HPV Vaccine: Why is the US Lagging Behind? Monday, August 18, 2014

Despite the preventative benefits of the vaccine in preventing cancer, the United States lags behind much of the developed world in immunization rates for human papillomavirus (HPV).

According to U.S.News & World Report, countries such as Canada and the United Kingdom have an HPV vaccination rate of up to 85 percent and 70 percent, respectively, (of girls who received all three doses), nearly double that of the U.S.

Recent numbers from the Centers for Disease Control and Prevention (CDC) show that about 57 percent of girls and 34 percent of boys ages 13-17 receive the first dose of the HPV vaccine.

About HPV

HPV is a sexually transmitted infection (STI), carried by both males and females, which can lead to genital warts and cervical cancer. Genital HPV is the most widespread STI: the CDC estimates about 20 million people in the U.S. are infected with HPV at any given time. , The American Social Health Association estimates three fourths of sexually active men and women between the ages of 15 and 49 have been infected at some point in their lives.

Because the virus is preventative, Children’s National’s Infectious Disease Specialist David Hyun, MD, recommends vaccinating children beginning at ages 11 or 12, before they become sexually active. While the vaccine can protect from up to 70 percent of HPV variants causing cervical cancer and 90 percent causing genital warts, as well as numerous head and neck cancers, there is still a great deal of controversy surrounding it throughout the U.S., according to the CDC. A study published in the journal Pediatrics found that the vaccine is effective for at least eight years.

The Stigma Behind HPV Vaccination

In 2012, a CDC survey asking parents of adolescents and teens whether they intended to vaccinate their daughters found that of the 23 percent who stated their daughters would remain unvaccinated, three of the top responses were: “vaccine safety concerns,” “vaccine not needed,” and “daughter is not sexually active.”

According to Dr. Hyun, this reluctance of parents to vaccinate their children stems from the fact that HPV is a sexually transmitted virus.

“Some parents view it as a green light for their kids to have sex, which gives it a stigma,” he said. 

A study published in Pediatrics found no connection between the HPV vaccine and an increase of sexual activity for up to three years after vaccination.

Rumors of the vaccine’s alleged harmful side effects have been bolstered by media personalities such as journalist and author Katie Couric, who publicized rare reports of vaccinated individuals who became ill or died, despite no evidence connecting their deaths to the vaccine. Although scientists were concerned about the risk of blood clots, a massive study involving half a million Danish women, published by the American Medical Association, revealed no association between blood clots and the HPV vaccine.

Numerous studies point to the effectiveness of the vaccine. One in particular, published in The Journal of Infectious Disease found “within four years of vaccine introduction, the vaccine-type HPV prevalence decreased among females aged 14 - 19 years despite low vaccine uptake. The estimated vaccine effectiveness was high.”

Dr. Hyun reports that, of the strains of HPV that Gardasil, a vaccine brand, protects against, the vaccine “has a 98 percent efficacy rate in preventing cervical cancer.”

Children’s National Division Chief of Adolescent and Young Adult Medicine, Lawrence D’Angelo, MD, has seen the stigma play out with his own patient families.

“It’s so important for primary care physicians to emphasize this is a cancer prevention vaccine,” Dr. D’Angelo said.

Ask your child’s pediatrician for more information on HPV vaccination.


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