don't have any data at all that this vaccine is unsafe other than perhaps an allergic reaction or a sore arm or a low grade fever. Those are associated with the vaccine.
CAVANAUGH: What about the claims that this is -- this is only good -- only effective for about five years? This series of vaccinations? And that women will need to get a booster shot? In that case, why would you vaccinate so young?
SINES: Well, right now, the vaccine has actually been approved in this country since 2006. So we've been vaccinating for about five years. The original clinical trials in the vaccine were conducted up to four years earlier that be we have had the vaccine here in the states. So we have data on women nine years out, four years ahead of the population here in the United States. And those women are constantly being challenged to see if they still respond with their immune response. And there's no doubt at all that we need a booster vaccine. If there does come a time that we would need a booster, we would know that four years ahead of when the U.S. population would first need a booster.
CAVANAUGH: Assembly woman Atkins, part of the controversy, the political controversy surrounding the vaccine that's been given rise to by these GOP debates is the accusation that one of the candidates got a lot of money from the drug maker, Merck, and that's why he legislated that everybody should have the HPV vaccine in his state. Opponents to AB499 have accused you of basing your legislation on Merck's donations to your campaign. How do you respond to that?
ATKINS: Well, it's just not true. I until I saw the ads in the Union Tribune, I didn't know who made girdisil. So I have gotten contributions from a wide range of high-tech biotech companies, but frankly I've gotten less than other candidates who cannot sponsor this legislation. So I think it's sort of a claim to throw out there. I have a background. I used to work in community clinics. I managed three community clinics for more than seven years in the late '80s, early '90s. Specifically related to serving this population. Of this is a bill that I brought forward because I really believe that it's necessary and I think it will help.
CAVANAUGH: We have another caller on the line. Doctor Philip diamond is calling from San Diego. Doctor diamond, hello.
NEW SPEAKER: Thank you for taking my call. I'm representing the American college of obstetricians and gynecologists, and we represent 5,000 OBGYNs across the state. Wee one of the cosponsors of this bill, so obviously we hope that the governor would sign it. Currently, adolescents can consent for the prevention of treatment and pregnancy, but only the treatment of sexually transmitted infections. The advent of guardisil and postexposure prove lactics for HIV disease has enabled us to have prevention opportunities for sexually transmitted infections. Having teens able to come to us so that we can talk to them about this gives us opportunities to talk about things like abstinence, contraception and saver sex. So we hope the governor Sines this bill because we do believe it's a significant public health opportunity to allow teens who are not comfortable talking to their parents to at least talk to healthcare providers and get the confidential services that potentially could save their lives
CAVANAUGH: Doctor diamond, thank you very much for the call. And for your comments. Doctor sines, even some people thattive read who support this vaccine say that they think it's being oversold to the public. Do you agree?
SINES: You know, I don't know exactly what group you're referring to. There are some people who say that cervical cancer is not a public health issue in the United States because there are -- and these are not my words -- only 12,000 cases a year, and only 4,000 women a year die from this disease. As someone who takes care of women with cancer, I think even one woman that dies from cervical cancer if it's preventible is a horrible outcome. Am but I think from a bigger perspective, we need to consider that the vaccine doesn't just prevent cancer, it prevents the dysplasias, the precancers that occur before the cancer diagnosis. And these cancers can actually cause women in their reproductive ages network their thirties and '40s that are trying to have babies, to be able to -- actually to lose their fertility. They can't carry children because they have had so many procedures to remove the affected parts of there of their sevenics, or even hysterectomies. I think it's a much bigger issue when we start talking about a lot of the precancers that would be prevented as well. Because now we're talking about hundreds of thousands of cases every year.
CAVANAUGH: Assembly woman Atkins, the governor recently said that not every social problem needs a law. I wonder if that makes you think he's more or less likely to sign AB499
ATKINS: Well, I think this is a public health issue, not a social, issue, if I differentiate between the two, I'm optimistic that the governor will see the reason that this is important for the public health of Californians. We should be extremely concerned about every single year there have been increases to young people under the age of 18 who are getting gonorrhea, chlamydia, syphilis, HIV, and certainly things that lead to cervical cancer. I couldn't agree more that this is a reason to do this, and I am optimistic that the governor will see that need
CAVANAUGH: When will we know?
ATKINS: Well, we should know by October tenth, ninth or tenth. He had 30 days to go through all of the bills, and as we know, the governor reads every bill. So I think he is doing his due diligence, and I appreciate that, and I'm hopeful for a good outcome.
CAVANAUGH: I've been speaking with assembly woman Atkins, and doctor Cheryl Sines. I want to thank you both.
SINES: Thank you.
ATKINS: Thank you.