Most US teens getting HPV vaccine, CDC says

Barsaba Taglieri
Agosto 25, 2017

The rate of rural teens who received the recommended first dose (of two) of vaccine against meningococcus, which can cause fatal meningitis, was almost 10 percentage points lower than it was for urban teens. "So, we were concerned to find vaccination rates were significantly lower for survivors of childhood cancer compared to their peers".

Childhood cancer survivors who are younger or male had an increased likelihood of non-initiation of the HPV vaccine, similar to what is seen in the general population.

"The oncology/survivorship team may believe that the primary care providers are managing the HPV vaccination because, traditionally speaking, they manage all other vaccines", Klosky added. The infection can cause cervical, vaginal and vulvar cancers in women, and penile cancer in men.

An estimated 14 million people, including teens, are infected with HPV each year. It can also cause anal cancer, throat cancer and genital warts in both men and women, according to the CDC. Most clear the infection on their own.

The HPV vaccine is recommended by the Children's Oncology Group as part of its Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers, and has been endorsed by many leading health organizations, including the American Society of Clinical Oncology, the American Academy of Pediatrics, the U.S. Centers for Disease Control and Prevention, and all 69 of the National Cancer Institute-Designated Cancer Centers, including UAB.

Many children are not completing the vaccination series, but new financial information may sway that statistic.

Median age at diagnosis was 12.2 years, and median time off therapy was 2.7 years.

The HPV vaccine is recommended for preteen boys and girls at age 11 or 12 so they are protected before ever being exposed to the virus.

Researchers compared results from survivors with general population data from the National Immunization Survey-Teen and the National Health Interview Survey.

Research that Brewer and others have conducted shows that the way doctors approach the issue of HPV vaccination influences whether parents will agree to let their kids get the shots.

Additionally, 72% of study participants reported that their health care provider did not recommend the HPV vaccine. Among those, only 5% received the vaccination.

Over the last decade, however, HPV vaccination rates have risen. "We know that if we vaccinate after 15 years old, their response is weaker", Johnson said. "The HPV vaccine is an important cancer-prevention tool that is readily available".

Perceived lack of health insurance coverage for the HPV vaccine also appeared to be a strong predictor for not getting vaccinated (OR = 7.5; 95% CI, 3.7-15.3) despite the fact the Affordable Care Act mandates that most insurance plans cover preventive services, including vaccines, without a copayment or deductible.

Stokley said cost is probably not the reason why some rural parents are getting their children immunized with Tdap vaccine, but not HPV or meningococcus.

"As a follow-up to this study, we aim to test interventions created to increase health care provider recommendation for the HPV vaccine as a mechanism to increase the rate of vaccination among survivors of childhood cancer", Klosky said.

Parents can take advantage of any visit to the doctor's office to get the HPV vaccine for their child.

Although childhood cancer survivors are living long lives after treatment, their health is more vulnerable, according to Merry-Jennifer Markham, MD, FACP, associate professor of hematology and oncology at University of Florida and an ASCO expert in cancer survivorship, who was not associated with the study.

"Now we need to understand and look into, 'If they're getting Tdap, why aren't they getting HPV?'" Dr. Stokley said.

Disclosures: The NCI, Merck and the American Lebanese Syrian Associated Charities funded this study. "Oncologists and primary care physicians are trusted resources for young survivors, and while barriers to HPV vaccinations certainly exist, this study suggests that starting a conversation can help break down at least one".

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