Communication can protect teens from HPV in the future

Tuesday , August 05, 2014 - 12:00 AM

Standard-Examiner staff

SALT LAKE CITY — As more teens receive vaccinations for human papillomavirus, or HPV, parents of non-vaccinated teens remain uninformed of the cancer preventing immunization. 

According to the Morbidity and Mortality Report published by the Centers for Disease Control and Prevention last week, one third of parents of girls reported that their physician had not recommended the HPV vaccine; 50 percent of parents of boys responded the same. 

“Despite availability of safe and effective HPV vaccines, the main reasons reported for not vaccinating teens against HPV underscore that addressing knowledge gaps among parents as well as increasing clinicians' HPV vaccination recommendations are critical to protecting teens against HPV-associated cancers and genital warts,” the report states. 

As state and government agencies stress the importance of vaccinating boys and girls against the infection, health care providers are missing opportunities to educate parents. In the report published last week, CDC stated that, had an HPV vaccine been administered during health care visits when another vaccine was given, coverage could have reached 91 percent by age 13  for adolescent girls born in 2000.

The President’s Cancer Panel cited several factors as to why physicians and health care providers could be hesitant to offer the vaccine to parents in their 2012-2013 report. Limited understanding of the benefits of the vaccine and the danger of HPV-associated diseases, safety concerns, concerns about inadequate reimbursement for vaccines, personal beliefs, discomfort about talking to parents of teens about a topic related to sexual behavior and concerns about parental resistance were several of the reasons listed. 

Objections have surrounded the vaccine since the FDA approval of Gardasil in 2006 and Cervarix in 2009, two CDC recommended versions of the immunization. Controversy broiled over the notion that medical professionals and lawmakers were assuming girls were becoming sexually active at that age, or that parents would feel they had to talk about sexual intercourse with their children at an earlier age. A 2013 study conducted by the Mayo Clinic found that two in five surveyed parents of girls thought the vaccine was unnecessary, and would not have their daughters immunized. 

The vaccine, which is administered in three doses over a six-month period, is effective for girls and boys ages 9 to 26, but is recommended between ages 11 and 12.

Rebecca Ward, health educator with the Utah Department of Health, said research has shown the vaccine works best when administered before a person comes in contact with the virus.

“Children seem to have a better response when you give the vaccine at a younger age,” Ward said. “So if we can give it to them now before they’re exposed to the virus, their immune system will be better able to fight it.” 

Utah vaccination rates rank among lowest in the nation at 41 percent, according to the Utah Cancer Control Program. To combat the low ranking, the UCCP and and the CDC launched the HPV Awareness Campaign in May, using radio, TV and public transport advertisements to inform the public that the HPV vaccine is crucial to preventing cervical cancer in women, penile cancer in men and a myriad of other cancers.

“What the CDC is really promoting now is, have the conversation, have it early,” said Tamara Sheffield, medical director for community health and prevention for Intermountain Healthcare. “And it’s not a conversation about your child’s future sexual activity, but about your child’s future cancer prevention.”

One function of the campaign is to make the HPV vaccine a routine part of a pre-teen’s immunization process. Because students are required to have the Tdap vaccine before entering middle school, Ward said physicians have a role to plan in making the first dose of the HPV vaccine another part of an end-of-summer routine.

“We do know that parents will listen to providers, so we have a component to this campaign for providers as well,” she said. “We want to be sure providers have good information, and we've provided them with information on how to address it with parents and how to make it part of the routine discussion.”

Sheffield said Utah and other western states are often on the low end of immunization coverage, family size being a determining factor. She has found most parents to be very open to discussing the HPV vaccine as cancer prevention. Parents who are hesitant must remember it’s not about the choices of their children, but the choices of their future intimate partner or partners. 

“We don’t necessarily have a conversation about how (we pass) chicken pox to each other,” she said. “We just give them the vaccine knowing it will protect them.”

Sheffield said attitudes toward the vaccine have improved with time and use.

“The medical community has become more educated about it as well as patients,” she said. “The individuals who are promoting it are both physicians and parents of adolescents, and they now better understand what the vaccine can do for the child and why the child should be protected against the virus.”

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