If there was an easy way to stop your children from getting cancer, wouldn’t you do it? And wouldn’t you at least expect your doctor to tell you about it? It’s a no-brainer, right?
Wrong. As it turns out, doctors aren’t always doing a good job of making sure kids are being vaccinated against HPV, which can cause cancer later in life. Over and over again, studies, including reports from physicians themselves, show that doctors simply don’t discuss the subject with parents.
This failure has even become a topic of concern nationally. “Doctors, Not Parents, Are The Biggest Obstacle to The HPV Vaccine,” read a recent National Public Radio (NPR) headline, which was accompanied by a story entitled “U.S. Teens Still Lag In Getting Vaccinated Against HPV.” The Boston Globe’s recent story on the subject was entitled “Study Says Doctors Passively Discourage HPV Vaccines,” while The Daily Beast asked “Why Do Doctors Hate This Vaccine?”
The upshot is that parents shouldn’t wait for doctors to recommend the HPV vaccine - parents should tell doctors that their kids (boys and girls) need the HPV vaccine, starting at age 11 and 12.
Doctors, Don’t Treat It As An Option
So why are doctors falling down on the job of getting kids immunized against HPV? At the recent American Public Health Association conference in Chicago, research revealed several interesting points.
For one thing, unlike every other vaccine, more than 60 percent of doctors think of the HPV vaccine as “optional,” especially when it comes to boys. And because doctors don’t rank the HPV as important, it often doesn’t get discussed at all, even during “sick” visits where other vaccines are commonly brought up. Doctors also perceive that a discussion of the HPV vaccine takes longer, so they often leave it to last, which also leads to it getting less attention. And, according to the NPR report, many doctors will discuss the vaccine without actually recommending it, while many others simply forget to mention it at all.
That is why health experts recommend that doctors get in the habit of treating the HPV vaccine as they do all other vaccines. At age 11 or 12, all boys and girls should start the three-dose HPV vaccine. As that is the same age that the Tdap (tetanus, diphtheria, pertussis) and meningococcal vaccines are administered, the HPV vaccine should be listed right along with those as a routine immunization. Researchers also says it helps when schools require the vaccination on medical forms as they do other vaccines.
Perception v. Reality
So how did this vaccine somehow end up on the D-List in doctors’ minds? The vaccine was given an unfortunate gender/sexual connotation that obscured what the vaccine really accomplished: preventing cancer in women and men. It is interesting, as well as a puzzlement to health experts, that the Hepatitis B vaccine, the only other vaccine that prevents cancer and is administered to infants, has no such connotation, even though Hepatitis B can be spread sexually, just like HPV. And while the vaccine was first approved for girls, it is now recommended for both boys and girls. Still many doctors became wary of discussing the HPV vaccine with parents at all, while others discussed it in terms of perceived sexual risk, another mistake.
That reluctance and mischaracterization can cost lives. Nearly all adults will get HPV at some point in their lives, with one in every four U.S. adults currently infected. And though most of those infections will go away on their own without people even realizing they are infected, a certain number will lead to cancer. The HPV vaccine can prevent many of those cancers, including cervical (the most common HPV cancer, with almost all cases being caused by HPV), as well as many vulvar, vaginal, penile, anal and head and neck cancers. The vaccine also prevents genital warts.
As for why the vaccine is administered to preteens, it is done at that time to help ensure the best immunological response (as with other childhood vaccines) and to make sure that the protection is in place well before those teens become sexually active. Concerns that the vaccine would promote sexual behavior have been shown to be completely unfounded, but, sadly only 38 percent of teen girls and only 14 percent of teen boys are getting all three doses of the vaccine, a rate that is far below the 80- and 90-percent rates for other vaccines.
Good News for Doctors
The latest research shows that doctors really can make a difference in increasing HPV vaccination rates. According to Melissa Gilkey, the lead author of the study featured in the NPR story, the single biggest barrier to HPV vaccination is not receiving a recommendation from a health provider. That factor far outweighs parental reluctance, with research showing that parents aren’t as hesitant as doctors about HPV vaccination and just require more information.
All doctors need to do is treat the HPV vaccine as any other and be prepared to answer questions about effectiveness, safety and misconceptions just as they would any other vaccine. In the words of Dr. John Hallberg, an MD and associate professor at the University of Minnesota Medical School, who produced a movie called “Just Another Shot: Reframing the HPV Vaccine” in conjunction with the Centers for Disease Control and Prevention (CDC), “No drama needed.”
For more information on the HPV vaccine, go to http://louisianacancer.org/hpv-vaccine/.
The CDC-funded Louisiana Cancer Prevention and Control Programs (LCP) are housed at the LSU Health Sciences Center School of Public Health. For more information on cervical cancer screenings, visit LCP’s Louisiana Breast and Cervical Health Program (LBCHP) at www.lbchp.org.