Photo by Judy Schmidt courtesy Centers for Disease Control and Prevention
Virginia is a national leader in getting its teens vaccinated against the most common sexually transmitted disease, human papillomavirus (HPV), which can lead to cervical and other cancers and genital warts.
The commonwealth led the nation with the highest percentage increase in the number of youth who are up-to-date in their HPV vaccinations, a 19.8 percent increase from 2016 to 2017, according to a Centers for Disease Control and Prevention report. Virginia also topped the nation with the largest average annual increase in the number of children receiving the vaccination, at 9.1 percent. Overall, 59 percent of teens were current on their HPV vaccines in 2017, compared with 39.2 percent the previous year, according to the Virginia Department of Health. The state reported that 75.6 percent of teens had at least one HPV vaccine last year, compared with 53.6 percent in 2016.
“This is really encouraging, that the vaccine rates are increasing,” says Bernard Fuemmeler, associate director of cancer prevention and control for the VCU Massey Cancer Center.
HPV occurs at some point in life in almost everyone who is sexually active and has not received the vaccine, according to the CDC. About 20 percent of Americans (about 79 million) currently have an HPV infection. Most will have no symptoms and will clear the virus in about two years.
But HPV can lead to cervical and vaginal cancer, penile cancer, cancer of the anus or rectum, and throat cancer. The vaccine provides nearly 100 percent protection against genital warts and cervical precancers, according to the CDC, and studies show that it has resulted in a 64 percent drop in HPV infections in teen girls since it was recommended for girls in 2006. A recommendation was issued for vaccinating boys in 2011. The vaccine is recommended for preteens at ages 11-12 and is usually administered in two doses six to 12 months apart.
Several factors may be at play regarding the boost in vaccination rates, according to Richard Brookman, a professor of pediatrics at the Children’s Hospital of Richmond at Virginia Commonwealth University, and a past president of the Society for Adolescent Health and Medicine.
Brookman, who has been treating adolescents since 1974, notes that VCU’s clinics have been proactive in recommending HPV vaccines. He says more parents are familiar with the vaccine, and a Virginia Chapter of the American Academy of Pediatrics initiative last year also sought to increase vaccination rates. “It’s not a new thing to the families, and it’s not being viewed [with] skepticism at all,” he says.
A key to increasing immunization rates has been to increase parental buy-in. That is enhanced by the pediatrician being upfront about the pros and cons, having the conversation with the parent and ensuring that they are part of the decision-making process, says Anne Marie Tuohy, a pediatrician with Bon Secours Pediatrics of Mechanicsville, and regional medical director for pediatrics for the Bon Secours Richmond Health System.
Nationally about 62.6 percent of boys and 68.6 percent of girls are up-to-date on HPV vaccines, according to the CDC. That compares with 91.9 percent of teens having had the vaccine against Hepatitis B, and 92.1 percent of adolescents receiving the MMR (measles, mumps and rubella) vaccine last year.
Side effects from the vaccinations are rare. Injection site pain and fever are the most common complications, according to Tuohy. Brookman says some kids may have some soreness where they received the shot, and one or two may become faint or, rarely, develop a rash in reaction to the liquid in the vaccine. “It seems to be really safe, and it seems to be really effective,” he says.
Some parents object to vaccines, though, citing religious beliefs or because of misinformation they’ve found in online research. Brookman notes that many of the parents do not remember a time before vaccines were available against measles and chicken pox, and have never seen or known someone who suffered severe complications from those diseases.
“You don’t realize that the lack of vaccination is a much greater risk than the vaccination itself,” he says.
Fuemmeler cautions that HPV vaccination rates need to continue to rise, to about 80 percent, to see a meaningful decline in cancers associated with the virus. He also notes that the numbers, while encouraging, may not be reflective of the situation in all communities across the state. Some areas may lag because of a lack of pediatricians or other factors. More needs to be done outside of the cities in terms of educating providers, parents and youth on the vaccine and its benefits. “There is still a lot of work to do,” he says. “It’s really a gift of medicine to have this vaccine.”
