Checking in on the HPV Vaccine

HPV vaccine coverage levels low despite no safety issues

(RxWiki News) Health officials celebrated when a safe and effective vaccine to protect against HPV (human papillomavirus) was made available to the public. But a vaccine can't protect the public if it isn't being used.

According to a new report from the Centers for Disease Control and Prevention (CDC), despite the wide availability of the HPV vaccine, the rates of young girls receiving the vaccination have leveled off. They state that this is leaving many of them at risk for HPV infections and HPV-related cancers.

"Talk to your doctor about vaccinations."

HPV is an extremely common sexually transmitted disease of which there are over 40 strains. According to the CDC, most types of HPV (around 90 percent) go away on their own before causing any health problems, and often before the person is even aware they have it. However, other strains of the virus can linger and cause health problems like genital warts and certain cancers. 

The virus is so common that the CDC has reported that "nearly all sexually-active men and women will get at least one type of HPV at some point in their lives."

The CDC estimates that 79 million people in the US are currently infected with HPV and another 14 million become newly infected every year.

According to this new report released Thursday by the CDC, in mid-2006 the Advisory Committee on Immunization Practices (ACIP) began recommending routine HPV vaccination of adolescent girls starting at ages 11 or 12. Three doses of the vaccination are required to fully protect these patients. 

The HPV4 and HPV2 vaccines protect against HPV types 16 and 18, which cause most cervical cancers. The HPV4 vaccine also protects against HPV types 6 and 11, which cause most genital warts.

However, the new data shows that while the vaccine coverage had been increasing since 2007, there was hardly any increase of HPV vaccination coverage between 2011 and 2012. 

Led by Shannon Stokley, MPH, of the CDC, the research team used data from the 2007–2012 National Immunization Survey-Teen (NIS-Teen), which collected data from all 50 states. Over 14,000 adolescents between the ages of 13 and 17 were included in the data.

Stokley and team discovered that although the percentage of girls who had received the vaccine had increased from 25.1 percent in 2007 to 53.0 percent in 2011, the number barely changed in 2012, when it measured at 53.4 percent.

Furthermore, only 33.4 percent of girls in 2012 had completed the series by receiving all three vaccine doses. 

This study also attempted to understand why parents were not choosing to get their daughters vaccinated. Some of the most common reasons included vaccine safety concerns, the daughter not being sexually active and lack of knowledge on the vaccine.

The CDC reported that the vaccine is safe, based on seven years of monitoring. No major safety issues have been seen during this time. 

In response to concerns over vaccinations before sexual activity begins, CDC Director Tom Frieden, MD, MPH, stressed the importance of early vaccinations.

“Parents need reassurance that HPV vaccine is recommended at 11 or 12 because it should be given well in advance of any sexual activity,” said Dr. Frieden in a press release. “We don’t wait for exposure to occur before we vaccinate with any other routinely recommended vaccine.”

Dr. Frieden also highlighted the need for efforts from healthcare providers to increase the HPV vaccination rates.

"Progress increasing HPV vaccination has stalled, risking the health of the next generation. Doctors need to step up their efforts by talking to parents about the importance of HPV vaccine just as they do other vaccines and ensure its given at every opportunity," said Dr. Frieden.

The CDC estimated that for every year the three-dose HPV vaccine rate stays at the current level of 33 percent, instead of reaching the goal rate of 80 percent by the year 2020, "an additional 4,400 women will be diagnosed with cervical cancer and 1,400 cervical cancer-attributable deaths will occur in the future."

Further research is needed to confirm the report's findings. Since the survey was phone-based, it did not include families without a telephone, which may have affected data. 

This study was published in the CDC's Morbidity and Mortality Weekly Report (MMWR) on July 25.

No conflicts of interest were reported.

Review Date: 
July 25, 2013