U.S. Department of Veterans Affairs


Date of this Version


Document Type



Journal of Adolescent Health 55 (2014) 659-664


U.S. Government Work


Purpose: To examine the policies state governments pursued and enacted across the United States in the 5-year period after the U.S. Food and Drug Administration licensed the human papillomavirus (HPV) vaccine in 2006, including the timing and number of bills introduced, the policies proposed, and the legislative success of HPV vaccine policy proposals.

Methods: Content abstraction and analysis of state-level HPV vaccine-related bills across the 50 states and the District of Columbia introduced between 2006 and 2010.

Results: All but five states (Alaska, Delaware, Idaho, New Hampshire, and Wyoming) introduced HPV vaccine bills between 2006 and 2010. Two-thirds of all bills were introduced in 2007. In all, 141 bills were introduced and 23% or 32 bills were enacted. Of the bills that were enacted, 43.8% provided information for parents and schools about the vaccine; 37.5% provided public financing for HPV vaccines; 34.4% were classified as other policies; 25% created awareness campaigns; 25% required private insurance coverage of the HPV vaccination; 12.5% included voluntary vaccination, and 9.4% mandated vaccination for school entry. One bill reversed prior mandatory vaccination policies. Overall, 91% of enacted HPV vaccine bills did not refer to mandated vaccinations but adopted alternate policy strategies in response to the availability of the new HPV vaccine.

Conclusions: Nationwide, states responded to the new HPV vaccine by introducing policies designed to increase the availability of information about the vaccine, provide funding, and regulate private insurance coverage rather than require vaccination for school entry.