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Keyword: ‘HPV’

Why Early HPV Vaccination is Beneficial

April 29, 2015 99 comments

Since the human papillomavirus (HPV) is transmitted from one person to another through sexual activity, many parents question why the CDC recommends the vaccine be administered to boys and girls as young as 11 or 12 years of age.  HPV vaccination is critical if we are to prevent the 27,000 cases of anal, mouth/throat, penile, cervicalvaginal, or vulvar cancers that are diagnosed each year in the U.S.  However, since some parents have difficulty acknowledging that their teenage children may be engaging in activity that puts them at risk of HPV, they’re often reluctant to vaccinate at the recommended age.

If you’re a parent who is questioning whether your preteen child should get the HPV vaccine, it’s important to realize the benefits of vaccinating at an early age.  

 hpv-cancer-prevention

The vaccine works best prior to exposure to the HPV virus.

The fact is that almost all sexually active people will get HPV at some point in their lives.  While most of these infections go undetected and may even clear up on their own, we know that one in four people in the U.S. are currently infected and that initial infection typically occurs in the teens or early 20s.

While most parents are hopeful that their teenagers will refrain from sexual activity until later in life, research tells us otherwise.  The data suggests that 5% of 12-year-olds, 10% of 13-year-olds and 20% of 14-year-olds are sexually active. And the likelihood of sex continues to escalate with each school grade level with 32% of 9th grade students to 62% of 12th grade students.  And since HPV can be transmitted through oral sex as well, it’s important to note that as many as 51% of 15-24 year-olds are having oral sex before they have their first sexual intercourse.

Since it’s entirely possible to get HPV the very first time that a person has sexual contact with another person, the question we must ask ourselves is why should we wait until a child is sexually active to offer vaccination? As we can see by the data, even a child as young as 12 years old can be at risk.  Even if a child should abstain from sex until marriage, there is no guarantee that their partner did the same, and they can still contract HPV that may one day lead to cancer.  However, if a child should complete the three dose series of HPV vaccination before they begin any type of sexual activity, then they’ll be better protected if they get exposed to the virus, at whatever age that may be.

The HPV vaccine produces a higher immune response in preteens than it does in older teens and young women.

Read more…

New ACIP Recommendations for Meningococcal, Influenza and HPV Vaccines

March 10, 2015 4 comments
Photo Credit: James Gathany, Centers for Disease Control and Prevention

Photo Credit: James Gathany, Centers for Disease Control and Prevention

written by: Amy Pisani, MS, Executive Director, Every Child By Two

The Advisory Committee on Immunization Practices (ACIP) conducted an abbreviated meeting on February 26, 2015 due to the threat of a winter storm in the Atlanta, Georgia region.  The ACIP, which consists of 15 voting members who have expertise in vaccinology, immunology, healthcare and public health, makes recommendations to the Centers for Disease Control and Prevention (CDC) regarding vaccinations approved for use by the Food and Drug Administration (FDA).  The recommendations pertain to the timing and intervals of vaccines which are included on the childhood, adolescent and adult immunization schedules.   At this February meeting, the ACIP conducted three important votes which altered or created new recommendations for meningococcal vaccine, influenza vaccine and HPV vaccine.  

Meningococcal Serogroup B Vaccine

Two new vaccines to protect against meningococcal serogroup B, which has been spreading through college campuses in recent years, were recently approved by the FDA. The Trumenba vaccine is developed by Pfizer Pharmaceuticals and requires three doses and the Bexsero vaccine has been developed by Novartis Vaccines and Diagnostics requiring two doses.  The ACIP has previously recommended one dose of MCV4 vaccine at ages 11-12, and a booster at age 16 to protects against the A, C, W and Y strains of meningococcal bacteria   Nearly 80% of teens between the ages of 13 and 17 have received at least one dose of the MCV4 vaccine, which is fairly remarkable considering the fact that it is recommended, but not mandated for use within states nationwide.  However, because of the complicated nature of the virus, the new meningococcal serogroup B vaccine would require a separate series of shots, in addition to those recommended for MCV4 vaccine.

The serogroup B strain of meningococcal is considered the most common cause of meningococcal disease  among adolescents here in the U.S. with a fatality rate of 12 percent in 11-19 year olds and 17 percent in 20 year olds over the last 14 years.  While the number of meningococcal cases have declined since 1996, many advocates believe that the aggressive nature of this disease, which often kills or maims it’s victims within hours, necessitates a broad recommendation for the vaccine.  However, the ACIP discussion at the February meeting was limited to recommendations for those at high risk for serogroup B infection, with a follow up vote anticipated at the upcoming June meeting where the Committee will review data and make a determination on whether to recommend the vaccine for a broader population. Authors note-  added June 2015: At the June ACIP meeting the following recommendation was made “A serogroup B meningococcal (MenB) vaccine series may be administered to adolescents and young adults 16 through 23 years of age to provide short term protection against most strains of serogroup B meningococcal disease. The preferred age for MenB vaccination is 16 through 18 years of age.”

Several advocates traveled to the meeting to provide their testimonials.  These included parents of those lost to the disease as well as survivors who have suffered amputations and serious life-long health consequences of this invasive disease.  Dr. Mary Ferris, who helped lead efforts to contain the 2014 meningococcal outbreak at University of California’s Santa Barbara campus, provided compelling testimony regarding the impact of the outbreak on the university.  Ferris noted that four cases, one of which led to the amputation of a student, spread panic throughout the campus and the local community.  Students were banned from volunteering at the on-campus daycare and attempts were made by the local community to close the campus entirely.   Dr. Ferris urged the Committee to consider the broadest recommendation Read more…

Do My Children Need the HPV Vaccine?

December 17, 2014 18 comments

This guest post was written by Denise Olson,  a mother of four who connected with The Arizona Partnership for Immunization (TAPI) in her efforts to learn more about the HPV vaccination.

Like all good moms, I want my kids to grow up safe and healthy. I want to make decisions that will benefit them right now, but I also need to think about things that could help them in the future. I feel like it’s a big job and a lot is depending on me. That is why I wanted to learn more about the HPV vaccine before my children were old enough to get it. I wanted to make an informed choice, and I had all kinds of questions.IMG_7492

What is HPV, anyway? Could a vaccine actually protect my children from cancer? Are there side effects? What about the scary rumors I heard on the internet? Why is the vaccine given at age 11? Are my kids really at risk for HPV, or is this unnecessary medicine?

I wrote this article to share the answers I found to my questions, and to hopefully convince other parents to think about how they can protect their own children, not only now, but in the future.

What is HPV anyway?

HPV stands for human papilloma virus.  HPV lives on soft mucous membranes and skin. Usually, it can be found on the genitals of an infected person, but it can also infect the anus, mouth and throat.

Some strains of HPV viruses cause genital warts, while others can cause tumors or cancers to grow. While there are many different types of HPV, there are several different HPV vaccines licensed by the Food and Drug Administration (FDA). The bivalent HPV vaccine (Cervarix) prevents the two HPV types, 16 and 18, which cause 70% of cervical cancers. There is also a quadrivalent HPV vaccine (Gardasil) which prevents against four HPV types: HPV 16 and 18, as well as HPV 6 and 11, which cause 90% of genital warts. The quadrivalent vaccine has also been shown to protect against cancers of the anus, vagina and vulva and is the only HPV vaccine licensed for use in males.  And just last week, the FDA approved a new HPV vaccine (Gardasil 9) which will protect against nine different strains has the potential to prevent approximately 90 percent of cervical, vulvar, vaginal and anal cancers.

Can the HPV vaccine actually protect my child from cancer?

Yes! The vaccine protects against cancer IMG_6743by training the body to find and destroy viruses before they have a chance to cause the infections that lead to cancer.

The primary cancer the HPV vaccine is designed to protect against is cervical cancer, the same cancer that is checked for when women go in for a pap smear. However, because the vaccine stops dangerous HPV viruses anywhere in the body, it may help protect against some cancers of the penis, throat, mouth, and anus. This is one reason it is recommended for boys as well as for girls. (The other reason is to protect future partners from cervical cancer.) Read more…

National Vaccine Advisory Committee Approves Recommendations to Improve HPV and Maternal Vaccine Efforts

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The National Vaccine Advisory Committee (NVAC) met last week in Washington, D.C. to deliberate recommendations aimed at continually improving our nation’s immunization system.

This federal advisory committee, which was authorized in 1987, provides vaccine and immunization policy recommendations to the U.S. Department of Health and Human Services (HHS).  The NVAC committee is made up of individuals with a wide variety of expertise including physicians, consumer organizations, state and local health agencies, vaccine researchers and manufacturers.

 

The NVAC is chartered to:

  • Study and recommend ways to encourage the availability of an adequate supply of safe and effective vaccination products in the States;
  • Recommend research priorities and other measures the Director of the National Vaccine Program should take to enhance the safety and efficacy of vaccines;
  • Advise the Director of the Program in implementation of sections 2102 and 2103 of the Public Health Service Act; and
  • Identify annually for the Director of the program the most important areas of government and non-government cooperation that should be considered in implementing sections 2102 and 2103 of the Public Health Service Act.

 

The NVAC has made recommendations on a wide variety of issues since its inception in 1987 at a time when vaccine supply, the improvement on existing vaccines, and vaccine resources and financing needs were the main focus of the committee’s time.  As issues arise which require further input to inform the full committee, NVAC forms subcommittees who, with tremendous support from the National Vaccine Program Office staff, deliberate the issue, conduct extensive research, and eventually develop draft recommendations.  The full committee reviews the report and votes to make recommendations on the issues at hand to the Assistant Secretary of Health.  These committees typically meet throughout the year on regular teleconferences; bringing in experts from a variety of health-related fields to inform their work.  A typical workgroup might meet for more than a year prior to developing a report and set of recommendations for full committee consideration.

The NVAC is one of several federal advisory committees who report, either directly or indirectly, to the Secretary of Health on issues related to vaccine development, approval and safety oversight.

agencyschematic

This valuable schematic, which was published in public health reports in larger format, includes each of the federal advisory committees along with the agency that supports their work.  Each of these committees provides liaison reports and input during the February, June and September meetings of the NVAC, along with several Ex Officio organizations.  This allows for better coordination of efforts at the national level on all matters related to the immunization system.

At the most recent NVAC meeting the HPV Working Group and the Maternal Immunization Working Group provided final recommendations for vote by the full NVAC.

The HPV working group was charged “to review the current state of HPV immunization, to understand the root cause(s) for the observed relatively low vaccine uptake (both initiation and series completion), and to identify existing best practices all with a goal of providing recommendations on how increase use of this vaccine in young adolescents.”   The committee was conducting their research at the same time as the President’s Cancer Panel (PCP), which was also preparing recommendations on a wide variety of cancer-related issues.  Recently the PCP report was released, with great focus on the importance of increasing HPV vaccination rates in order to reduce the number of cancers in women and men.  The NVAC HPV Working Group focused their recommendations in support of the PCP report and will continue to investigate the need for additional recommendations to the Assistant Secretary.

The NVAC approved the following recommendations in full, which will be posted in the near future for the public:

1. NVAC and the ASH should endorse the President’s Cancer Panel (PCP) report, Accelerating HPV Vaccine Uptake: Urgency for Action to Prevent Cancer, and adopt the recommendations outlined therein.

2. As written in the PCP report, NVAC should, “monitor the status of uptake and implementation of the recommendations.” This should be done by hearing an annual progress report from stakeholders identified in the PCP report.

3.  The working group will continue to work on a shortened schedule and will report back to NVAC on whether there are additional recommendations to me made.

The Maternal Immunization Working Group also made a series of significant recommendations aimed at fulfilling their charge “to review the current state of maternal immunizations and existing best practices.”  The working group was asked to first identify programmatic barriers to implementation of current recommendations regarding maternal immunization and make recommendations for overcoming these barriers. Efforts to identify barriers to and opportunities for developing vaccines for pregnant women should then be identified as well as ways to overcome these barriers and leveraging the opportunities.

In particular the working group made a series of recommendations aimed at:

1. Enhancing communication to address the safety and effectiveness of all currently recommended immunizations during pregnancy;

2. Maximizing obstetric provider recommendation and administration of recommended maternal immunizations;

3. Focusing efforts to improve financing for immunization services during pregnancy and postpartum;

4. Supporting efforts to increase the use of electronic health records (EHRs)and Immunization Information Systems (IISs) among obstetrical care providers; and

5. Recognizing and addressing current vaccine liability law barriers to optimize investigations and uptake of recommended and future vaccines during pregnancy

This committee’s work will be instrumental in forwarding the efforts to ensure the vaccination of pregnant women against whooping cough and influenza and build on policies and procedures necessary as potential new vaccines are recommended for the benefit of pregnant women and their newborns.  The recommendations, which are extensive, will be available to the public in the near future, at which time Every Child By Two will provide them to our readers.

The Vaccine Hesitancy Working Group will continue its research and prepare a draft report and recommendations to the full NVAC at the September 9 – 10 meeting.  To register for this public meeting please visit the National Vaccine Program Office website.  Note that all meetings are webcasted live to the public as well.  Stay tuned.

Victims Katie Couric Neglected To Mention In Her Discussion of HPV

December 5, 2013 232 comments

A few weeks ago I wrote about the fact that Katie Couric’s new daytime television show Katie was planning to air a segment about HPV vaccine.  After hearing the proposed line-up for the show it was clear that the HPV vaccine was not going to be portrayed favorably.  And as expected, the conversation has blown up all over the internet in the past 24 hours with many reporters and bloggers calling out Katie Couric and her producers for how poorly they’ve handled this important conversation.

Unfortunately, daytime television ratings are driven by emotion and controversy and Katie Couric’s producers know that.  So despite the overwhelming research available on the safety and efficacy of the HPV vaccine, that information was not adequately presented to the millions of viewers of her show.

But there was one other thing notably missing. 

It was the voices of those who have suffered with HPV related cancers.  And those family members who speak out on behalf of those lost to HPV related cancers.  

Since the Katie Couric neglected to include a single cervical cancer survivor, I’m encouraging anyone who has had a personal experience with an HPV related cancer to speak out and let others know just how terrifying it has been for you.  You may share your story in the comments below or send them to us at shotofprevention@gmail.com.  And I would like to encourage everyone to share your opinions of the episode with one of the show’s producers (Beth.Cochran@katiecouric.com).

Below are just a few of the HPV related stories that are featured on the Shot By Shot website.  They are all very compelling and emotional and I hope that someday they will get the kind of attention that the Katie show has given to those critical of the vaccine.

In this video, Heather Burcham shares her story of cervical cancer just two months before she died.  Her hope was to change just one person’s life by encouraging others to get the HPV vaccine.

This is an excellent video filmed at the national Cervical Cancer Coalition conference in Atlanta, GA, in January 2013 which highlights stories from cervical cancer survivors and family members of women who have died from the disease.  These personal stories highlight the devastating impact of cervical cancer and emphasizes the importance of prevention in the form of vaccines and regular screening–prevention that can save lives.

Read more…

Why Some Parents Are Refusing HPV Vaccine For Their Children

August 20, 2013 615 comments

Some of the data contained in this post has been updated.  For a more recent review of the prevalence of HPV infection and more current data on the safety and efficacy of the HPV vaccine, click here to read “Questioning Whether to Get Your Child The HPV Vaccine?  Read this“, published in January, 2016.  

This post is not the result of an official survey. Rather, it’s a collection of the most common explanations I’ve heard parents make when refusing HPV vaccine for their children, followed by points to consider.

REASON #1: My child is not/ will not/ should not be having sexual relations. So why would they need an HPV vaccine?

As a mother to five daughters I get it. Every parent wants to believe that their son or daughter will remain abstinent until marriage. And some may. But the reality is that some children, even as young as 12 and 13, are already involved in sexual relations and this reality is what has influenced the age at which the HPV vaccine is recommended.  Here is what the studies suggest:

The HPV vaccine is most effective when the complete three shot series is given long before any sexual activity begins, which is one reason the vaccine is recommended for boys and girls between the ages of 11 and 12. Additionally, the vaccine illicits a greater immune response and produces higher antibody to fight infection when given at this age, compared to receiving the vaccine at a later age.

Regardless of the when a child becomes sexually active, the HPV vaccine is important because the prevalence of HPV infection is staggering:

Some parents may be surprised to learn that sexual intercourse is not necessary for infection.  Oral-genital and hand-genital transmission of some genital HPV types is possible and has been reported.  Studies show that HPV was detected in 46% of females prior to first vaginal sex.  Based on this information, it’s possible that a person can become infected during their first sexual encounter. Even if someone remains abstinent until marriage, there’s no guarantee that the person they are marrying isn’t already infected.

Yet, some parents remain concerned that vaccinating a child for a sexually transmitted disease is like giving them permission to have sex. However, research indicates that HPV vaccination has had no notable difference in the markers of sexual activity, to include pregnancies, counseling on contraceptives, and testing and diagnosis of sexually transmitted infections. In other words, the vaccine does not appear to be changing sexual behaviors, only protecting those when they eventually engage in them.

The way I see it, most children by the age of 11 can understand that the HPV vaccine can protect them from various types of cancers, but not from pregnancy and STDs. It’s a simple matter of communication by which the parents can explain that the vaccine doesn’t equate to a free pass to have sex.  If a child chooses to refrain from sexual relations, I would venture to guess that it has more to do with their upbringing and strong moral character, than whether or not their parents choose to protect them with the HPV vaccine.

REASON #2: Won’t regular PAP smears detect any abnormalities and identify cervical cancer without the need for the vaccine? Read more…