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HPV: What gynecologists say parents and young women & men should know

CDC: Teens’ HPV vaccination rates improve slightly but numbers need to improve

COLUMBIA, S.C. — National Immunization Awareness Month (NIAM) is a campaign held each August to highlight the importance of vaccination in the prevention of serious, sometimes deadly, disease of people of all ages.  

 According to the CDC most children are vaccinated but many children are still at risk for disease. 

When it comes to protection against human papillomavirus (HPV) the most common sexually transmitted infection, just over half of U.S. teens were up to date on HPV vaccination in 2018, a small improvement over the year before and doctors say we can improve.

 “I‘m really excited to see that numbers are on the rise, but I definitely think there is some room for improvement here for vaccination for both our young ladies and our young men,” shares Kristl V. Tomlin, MD Prisma Health Pediatric and Adolescent Gynecologist.

Human papillomavirus infection (HPV) is a viral infection affecting both men and women.  The Centers for Disease Control and Prevention (CDC) say HPV is the most common sexually transmitted infection, and nearly 80 million Americans are infected.

There are more than 100 varieties of human papillomavirus (HPV). Some types of HPV infection cause warts, and some can cause different types of cancer.  Most HPV infections don't lead to cancer. But some types of genital HPV can cause cancer of the lower part of the uterus that connects to the vagina (cervix). Other types of cancers, including cancers of the anus, penis, vagina, vulva and back of the throat (oropharyngeal), have been linked to HPV infection.

HPV vaccination, which protects against several types of cancer, and could prevent over thirty thousand cases of cancer each year continues to lag far behind other vaccines recommended for adolescents, according to a new report from the Centers for Disease Control and Prevention (CDC).

The CDC analyzed data on 18,700 adolescents ages 13-17 from the 2018 National Immunization Survey and found 51.1% of teens were fully vaccinated against HPV compared to 48.6% in 2017. The percent of those receiving at least one dose improved from 65.5% to 68.1%, according to the Morbidity and Mortality Weekly Report.

Girls continue to be vaccinated at a higher rate than boys, but boys made a bigger improvement in 2018. About 53.7% of girls were up to date on HPV vaccine last year, up from 53.1% the year before. Among boys, 48.7% were fully vaccinated compared to 44.3% in 2017.

The American Academy of Pediatrics recommends starting the HPV vaccine series between ages 9-12 years. The CDC found teens are more likely to get at least one dose of HPV vaccine if a health care provider recommends it. A mayo Clinic Study found a rising percentage of parents holding off on the vaccine for their teen daughters, even though physicians are increasingly recommending adolescent vaccinations.

Tomlin says the health care system as whole can do better, “I think increasing education and awareness out in the community about the importance of the vaccine is something really important that educators and clinicians can do for families.”

National Immunization Surveys numbers reveal fears and misconceptions surrounding the safely of the HPV vaccine. Researchers analyzed vaccination data for teens ages 13 to 17 in the 2008-10 National Immunization survey of Teens. They found only about one-third of girls were immunized against HPV. That number was low compared to other routine childhood recommended vaccines.

Tomlin shares the concerns and misconceptions she hears the most in her practice,  “I see a lot of different concerns when parents and families come into my office one of the biggest ones I hear about is parents are worried because there is sexual contact involved in the transmission of HPV, that somehow by giving this vaccine to their daughters, that it is going to promote or encourage sexual activity , and we have really great research , not just in the HPV literature but in contraception as well to show that just isn’t true.  Girls are not more likely to go out, have an earlier sexual debut as a result of this vaccine.”

The research supports the safety of the vaccine and shows the earlier the HPV vaccine is administered to patients, the better chance of prevention. Pediatricians say, the vaccine works better the younger the child is, and it doesn't work after the child is grown up and is exposed to the virus and accurate information is key.

Tomlin goes on to explain , “I would definitely encourage you to read up and learn about the safety profile of this vaccine since it’s inception , and since it’s FDA approval in the united states we have given out over 60 million vaccines and it has one of the best safety profiles, of any other vaccine on the market .” Side effects are really rare , the biggest things we hear about it that girls tell us that it tends to hurt ,  and we had a few episodes of fainting ,  so we encourage our patients to sit quietly for ten to 15 minutes after getting the vaccine but in the grand scheme of side effects  I think that is pretty low.”

She recommends parents and guardians turn to their doctor , the CDC and credible hospital driven and patient friendly  websites such as a Boston Children’s Hospital site specializing in young women and young men’s health issues, “There are a couple of really good ones , the CDC has a really great fact sheet   for parents and for patients that talks about the HPV vaccine.” I also recommend a website called www.youngwomenshealth.org.”

More and more unvaccinated teens are doing their homework and are beginning to confront parents about their vaccination choices.  It is a grey area gaining more attention. Tomlin is firm higher levels between parents and children are necessary to make informed decisions, “It’s a sticky subject for sure, but I will say this our teenagers have a lot of interest in maintaining their health. And I think It is important as a family to encourage your adolescent to be autonomous and involved in their healthcare decision.  I definitely have teenagers come to my office asking to get the HPV vaccine and in South Carolina the age of sexual consent for sexual health services is sixteen, so I have plenty of young ladies who come to my office asking about this and I definitely think this is something that should be addressed.  “