HPV infections plummet even as low number of teens vaccinated
February 22, 2016 12:00 AM
Charles Rex Arbogast/Associated Press
The human papillomavirus vaccine, which has been recommended for girls since 2006 and for boys since 2011, involves three shots given within six months.
By Anya Sostek / Pittsburgh Post-Gazette
Ana Radovic has heard from parents that it’s just too early for them to think about giving their 11-year-olds a vaccine concerning a sexually transmitted disease. She has also heard concerns about the safety of the vaccine meant to prevent human papillomavirus.
And despite her efforts — and the efforts of many other pediatricians over the past decade — in allaying those concerns, national HPV vaccination rates are significantly lower than those of other adolescent vaccines, with fewer than half of girls ages 13 to 17 fully vaccinated.
Even with those relatively low coverage rates, however, the prevalence of actual HPV infections is plummeting, according to a study published today in Pediatrics, the journal of the American Academy of Pediatrics.
Girls between 14 and 19 years old saw infection rates on the four types of HPV covered by the Gardasil vaccine fall 64 percent from the rate prior to the vaccine’s introduction — from 11.5 percent in 2003-2006 to 4.3 percent between 2009 and 2012. In women ages 20 to 24, prevalence of the infection declined 34 percent in those years, from 18.5 percent to 12.1 percent.
“What we saw was what one would expect to see with an effective vaccine,” said Lauri Markowitz, author of the study and a medical epidemiologist at the Centers for Disease Control and Prevention. “The takeaway is that we’re seeing an impact of the HPV vaccination program.”
The human papillomavirus, spread through sexual contact, is thought to cause virtually all cases of cervical cancer. The majority of infections clear the body harmlessly, but those that do not can also cause genital warts and throat cancer, anal cancer, vaginal cancer, vulvar cancer and penile cancer.
The vaccine, which has been recommended for girls since 2006 and for boys since 2011, involves three shots given within six months.
Locally, HPV vaccination rates are far lower than the national average. In the Pittsburgh region, 27 percent of girls and 21.8 percent of boys ages 14-17 were fully vaccinated in 2014, the Jewish Healthcare Foundation calculated using data compiled from regional health insurance plan claims. The Jewish Healthcare Foundation is tracking regional rates as part of a public health campaign urging HPV vaccination.
According to CDC data for 2014, 48.2 percent of females in Pennsylvania ages 13 to 17 and 26 percent of males had gotten all three shots.
“There is a wide variation across the country. There’s no question about that,” Dr. Markowitz said.
The study describes the decline in HPV infections as “greater than expected” given the percentage of the population that has had all three shots — a result Dr. Markowitz attributes to the possibility fewer than three shots provides some immunity or that herd immunity may be protecting even those who aren’t vaccinated.
“This is even more evidence showing how effective the vaccine is in decreasing HPV across the population,” said Dr. Radovic, assistant professor of pediatrics in the Division of Adolescent and Young Adult Medicine at Children’s Hospital of Pittsburgh of UPMC, “I think it’s great this study was done.”
Despite the drop among adolescents and young teens, Dr. Radovic said, HPV is rampant among the general population, noting that roughly 80 percent of 50-year-olds have been infected.
“The question is not whether you’ll be exposed, but when,” she said.
The vaccine is currently recommended for both girls and boys at 11 or 12 years old. While many parents do not want to think about the possibility of a sexually transmitted disease when their children are that age, Dr. Radovic stresses that the focus is on prevention.
“The goal is to provide coverage way before anyone would experience sexual activity,” she said. “Studies have shown that this pre-teen time, around 11 or 12, the body has the best immune response toward HPV.”
Dr. Radovic is now recommending that patients get a newer vaccine, Gardasil 9, which protects against more strains of HPV.
The topic doesn’t have to be one that parents shy away from, she said, noting that the vaccine may provide a good opening for parents to discuss sexually transmitted diseases and sexual health with their children.
Dr. Radovic also said that she is confident that the vaccine is safe, noting that the CDC has investigated claims of side effects extensively and still recommends the vaccine.
Anya Sostek: firstname.lastname@example.org or 412-263-1308.
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