Doctors should do more to vaccinate all kids against cancer-causing HPV, experts say.
The USA is failing to protect children from preventable cancers that afflict 22,000 Americans a year by not vaccinating enough of them against HPV, a new report says.
Although a safe and effective HPV vaccine has been available for eight years, only one-third of girls have been fully immunized with all three recommended doses, according to a report from the President's Cancer Panel, which has advised the White House on cancer since 1971. HPV, or human papillomavirus, is a family of viruses that causes cancer throughout the body, including cancers that predominantly affect men, such as a type of throat cancer. Only 7% of boys are fully vaccinated, although the Centers for Disease Control and Prevention has recommended the shots for them since 2011.
Raising vaccination rates to at least 80% of teen girls could prevent 53,000 future cases of cervical cancer in girls alive today, according to the CDC.
"Our children deserve this protection," says panel chairperson Barbara Rimer, a professor at the University of North Carolina at Chapel Hill.
Administering the HPV shot poses practical difficulties not faced by other adolescent vaccines, because it currently requires three doses, at least two months apart, beginning when kids are 11 or 12, says pediatrician Mary Anne Jackson, director of infectious diseases at Children's Mercy Hospital & Clinics in Kansas City, Mo., who wasn't involved in the new report. Although emerging research suggest that two doses could be equally effective, experts have not yet changed their recommendations.
And at a total cost of $400 for three shots, the HPV vaccine is also more expensive than other vaccinations, although it's often covered by insurance, Jackson says.
The real problem, research shows, is that doctors are treating HPV vaccinations differently than other shots recommended for kids at that age, such as meningitis and whooping cough boosters, Jackson says.
All too often, doctors offer HPV shots, giving parents the option to vaccinate, without strongly recommending them, says Debbie Saslow of the American Cancer Society, who served as an adviser on the report. That could be because doctors are leery of initiating a discussion about sexual activity, which is how HPV spreads, Saslow says. Doctors recommend giving HPV shots to kids at a young age, when they're most effective.
Yet studies show that most parents are likely to follow their pediatrician's recommendations, Jackson says. Most families would likely agree to HPV vaccinations if doctors simply included it in their general package of middle-school shots, Jackson says. Studies have found the vaccine to be extremely safe, with no increase in serious side effects, in spite of giving 56 million doses of the shots in the USA alone.
Future HPV vaccines may soon be even more protective than the original shot. While the current vaccines can prevent about 70% of cervical cancers, HPV vaccines under development will protect against 90% of cervical tumors, the report says.
"If we could get physicians to give a strong message about HPV vaccination to every child, we could make a real difference," says Rimer, whose report notes that 60% of girls in the United Kingdom and 71% in Australia are fully vaccinated against HPV. "The conversation needs to be framed around cancer prevention, not about sex."
State lawmakers could help boost vaccination rates, Rimer says, by passing laws to allow pharmacists to administer HPV shots to teens just as they do flu shots. Only 6% of pharmacists are in states that allow them to give HPV shots without prior approval from a physician.
The panel also asks President Obama to lend his support to HPV vaccination.
"Your support of widespread HPV vaccination starting today can help save thousands, and perhaps hundreds of thousands, of lives, and could forever alter the landscape for cancers related to HPV," the report says. "No man or woman should have to suffer or die from cancer or other diseases when the means by which to prevent them is within our grasp."