When my wife and I were given the choice to vaccinate my daughter and older son against Human Papilloma Virus (HPV), it was an easy decision. When it’s time for my younger son, now 7, to get the vaccine, we’ll do it again.
Two shots, 6-12 months apart, protect our kids against multiple strains of a virus responsible for more than 30,000 cancer deaths every year in the United States.
This is the case not just for our daughter, but for our sons as well. HPV is associated with 99 percent of cervical cancers. It’s also responsible for 95 percent of anal cancers, 70 percent of throat and neck cancers, 65 percent of vaginal cancers, and 35 percent of penile cancers.
Unfortunately, many parents, and even many providers, don’t know all the facts about HPV, the vaccine, and cancer. That’s one of the major reasons why the American Cancer Society has just launched a national campaign to encourage vaccination.
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This is particularly needed in Texas. In 2016, only 33 percent of Texas teens ages 13-17 were fully vaccinated against the most dangerous strains of HPV. That compares to 85 percent of our kids who were vaccinated for protection against dangerous pathogens like tetanus, diphtheria, pertussis, and meningococcus.
Our HPV vaccination rate is among the worst in the country, according to the National Immunization Survey. Only Wyoming, Mississippi, South Carolina and Utah have lower rates. More importantly, it represents an extraordinary missed opportunity for protecting our children against cancer. If we can make HPV vaccination as routine as other adolescent vaccines, we can improve and even save thousands of lives.
A recent review of HPV vaccination programs in high-income countries shows that when more than 50% of kids and adolescents receive the full vaccine, rates of HPV infection go down more than 60%. In Australia, which was the first country to begin routine vaccination, there is direct evidence of a decline in precancerous symptoms in teens and young adults.
A lot of this is new information. The link between HPV and cervical cancer was only established in the 1980s. Our knowledge of the virus’s connection to other cancers, including cancers that affect men, is even more recent.
Getting our rates up is achievable. Our rates for other adolescent vaccines are high, and in line with the rest of the country. In certain parts of Texas, we are doing really well getting our kids vaccinated against HPV. In El Paso, for instance, 66% of adolescents are up to date on their HPV vaccination. That rate is among the best in the country.
There is no reason the rest of us can’t do as well as El Paso, and no reason El Paso can’t do even better. There are a number of evidence-based strategies we can deploy, now, to get our rates up to where they should be.
Number one is to educate clinicians about the best strategies for counseling and recommending vaccines to patients. Parents want to protect their kids from cancer. When given accurate information, and their doctors’ recommendation, they usually say yes.
Because it’s a two- or three-dose vaccine (depending on age), we need to develop methods for improving the rates at which parents bring their kids back for the second or third dose. When a dose is given, for instance, the next should be scheduled before the patient leaves the office.
In the long run, these strategies and others will save lives.
In the history of major public health advances, there is often a lag time between the development of a new vaccine and the full implementation of its use. We’re in that lag time right now. The shorter we can make it, and the faster we can implement good policies and strategies, the more lives we can save. And not just any lives. It's our kids’ lives.
Dr. David Lakey, MD, is Vice Chancellor for Health Affairs and Chief Medical Officer for the UT System. From 2007-2015 he served as Texas Commissioner of Health.