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Although the vast majority of pediatricians and family physicians nationally are offering the human papillomavirus vaccine, also called HPV vaccine, fewer of those physicians are strongly encouraging it for 11- to 12-year-old girls as recommended by national guidelines. Moral or religious reasons are cited as a major barrier.
Research funded by the Centers for Disease Control and Prevention and published in the September 2010 issue of Pediatrics, the journal of the American Academy of Pediatrics, is the first study to look at current HPV vaccination practices of U.S. physicians since the three-dose vaccine series was licensed in 2006 and became widely available.
University of Colorado School of Medicine and The Children's Hospital in Denver researchers surveyed 429 pediatricians and 419 family physicians in early 2008 from across the U.S., and found that 98 percent of pediatricians and 88 percent of family physicians reported that HPV vaccine was being administered to their female patients.
The goal of the HPV vaccine is to prevent HPV infections and ultimately reduce the rates of cervical cancer. Virtually all cervical cancer is caused by HPV infections. Approximately 20 million people in the United States are currently infected with genital human papillomavirus. Researchers estimate that the virus causes 500,000 cases of cervical cancer in women each year around the world. The virus can also cause warts in the genital area and low-grade (precancerous) cervical growths. Those two conditions are thought to strike 30 million people annually.
There are many different HPV strains. Currently, HPV vaccines protect against two HPV strains that cause roughly 70 percent of cervical cancer cases and another two strains that cause genital warts. The vaccination is recommended currently for 11- to 12-year-old girls, with "catch-up'" vaccinations for 13- to 26-year-female patients who have not been vaccinated.
“HPV vaccination is our best chance at preventing cervical cancer, so it's reassuring doctors are using it. However, vaccinations should ideally begin at 11 years of age, before there is any contact with relevant HVP types, and so that young women have time to complete the three-dose series and are protected,” said study lead author Matthew F. Daley, MD, a pediatrician and a researcher at the University of Colorado School of Medicine and the Kaiser Permanente Institute for Health Research in Denver.
Interestingly, the survey uncovered a range of attitudes among doctors related to administering the HPV vaccine to female adolescents. Forty two percent of pediatricians and 54 percent of family physicians considered it necessary to discuss sexuality before recommending HPV vaccine, though few physicians thought that vaccination would encourage earlier or riskier sexual behavior among teens. However, almost half of the physicians reported that parents were concerned about this issue.
Parent opposition to HPV vaccination for moral or religious reasons was perceived as definitely or somewhat a barrier by 23 percent of pediatricians and 33 percent of family physicians. The study also found most surveyed physicians were not using active strategies, such as sending patients reminders, to ensure those who started HPV vaccination received all three doses, which may further delay the age which patients are fully immunized.
In October 2009, The Food and Drug Administration (FDA) approved the HVP vaccine, Gardasil, for use in young boys and men ages nine to 26. In addition to protecting against cervical cancer, a recent Swedish study recently showed that the vaccine “provided strong and sustained protection” for four years against 90 percent of genital warts and other pre-cancerous female genital growths.
The Centers for Disease Control and Prevention has more information about the HPV vaccination at http://www.cdc.gov/std/hpv/STDFact-HPV-vaccine-young-women.htm
Lynette Summerill is an award-winning writer who lives in Scottsdale, Arizona. In addition to writing about cancer-related issues, she writes a blog, Nonsmoking Nation, which follows global tobacco news and events.
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