Some states and the federal Centers for Disease Control and Prevention are advocating that young girls be vaccinated against a cancer-causing virus, but North Dakota is not contemplating a mandate, health officials say.

"I really don't know that I see that we would mandate it, but I think that we would probably readily encourage it," said Valerie Fischer, director of school health for the state Department of Public Instruction. "If it can be a cure for cervical cancer, I think we would be remiss if we didn't encourage it."

Last week, Gov. John Hoeven signed legislation that gives the state Health Department $50,000 for public education about the human papilloma virus, which causes cervical cancer, and the vaccine Gardasil, which Merck & Co. began selling last June.

It is the first vaccine to prevent cervical cancer, which afflicts about 20 North Dakota women and leads to about eight deaths each year, Health Department statistics say. It is given in three doses over six months, and costs about $360.

The human papilloma virus is a sexually transmitted disease. Last month, a CDC immunization advisory committee recommended the vaccine for females ages 13 to 26. It said girls should begin getting vaccinated at 11.

Merck recently suspended a controversial lobbying campaign, aimed at coaxing state legislatures to require 11- and 12-year-old girls to get the vaccine as a requirement for school attendance.

The pharmaceutical company channeled money for the campaign through Women in Government, an advocacy group of female state lawmakers around the nation.

Rep. Mary Ekstrom, D-Fargo, the sponsor of the North Dakota legislation, is a member of Women in Government. She said the $50,000 Health Department grant is not intended to promote a vaccine mandate, but to "educate parents of girls between 9 and 12 about the efficacy of the vaccine that is now available … Get it into their minds that we can wipe out cervical cancer in their lifetimes."

Fisher said the legislation may prompt debate on a vaccine mandate anyway.

"What role, if any, do we have in saying this should or should not be part of the state (school vaccination) requirement?" she said. "I think that is an issue that will come up."

Shari Orser, an obstetrician/gynecologist at the Medcenter One Women's Medical Center in Bismarck, said she believes it is too soon to discuss requiring girls to be vaccinated against the virus. "I think we should … wait and see how widespread voluntary immunization is," she said.

Questions about the vaccine are common among her patients, Orser said. "We have started speaking to all of our patients at the appropriate age about the availability of the vaccine," she said. "We've vaccinated a lot of people already."

Elizabeth Burns, a professor at the University of North Dakota's medical school, said the vaccine mandate issue is likely to arise in North Dakota, though she said mandates don't always work. Recent outbreaks of whooping cough are proof of that, she said.

"I think the one advantage to making things mandated is that it may help insurance companies decide whether they're going to cover it," Burns said.

Larry Gauper, a spokesman for Blue Cross Blue Shield of North Dakota, the state's largest medical insurer, said Blue Cross covers the cost of the vaccine for women up through age 26, minus any co-payment or deductible under a woman's insurance plan.

Efforts in other states to require the vaccine have prompted criticism that mandatory vaccination may encourage premarital sex, by lessening fears of getting the HPV. Orser and Burns said the fact that the virus is sexually transmitted should not be the focus of the vaccine debate.

"We really talk about the immunization as protection against cervical cancer, not protection against a sexually transmitted disease," Orser said.

Said Burns: "I think the decision to become sexually active depends on a lot more than just a vaccine."

Tom Freier, a spokesman for the North Dakota Family Alliance, said the legislation was not a high priority for his group, but that officials will review it after the session ends.

Christopher Dodson, director of the North Dakota Catholic Conference, said he "appreciated that it wasn't a proposal like we've seen in other states."

"This is simply an education bill," Dodson said. "We think that's the correct approach … in North Dakota."

Kirby Kruger, a Health Department disease specialist, said the agency will promote the vaccine because of the potential reduction in cervical cancer cases. He does not see the bill as a step toward mandating Gardasil for school-age girls.

"The bottom line in North Dakota is that parents have the final say on what vaccines their children get," he said.

Health officials have not yet determined how the educational effort called for in the legislation will be carried out. Getting schools involved is only a possibility, Kruger said.

However, Ekstrom said schools will be a primary focus, and Fischer said the Department of Public Instruction will work with the Health Department to write an implementation plan. Information could be distributed through health education classes or counselors, she said.

The bill is HB1471.