Archives for November 2016

Minor Consent for Human Papillomavirus Vaccination

Nina Suresh, MD

Nina Suresh, MD

“Minor Consent for Human Papillomavirus Vaccination”

(The local AAP Chapter is heavily involved with advocacy efforts in Albany, over the past several years, our voice has been critical in expanding paid family leave, ensuring parents are offered Tetanus, Diphtheria and Acellular Pertussis vaccine, and combating exemptions to vaccination prior to school entry [to name a few].  This month’s blog post outlines the case for supporting a proposal to allow minors to consent for Human Papilloma Virus Vaccination.  Last year, the bill was referenced as “New York State Bill S.2712/A.1528,” and though it did not pass, it is expected to be re-introduced when the legislature convenes next January).

by Nina Suresh, MD

This year alone, almost 300 women in New York State will die from cervical cancer (1).  On average, 2,400 New York State residents are diagnosed with cancers associated with human papillomavirus (HPV) each year[1]. Virtually every single sexually active person will become infected with the virus at some point during his or her lifetime, and HPV causes almost all cases of cervical cancer, over 80% of anal cancers, and over 50% of vaginal, penile, and oropharyngeal cancers (2).

Fortunately, acquisition of the most virulent strains of HPV can be prevented with the HPV vaccine, recommended by the CDC for both boys and girls ages 9 to 26 years.

As pediatricians in New York City, we frequently see young patients who are delayed in receiving the HPV vaccine because they cannot legally consent for vaccination. We treat teenagers for sexually transmitted infections each day in our clinics. Current New York State legislation allows qualified health care professionals to provide treatment for sexually transmitted infections to minors without parental knowledge or consent. However, these same minors do not have the right, under interpretation of our current legislation, to consent for HPV vaccination, an unfortunate missed opportunity to provide them protection from both sexually transmitted infection and certain cancers.  This is particularly dangerous since the vaccine is most effective when given to children as young as 9 years old, prior to the onset of sexual activity.

Bill S.2712/A.1528, introduced by New York State Representative Amy Paulin and Senator Liz Krueger will expand a health care professionals’ scope of practice beyond treatment for sexually transmitted infection to preventative care as well, including the administration of HPV vaccine to minors with their consent alone.

HPV vaccine is effective.  In 2013, the Centers for Disease Control (CDC) showed that that since the vaccine was introduced in 2006, rates of HPV have decreased 56 percent among female teenagers 14-19 years of age.  But vaccination rates are still low.  The U.S. rates of HPV vaccination in teenage girls are lower than vaccination rates in Rwanda.  The CDC estimates that 50,000 lives could be saved if HPV immunization rates reached 80%.  Allowing minors to consent for vaccination, in the same way they consent for treatment of sexually transmitted infections, will help increase vaccination rates and provide pediatricians a teachable moment in sexual health and prevention.

As pediatricians, we strive to protect the health and welfare of our patients through effective counseling and anticipatory guidance, as well as effective preventive measures and treatment. Without all of these aspects of care, we miss significant opportunities to protect our patients. For these reasons, I support Bill S.2712/A.1528 to enable us to provide not only treatment for minors, but also safe and effective preventive care that will protect them against this deadly, cancer-causing virus.

(Nina Suresh, MD is a resident in pediatrics at NewYork-Presbyterian/ Weill Cornell Medical Center.)


  2. National Cancer Institute at the National Institutes of Health, “HPV and Cancer,” March 2012,