It’s been nearly 10 years since the CDC first recommended immunization against human papillomavirus (HPV), the disease known to cause many types of gynecological and reproductive cancers. During that time, numerous studies have supported the vaccine’s efficiency. Yet through a decade of endorsements and advancements, the HPV vaccine continues to fall below target rates.
According to the CDC, four out of every 10 girls and six out of every 10 boys are not vaccinated against HPV. Because HPV is a multi-dose vaccine, adoption rates, which reflect the number of people who have completed the full series of shots, are even lower. Today, the HPV vaccine remains the least-followed in the vaccination schedule, with adoption rates of only 38 percent among girls and 14 percent among boys. By comparison, other vaccines have an 80 to 90 percent adoption rate.
So what’s the hold up? And why such disparity between the genders?
"The single biggest barrier to increasing HPV vaccination is not receiving a health care provider's recommendation," Dr. Melissa Gilkey, lead study author assistant professor of population medicine at Harvard Medical School, told NPR.
The study produced by Dr. Gilkey and her team revealed that while 99 percent of doctors understand the vital benefits of HPV vaccines, more than 25 percent of them still refrain from making strong recommendations to patients. Among those who did make recommendations, they were less likely to suggest the schedule for male patients than female. Furthermore, most of the doctors did not recommend the vaccine as part of the routine schedule, but rather approached the conversation with parents from a risk standpoint. The hesitation, both among doctors and parents, is the taboo nature of HPV. Since the disease is mainly transmitted sexually, it can be challenging to approach the topic with parents.
Another challenge for the vaccine is the lack of communication between medical practices and patients. The HPV vaccine is given in three shots. The second shot is given one to two months following the first shot, and the third shot is given six months after the first shot. A study in Human Vaccines & Immunotherapeutics found that 65 percent of parents whose children did not complete the HPV series expected the medical practice to notify them about the next doses. And often times, the practices never do.
Finally, the misconception that the HPV vaccine is only for girls has been a challenge to overcome. HPV-related cancers and diseases can affect both males and females. The 2016 immunization schedule, produced by the CDC, includes a recommendation for HPV vaccinations for both boys and girls between the ages of 11 and 12 so they are protected before ever being exposed to the virus. However, if not previously vaccinated, the HPV vaccine should be a topic of conversation for both male and female patients through age 26.
Healthcare practitioners are the key to helping families acknowledge the importance of protecting children, teens, and even young adults from HPV and the cancers it can cause. Parents want and expect communication from their providers, and therefore, healthcare practitioners should not shy away from these tough conversations with parents and patients. Rather, providers’ recommendation and continued care should be what propels the full and on-time adoption of this important vaccine.