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HPV vaccination vital for children, adolescents to prevent adult disease
This week, researchers reported that one out of nine adult men in the U.S. have oral human papillomavirus, likely contributing to the rise in oropharyngeal cancers today.
Today, six out of 10 parents in the United States are getting their children vaccinated against HPV, but many children are not completing the vaccination series, leaving them vulnerable to HPV-associated cancers.
According to MMWR findings, 60% of adolescents aged 13 to 17 received one or more doses of HPV vaccine in 2016, which is 4 percentage points higher than 2015; but, only 43% of teens had received all the recommended doses of HPV vaccine.
Although teen vaccination coverage continues to improve, strategies to expand coverage even more and increase HPV-associated cancer prevention are still needed. Healio.com spoke with Shannon Stokley, DrPH, associate director for science at the Immunization Services Division in the CDC’s National Center for Immunization and Respiratory Diseases, to learn more about the benefits and barriers of HPV vaccination as well as approaches on how to improve rates among teens and children. – by Julia Ernst, MS, and Savannah Demko
Healio: Can you describe the benefits of the HPV vaccine?
Stokley: The major benefit of the HPV vaccine is that it prevents cancer. We know that more than 30,000 cases of cancer related to HPV occur every year; 29,000 of those cases could be prevented by the vaccine. This is a very powerful tool. There are very few opportunities that we have where we can prevent cancer.
Healio: What are some of the major barriers that prevent uptake of the vaccine?
Stokley: When we’ve talked with parents who haven’t had their children vaccinated, we ask them about their reasons why. What we frequently hear is that the health care provider didn’t recommend the vaccine. For the past few years, we’ve been doing a lot of work with our partners and also with clinicians to give them the tools so they can confidently talk about this vaccine with parents and make an effective recommendation. This includes bundling the recommendation for the HPV vaccine with the other vaccines that are recommended at this age –recommending it the same way and on the same day as the other vaccines that teens should receive.
Healio: Are there different approaches when discussing the need to vaccinate boys and girls?
Stokley: This vaccine is recommended for both boys and girls. Men can develop cancer from HPV infection; a third of cancers caused by HPV occur in men. This isn’t just a disease that affects women, which is what people traditionally think of because of cervical cancer. This is something that also impacts men. It’s just as important for boys to get this vaccine as it is for girls. ...
We know that clinicians have been working hard to promote this vaccine. We’re seeing increases in HPV vaccination for boys. We’re also seeing a narrowing of differences in vaccination coverage between boys and girls.
Healio: How can providers overcome major barriers to increase uptake?
Stokley: It’s really about this bundled recommendation of grouping the HPV vaccine recommendation with the recommendation for Tdap and meningococcal conjugate vaccines. That’s the recommendation; this is the standard of care. To protect our children, we need to give these three vaccines on the same day.
It’s also about simplifying the message and just saying: “This is what’s recommended for them today; let’s do it” and not treating it as something different or optional.
Sometimes providers may overestimate parental concerns or hesitancy, so it’s important to remember: Don’t interpret a question from a parent as refusal, necessarily. They may just want more information, so listen to their questions and address their concerns.
... We do have a lot of materials on the CDC website if providers are looking for resources to support their conversations with parents. It’s very simple language about how to clearly and concisely address questions that parents frequently ask.
There are many things that can be done at the practice level as well. Every time an adolescent is in the practice, check their vaccination status to see if they are due for any vaccines; if they are, that’s an opportunity to offer and recommend the vaccine. Don’t just wait for well child visits; even in acute care visits, you can give the vaccine.
Also, take advantage of your electronic systems (if your practice has them) to do what we call reminder/recall. This, especially, will help with getting parents back in to make sure their children get their second dose of HPV vaccine. You can send out reminders when the vaccine is due or when they have a visit to remind parents to come back. ... As kids are coming back to the office for their back-to-school checkups, it’s a great opportunity to check their vaccination status and offer vaccines that they may be due for. We really want to make sure that we take advantage of every opportunity when we interact with adolescents to make sure they’re up to date on their vaccines. ...
We’re doing great at getting them started, but now we need to work on getting them finished with the series.
References:
Walker TY, et al. MMWR Morb Mortal Wkly Rep. 2017;doi:10.15585/mmwr.mm6633a2.
Disclosure: Stokley reports no relevant financial disclosures.