With Vaccines for HPV Cancers, Why are so few Alabama Children Protected?

Jan 12, 2016 at 12:42 pm by steve

Karen Landers, MD

So why is it that only 30 percent of girls and 9 percent of boys in this state are being protected with the vaccines we do have that could keep them from getting 90 percent of cervical and anal cancers, 70 percent of vaginal, vulvar and oropharynx cancers, and more than 60 percent of penile cancers?

“Primarily, the problem is a lack of education and awareness,” pediatrician Karen Landers, MD, said. In addition to caring for children in northwest Alabama, Landers consults with the Alabama Department of Public Health on immunization issues. Along with the CDC and numerous public health organizations, she believes that vaccinating 11 and 12 year olds against the potentially lethal effects of HPV viruses should be a priority.

“The newest version of the HPV vaccine is effective against more strains of the virus, and it can protect both boys and girls from multiple cancers they might otherwise face years from now. In just a few years, it can also protect them from the discomfort of genital warts and the ethical dilemma of possibly passing HPV on to someone they love,” Landers said. “When you talk with parents, they respond to the opportunity to protect their child from cancers that tend to show up in adulthood and middle age. When you’re talking with adolescents, their concerns tend to be more immediate. The idea of being able to avoid genital wards can be persuasive.”

The immune system responds best when the vaccine is given between 11 and 12 years of age, with the second dose optimally timed at six weeks and the third dose at six months. Catch up vaccines are recommended for males through age 21, and females and those with compromised immune systems through age 26 if they didn’t receive the vaccine when they were younger.

Another factor in why so many children are missing out on the opportunity to be protected is that, according to surveys, around 27 percent of health care providers aren’t actively recommending and explaining the benefits of immunization at the time children become eligible for it.

“When children come in for their annual checkup at age 11, or for exams for sports and other activities, HPV vaccines should be part of the routine immunizations we recommend at that time,” Landers said. “Parents want to protect their children and do all they can to keep them safe. They value the information and recommendations we give them. We need to be ready to give the first injection the same day, and to schedule appointments for the second and third dose and make sure parents understand why it’s important to get all three for the best immunity.”

Another roadblock to immunization in the past has been cost. Together, the three doses of the vaccine cost about $400 and sometimes more, plus paying someone to administer the vaccine and in some cases the cost of office visits. Under the ACA, as preventive care, immunizations should be covered, but choice of vaccine, who is eligible, and other details can vary with different private insurance plans. If cost is a problem, there are programs that may be able to help with funding.

In the past, some parents were concerned that vaccinating their children against a virus that is transmitted sexually might encourage promiscuity, but research has shown that not to be the case.

“Parents can’t always protect their child from bad things that could happen, but they can protect them from this,” Landers said. “Even if their children only have one partner their whole life, they could become infected. This virus causes cancers that could affect their child’s ability to have children, and in rare cases, it could even infect their grandchild as it is born. They can protect their children, the same as they would protect them against measles, by simply including HPV vaccinations as part of their routine immunizations.”

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