Many girls in state get cervical cancer shot

70% of teens have first dose; many don’t get all three

By Marissa Harshman, Columbian health reporter

Published:

 

Washington girls are getting vaccinated against human papillomavirus, or HPV, at a rate significantly higher than that of girls nationwide.

Nearly 70 percent of 13- to 17-year-old girls in Washington receive the first dose of the three-dose vaccine, compared with just 48.7 percent of teen girls nationwide, according to the 2010 National Immunization Survey.

But, as in other areas of the country, many girls in the state fail to complete the immunization series. Only 45.5 percent of Washington teen girls receive all three doses, compared with 32 percent of all U.S. teens, according to the recently released survey results.

Local pediatrician Dr. Mike Wilmington couldn’t explain why Washington teens get the vaccine at a higher rate than their counterparts, but said the reasons girls fail to get the second and third doses are similar everywhere. Among the causes for the drop-off are the cost of the vaccine and the inconvenience of multiple visits to a physician’s office, said Wilmington, a Kaiser Permanente physician.

The Centers for Disease Control and Prevention recommends the vaccine for 11- and 12-year-old girls, and for females ages 13 through 26 who didn’t receive the vaccine when they were younger. The vaccine can be given to girls as young as 9.

Currently, there are two HPV vaccines available: Gardasil and Cervarix. Both protect females against the types of HPV that cause most cervical cancers. Gardasil is also available to boys and men ages 9 to 26 because it protects males and females against most genital warts, according to the CDC.

Bachmann’s claims

The HPV vaccine was thrust into the national spotlight earlier this week when U.S. Rep. Michele Bachmann, R-Minn., questioned its safety. Bachmann called the vaccine potentially dangerous and shared with national media an anecdote of a mother who claimed her daughter suffered from “mental retardation” after getting the vaccine.

Physicians across the country have since spoken out against Bachmann’s claims.

“There is absolutely no scientific validity to this statement,” Dr. O. Marion Burton, president of the American Academy of Pediatrics, said in a news release. “Since the vaccine has been introduced, more than 35 million doses have been administered, and it has an excellent safety record.”

Wilmington, who’s been a pediatrician for 20 years, said its not the first time he’s seen a vaccine aimed at ’tweens get criticized.

When the hepatitis B vaccine was first released, it was recommended for pre- and young teens. But some saw it as a “dirty vaccine” for people who have sex or use needles, Wilmington said.

When the recommendations changed and physicians suggested vaccination during infancy, immunization rates went up and the controversy disappeared, he said.

“HPV had a very similar rocky course,” Wilmington said.

HPV is the most commonly sexually transmitted infection, but it’s not transmitted only through intercourse. At least 50 percent of sexually active people will have HPV in their lifetime, according to the CDC.

“I think it’s just the American public is uncomfortable about issues related to sexuality,” Wilmington said.

$120 per shot

In addition to the stigma, the vaccine has barriers related to its cost and the need for multiple doses.

The vaccine costs $120 per shot, and in many cases, patients also have to pay for an office visit. Some private insurers don’t cover the cost of the vaccine. However, the state and federally funded Vaccines for Children Program does include the vaccine, meaning uninsured and underinsured children younger than 19 can receive the vaccine for free, said Dr. Alan Melnick, Clark County health officer.

The CDC recommends people receive all three doses of the vaccine over six months. The inconvenience of multiple trips to the medical office is sometimes enough to keep children from getting all three doses, Wilmington said.

A National Cancer Institute study suggested that people with only one or two doses of the vaccine had high levels of protection against the virus. The study was based on a clinical trial and looked only at protection levels four years after the vaccine was administered. More follow-up is needed in order to determine how long the protection lasts, according to the National Cancer Institute.

Every year in the U.S., about 6 million people, including teens, become infected with HPV, and 4,000 women die from cervical cancer, according to the American Academy of Pediatrics. HPV infections have also been linked to other cancers, such as anal, penile, vaginal and oropharynx (the middle part of the throat), according to the Cancer Institute.

Physicians hope those risks are enough to encourage parents and teen girls to get the vaccine.

“It helps prevent cancer,” Melnick said. “I don’t understand why people would be opposed to it.”

Marissa Harshman: http://twitter.com/col_health; http://facebook.com/reporterharshman; marissa.harshman@columbian.com; 360-735-4546.