Too Few Girls Getting HPV Vaccine: CDC
Lagging rates will lead to more cervical cancer cases, health officials contend
Thursday, July 25, 2013
HPV vaccination rates for adolescent girls remained about the same between 2011 and 2012, hovering around 53 percent for girls who received at least one dose of vaccine, according to survey results published in the July 26 issue of the CDC's Morbidity and Mortality Weekly Report.
Only one-third of all girls have received the full three-dose series of shots, a rate that actually declined slightly between 2011 and 2012.
"We're dropping the ball," CDC director Dr. Tom Frieden said. "We're missing opportunities to give HPV vaccination, and that needs to change to protect girls against cervical cancer."
The news is particularly discouraging given that last month the CDC released findings that showed the HPV vaccine is more effective than previously thought, with vaccinations resulting in a bigger-than-expected drop in the virus' prevalence, Frieden said.
The HPV vaccines Cervarix and Gardasil guard against strains of the virus that are responsible for 70 percent of all cases of cervical cancer. Vaccination is recommended at age 11 or 12 years.
The CDC estimates that an additional 4,400 women will be diagnosed with cervical cancer and 1,400 cervical cancer deaths will occur for every year that three-dose coverage remains at 33 percent instead of the goal of 80 percent coverage.
Approximately 79 million Americans are currently infected with HPV, and another 14 million become newly infected each year, according to the CDC. HPV is so common that nearly all sexually active men and women will get at least one type of HPV at some point in their lives.
The issue doesn't lie with availability of the vaccine, the CDC report noted. Parents and doctors simply are missing opportunities to have girls vaccinated against HPV.
About 84 percent of 11-year-old girls have had a doctor's visit where they received another vaccination but not the HPV vaccine, the annual vaccination survey found. If the HPV vaccine had been administered at the same time, today's coverage rate could have exceeded 92 percent, officials noted.
"The girls are in the doctor's office, they're getting another vaccination, but they aren't getting the second or third dose of HPV vaccine," Frieden said. "Doctors need to recommend this vaccine just as they do others, and ensure that it's given at every opportunity."
One of every four parents told the CDC they do not intend to have their daughters vaccinated against HPV. When asked why, the parents gave a variety of responses:
- 19 percent said the vaccine isn't needed.
- 14 percent said their doctor had not recommended the vaccine to them.
- 13 percent said they had safety concerns about the vaccine.
- 13 percent said they didn't know about either the vaccine or the disease.
- 10 percent said their daughter doesn't need the vaccine because she isn't sexually active.
In the early days of HPV vaccination parents had some reservations about giving the vaccine to children who aren't sexually active, but American Academy of Pediatrics president Dr. Thomas McInerny said those concerns are ebbing.
"Parents are beginning to understand this is an anti-cancer vaccine, that it's important to give it at this age, and that it's not about sexuality," McInerny said.
Frieden agreed, noting that multiple studies have found that kids vaccinated against HPV are no more promiscuous than kids who have gone without the vaccine.
"HPV vaccine does not open the door to sex," Frieden said. "HPV vaccine closes the door to cancer."
Most health plans now cover HPV vaccination, and in the wake of the Affordable Care Act many provide the vaccine without any co-pay or deductible.
"We don't think cost is a barrier, and it's not showing up as a main concern in our survey," said Dr. Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases. "That's one of the responses they may offer, but we're not seeing it."
The HPV vaccine has a strong track record of safety, the CDC said.
About 56 million doses of Gardasil, the more popular HPV vaccine, were distributed in the United States from June 2006 through March 2013, according to the report. Those doses have resulted in just 21,194 reports of adverse reactions to the vaccine, with 92 percent classified as nonserious side effects. Reports of adverse reactions have steadily declined since 2009.