Hawaii will require sixth-graders to get the HPV vaccine and other immunizations before the start of the next school year, health officials said.
More than 13,200 sixth-grade students in public schools, including charters, will be affected by the new rule, the Honolulu Star-Advertiser reported Thursday.
Parents risk the exclusion of their children from middle school enrollment without the immunizations, officials said.
Parents will need to provide proof a child received one dose each of the tetanus, diphtheria, whooping cough and meningococcal conjugate vaccines, officials said.
Students also will need proof of two doses, given six months apart, of the vaccine against HPV, a common sexually transmitted disease that can cause cervical and other types of cancer, officials said.
The requirement does not apply to children in higher grades.
Beginning July 1, however, the state will require additional immunizations for students entering child care, preschool, kindergarten, seventh grade and postsecondary schools, officials said.
HPV infects nearly 80 million Americans, and health officials project more than 41,000 cases of new diagnoses of HPV-related cancers annually.
A 2018 study by the University of Hawaii's Office of Public Health Studies found only 35% of girls and 19% of boys had received the recommended HPV vaccine shots. Some parents are concerned that the vaccine could contribute to promiscuity, the study authors said.
"Like in anything brand new, there's always going to be pushback," said Ronald Balajadia of the Hawaii Department of Health's immunization branch. "The issue more than anything else is that we're talking about disease and we're talking about trying to prevent cancer."