In recognition of Cervical Cancer Awareness Month, Dr. Lara Zibners* has contributed this guest post on the importance of HPV vaccination for both girls and boys.
Last year I went on a cycling weekend out in California with four other women, all of us doctors. We were there to celebrate my dear friend’s recovery from breast cancer. Of course there was the usual debauchery– feather boas included– that takes place when 5 middle-aged women have left their husbands in charge of the children. But there was still a sense of sobriety, knowing why we were all there and wishing that “chemo” and “reconstructive surgery” weren’t the frequent topics of conversation that they were. And with cancer on our minds, this group of five female physicians soon found ourselves talking about—what else?—genital warts.
The OB-Gyn in the group waxed poetically about how excited she was to immunize her patients against HPV—the human papillomavirus. It’s long been known that HPV is responsible for nearly all cases of cervical cancer in women. HPV is a nasty little virus that spreads from skin-to-skin, person-to-person. Often this occurs during sexual contact but can also be passed from mother to child. Many people infected with HPV don’t even realize it, meaning they continue to pass the infection to others. Hence the some 6 million people infected every year with HPV. And while HPV causes unsightly genital warts, that’s not what bothers physicians about it. What bothers us is that HPV causes cancer. And cancer, to put it bluntly, sucks.
Good news is there’s a vaccine that can protect us from the most common strains of HPV that cause cancer. It is currently recommended that girls between the ages of 11 and 12 receive 3 doses of the vaccine. As of 2011, this was extended to include the routine vaccination of boys. Naturally this caused a stir, since HPV is usually blamed for causing cervical cancer. And a boy isn’t supposed to have a cervix. So what was this? An act of chivalry? A sort of “holding the door” open so cancer wouldn’t whack a girl in the head? Read more…
This morning I was reminded of the importance of human papillomavirus vaccination after reading an article that appeared yesterday in Ob.Gyn. News. As the parent of five daughters, and the friend of several people who have had various health complications as a result of HPV, I’m disappointed that there is a safe and effective vaccine that is currently underutilized at this point in time. Data released as part of the CDC’s National and State Vaccination Coverage Among Adolescents Aged 13–17 Years revealed that only 23% of 13-year-old girls in the U.S. had completed the recommended three-dose HPV series. Additionally, as of 2011, only about 35% of all 13-17 year-old girls had completed the series.
If you are a parent that has yet to begin your child on the 3 dose HPV vaccination series, you may want to consider these tidbits of information that were included in the Ob.Gyn. News article:
- Three-quarters of the general population become infected with HPV, and three-quarters of those infections occur at 15-24 years of age.
- More than 50% of those who become infected with HPV do so within 2 years after becoming sexually active.
- Studies show that more than 20% of males and females have already had vaginal sex by age 15.
- One-third of all HPV-related cancers occur in men which is why the CDC recommended vaccination for 11-12 year old boys, as well as 11-12 year old girls.
- Protecting boys will secondarily increase protection against cervical cancer in girls.
The article also discusses how vaccination can reduce the cost burden of this disease and references other interesting considerations regarding HPV and the vaccine to prevent it. But what I found most interesting were the statistics that have come out of Australia, the first country to fund a HPV vaccination program for all females aged 12-26 years.
After the first two years of the Australian program, which began in July of 2007, a national surveillance program had identified a 59% reduction in new diagnoses of genital warts among women in Australia. There was also a 39% drop in new cases among heterosexual Australian males aged 12-26. Even though they weren’t included in the vaccine program, the rate drop among men seems to suggest evidence of herd immunity, especially since they can be compared among the unchanged rates among men who have sex with other men. In a subsequent report with updated data through mid-2011, Australian investigators credited ”the dramatic decline and near disappearance” of genital warts in women and heterosexual men under age 21 year, to be a result of the national HPV vaccination program that had been initiated just four years prior.
This is just one example of what can be accomplished here in the United States if we work to improve HPV vaccination rates. There are obviously some challenges we face, but when I think of my friend and fellow Shot@Life immunization champion, I’m committed to finding a way to educate parents and encourage vaccination. Here is her story and her message to parents everywhere.
What do you feel are the biggest challenges we face in improving HPV vaccination rates?
A new study published in Pediatrics is getting a lot of media attention today. CBS News, HealthDay News, The Inquisitr and Examinir.com, are among the many news outlets that have been reporting about the human papillomavirus (HPV) vaccine.
The results of the study show that the HPV vaccine has been effective at reducing the number of infections that people are getting, while also protecting those people who haven’t been vaccinated. The study abstract concludes that
The abstract specifically states that
“the prevalence rate for vaccine-type HPV decreased substantially from 31.7%–13.4% and the decrease in vaccine-type HPV not only occurred among vaccinated (31.8%–9.9%) but also among the unvaccinated (30.2%–15.4%)”.
Since vaccine critics often question the validity of “herd immunity”, it’s encouraging that this study was able to illustrate the reduction of disease, not only in the vaccinated population, but also among the unvaccinated. The simple suggestion is that if we can protect a critical portion of the community from ever contracting these particular strains of HPV covered by the vaccine, than we can effectively reduce the overall transmission of these viruses and reduce the incidence of infection even among those who remain unvaccinated. This is especially good news since the vaccine has had less than optimal uptake since it was first recommended to pre-teen girls several years ago.
In reading various immunization related news this week, I was surprised to find at least a dozen or more articles still focusing on the political aspects of the HPV vaccine.
This time, rather than focusing on Michele Bachmann’s careless disregard for the vaccine, several articles were focusing on what may have been a significant motivator for Rick Perry’s decision to try to require the HPV vaccine for young Texas girls. Interestingly enough, the focus has turned to Perry’s own wife. As The New York Times describes, Anita Thigpen Perry is not only her husband’s ”close confidante”, but a woman ”with expertise in women’s health… a nurse, country doctor’s daughter, and career-long advocate for victims of sexual assault who has been a vocal proponent of immunizations”. I can’t say that I’m surprised. Nor am I offended. I think it’s only natural that Governor Perry may have been influenced by his wife’s personal experiences.
However, while Perry has come under fire for his attempt to mandate the HPV vaccine years ago, California Governor Jerry Brown is currently faced with another controversial bill that would allow minors, 12 and older, to receive prevention services for STDs without parental consent. Such services would therefore include the HPV vaccinations to protect against strains of Human papillomavirus, a virus that can cause cervical cancer.
In contemplating this measure, it’s important to note that children as young as 12 are already able to consent to diagnosis and treatment for STDs. As one doctor explains, ”What this adds is them being able to receive prevention … which is obviously a very important part of health care.”
Last week, Michele Bachmann’s misinformed statements on the HPV vaccine illustrated just how much impact politicians can have on public health.
In a matter of hours, with the help of several major news sources, Bachmann was able to inject an irrational fear of the life-saving HPV vaccine based on the anecdotal evidence of “Some Lady I Just Met”. One week later, the complaint in The New York Times remains that Bachmann’s brief, but damaging comments, regarding the safety of the HPV vaccine, may have instilled so much doubt among parents and young women that there may be ripple effects in HPV vaccine uptake for years to come.
Interestingly enough, Bachmann began her complaint about the HPV vaccine in response to a concern about her political opponent Rick Perry. Back in 2007, the Texas Governor attempted
to use an executive order to mandate the anti-cancer HPV vaccine in Texas. There were plenty of critics at the time, many suggesting that the HPV vaccine would promote promiscuity among adolescent girls and others who did not agree with immunization mandates. Eventually, the legislative pressure forced Perry to rescind the order. However, even today, the Governor’s
decisions are stirring up a political debate. Last week in Tampa, Bachmann accused Perry of “crony capitalism,” suggesting that his efforts to mandate the vaccine were motivated by political funding from the vaccine manufacturer.
While it’s no longer surprising to see politicians accused of wrong doing – and it’s almost common place to witness political mud-slinging – it’s disappointing to witness public health practices, such as beneficial vaccines, being damaged in the crossfire of political debates.
However, in the week since the Tampa debate, as medical professionals speak out to correct Bachman’s irresponsible comments, we are also discovering that Rick Perry’s support of public health goes beyond accusations. Read more…
If you haven’t heard by now, than you probably haven’t read or watched any major news source in the past few days.
GOP presidential hopeful, and Minnesota Congresswoman Michele Bachmann, made some serious allegations about the HPV vaccine during Monday night’s debate. Her main objective was to criticize her political opponent Rick Perry for his attempt to mandate the HPV vaccine for girls in his home state of Texas. While Perry’s attempt to protect his constituents from cervical cancer may have been heavy handed, his executive order was overruled and the mandate never enforced. But Michele Bachmann’s reckless comments have taken hold in just a matter of days , injecting fear and doubt about the safety of the HPV vaccine.
It’s important to note that Bachmann, who claims to be a defender of our freedoms, failed to even acknowledge the liberties we do have in this country. No child is being forced to get this vaccine. Suggested and encouraged? Yes. But forced? No. Even if Rick Perry had been successful at making HPV a state mandated vaccine in Texas, parents would still have been able to exercise their option to exempt their child.
In her Tuesday morning interview on The Today Show, Bachmann once again demonstrated her ignorance on this subject when she suggested that the vaccine could cause “mental retardation” (her words, not mine). As if that claim wasn’t bad enough, she made the statement in response to a brief conversation she had with a random mother she had met only hours before. Any good parent – or politician – would know enough not to take the word of a complete stranger, but to consider doing some research before blasting opinions out over the airways that could impact the health decisions of millions of people. Read more…