Sunday, October 1, 2017

Ky. teens still far below average in getting vaccine that prevents cervical cancer, a disease more common here than most states

By Melissa Patrick
Kentucky Health News

Fewer than half of Kentucky's teenagers are getting the human papillomavirus vaccine, which is known to prevent several cancers, including cervical cancer -- a disease for which Kentucky leads the nation.

A federal Centers for Disease Control and Prevention report, using data from the 2016 National Immunization Survey for teenagers, found that 48 percent of Kentucky's teens between 13 and 17 received one or more doses of the HPV vaccine, but only 34 percent completed the recommended series of doses. Both rates were lower than the national average.

Nationwide, the report found that 60.4 percent of teens received one or more doses of the vaccine in 2016, up from 56.1 percent in 2015; by the age of 17, 43.4 percent had received all recommended doses.

"For a state recognized for high rates of all HPV-related cancers, it's troubling to see HPV vaccination rates among our adolescents lag behind the rest of the country," Dr. Robin Vanderpool, an associate professor at the University of Kentucky College of Public Health, said in an e-mail to Kentucky Health News.

Vanderpool said requiring the vaccine for entry to school would boost the HPV vaccination rates in Kentucky, but she also recommended state and local approaches to improve parents' knowledge of HPV vaccination as cancer prevention -- as well as efforts to increase health-care provider recommendations of the vaccine, a major obstacle.

Experts at an immunization conference last year placed most of the blame for the poor rate of HPV vaccinations on physicians, citing studies that show a "clear, same-day recommendation" from a physician to a parent is the most important factor in whether a child gets vaccinated.

"Through population-level HPV vaccination coverage, a whole generation of Kentucky youth could be protected from ever developing cancer," Vanderpool said. "What a tremendous public health achievement Kentucky could be a part of!"

HPV causes more than 90 percent of anal and cervical cancers; 70 percent of vaginal, vulvar and middle-throat cancers; and more than 60 percent of penile cancers. And two of the HPV strains are associated with more than 90 percent of anal and genital warts.

The report says that every year, an estimated 31,500 newly diagnosed cancers in men and women are attributed to HPV, and approximately 90 percent could be prevented by the HPV vaccine, which protects against nine different strains. Kentucky ranks in the top 10 states for cervical cancer incidence, and the top 20 for deaths from it.

Another obstacle to vaccination is the need for more than one dose. New CDC guidelines recommend a two-dose series if given before the age of 15 and a three-dose series if given after 15. The vaccine is recommended between 11 and 12, but can be given to females up to 26 and males as old as 21.

HPV is most commonly transmitted through sexual intercourse, but it can also be transmitted through intimate skin-to-skin contact.

The report found that HPV vaccine is becoming more common among boys. Nationally, 65 percent of girls received the first dose of HPV vaccine in 2016, compared to 56 percent of boys, a 6 percent increase from 2015 for boys and about the same rate for girls. In Kentucky, 55 percent of girls received at least one dose of the HPV vaccine in 2016, compared to 42 percent of boys.

It also found that HPV vaccination rates were lower in rural areas (50.4 percent) compared to urban areas (65.9 percent).

The CDC news release says that since the introduction of the first HPV vaccine over 10 years ago, "infections with HPV types that cause most of these cancers and genital warts have decreased by 71 percent in teen girls and 61 percent in young women."

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