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Parental discussion key to improving HPV immunization rates

NEW YORK — Providing parents with the appropriate information regarding HPV vaccine and its benefits is important. But according to Kenneth A. Alexander, MD, PhD, the parents’ decision to vaccinate their child against HPV can hinge on the manner in which the information is delivered.

“If you say to a parent that HPV stands for human papillomavirus; HPV causes genital warts, cervical cancers and anal cancers; it’s sexually transmitted, and many adolescents become sexually active by age 13 — and then ask if they want this vaccine for their 11-year-old … the answer will be ‘no,’” Alexander said in a CME session sponsored by Merck & Co. during the 25th Annual Infectious Diseases in Children Symposium.

 

Kenneth A. Alexander

In contrast, Alexander, who is professor of pediatrics and chief of the section of pediatric infectious diseases at the University of Chicago, said the discussion about HPV immunization should focus on the diseases the vaccine prevents and not how the diseases are acquired.

“Ask the parent if anyone they are close to has ever had cancer. Ask what it was like for them or for the caregiver of that person,” he said. “Tell them we can reduce the risk of their son or daughter having a cancer experience with this vaccine, and then ask if they want to do that.”

It is through this approach, with a focus on the risk for cancers from HPV and recommending a vaccine to prevent it, in which rates of HPV immunization will increase.

Alexander said parents should be told that more than 85 million doses of HPV4 (Gardasil, Merck) have been administered worldwide, with excellent safety and efficacy results.

“The safety profile is as good as or better than with any vaccine,” he said.

In addition, although the vaccine is recommended by the AAP and many other organizations, Alexander said the most important thing to tell a parent is that “the vaccine is recommended by our practice, we give it to our kids and you should give it to yours.”

Both vaccines, HPV4 and HPV2 (Cervarix, GlaxoSmithKline), can be given to females aged 9 to 26 years. CDC recommends that all 11- or 12-year-old girls get the three doses of either brand of HPV vaccine to protect against cervical cancer.

Girls and young women aged 13 to 26 years should get the HPV vaccine if they have not received any or all doses when they were younger.

HPV4 is also licensed for males aged 9 to 26 years, and the CDC recommends HPV4 for all boys aged 11 or 12 years, and for those aged 13 to 21 years who did not get any or all of the three recommended doses when they were younger. – by Cassandra A. Richards

Disclosure:Alexander receives consulting fees from Merck Vaccines and fees for non-CME services from Merck, Sharp and Dohme.