Physicians must take responsibility for improving the rate of human papillomavirus (HPV) vaccinations among teenagers, according to Anne Schuchat, MD, assistant surgeon general and director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention.
Overall, US teenagers had more vaccinations in 2014 than in previous years, including against HPV, said Dr Schuchat, when discussing the results of a new survey in a press conference held July 30. But most parts of the country are still lagging, primarily because physicians are not doing enough, she said.
"We think the principle road block is providers not recommending the vaccine," she said.
Researchers from the Centers for Disease Control and Prevention published the findings from a survey of 20,827 teenagers in the July 31 issue of the Morbidity and Mortality Weekly Report.
General trends in the annual National Immunization Survey–Teen are positive. An uptick in HPV vaccination started in 2012 after years in which HPV vaccination rates appeared to be stagnating, Dr Schuchat said.
There are some particular bright spots. For example, the proportion of teenage boys who had gotten at least the first of the three recommended doses of HPV vaccine increased from 33.6% in 2013 to 41.7% in 2014.
However, the proportion among boys is still far below the 60.0% rate of first-dose HPV vaccination seen for girls in 2014.
Moreover, girls are lagging in their HPV vaccinations when compared with vaccination rates for tetanus-diphtheria-acellular pertussis (Tdap) and for meningococcal conjugate (MenACWY). Among boys and girls combined, 87.6% had gotten at least one dose of Tdap and 79.3% got at least one dose of MenACWY in 2014.
This suggests that parents and clinicians are not taking HPV vaccination as seriously as the other vaccinations recommended for teenagers, Dr Schuchat noted.
"Our research shows that a recommendation from a healthcare provider is crucial to parents getting an HPV vaccination for their child," she said. "And the way to give an effective vaccination is to recommend an HPV vaccination in the same way and on the same day that you recommend other routinely recommend teenage vaccines."
Although the rate of HPV vaccination increased among children older than 13 years, it did not increase among younger adolescents, leading Dr Schuchat and colleagues to conclude that physicians and parents are delaying HPV vaccination until children get older.
"I want to stress to clinicians and parents that 11- to 12-year-olds are recommended to get the HPV vaccine," she said. "That's not too early."
Table. Estimated Vaccination Coverage
Vaccine
2013, n = 18,948
2014, n = 20,827
Tdap ≥ 1 dose
84.7
87.6
MenACWY ≥ 1 dose
76.6
79.3
HPV ≥ 1 dose, boys
56.7
60.0
HPV ≥ 1 dose, girls
33.6
41.7
The annual National Immunization Survey–Teen survey included both telephone interviews and efforts to verify vaccinations by contacting healthcare providers.
The findings reveal a handful of other reasons for optimism. In contrast to other vaccinations, the rate of HPV vaccination among teenagers living in poverty is higher than among wealthier teenagers, the results showed.
"There may be differences in provider behavior where many kids are low income," Dr Schuchat said. "There may be better practices in those areas."
She also pointed out that HPV is more expensive than other vaccinations, and government subsidies are available to cover the cost for low-income children.
However, research shows that the expense of HPV does not explain the difference in coverage for HPV compared with other teenage vaccinations in the population as a whole, she noted.
The researchers point out that successful initiatives in cities and states scattered around the country suggest that the right approach can yield results.
In particular, Dr Schuchat highlighted improvements in vaccination rates in Illinois, Montana, North Carolina, and Utah among states, and in Chicago, Illinois, and Washington, DC, among cities.
The experience of these communities suggests a combination of strategies is needed, including:
coordination of cancer prevention and immunization initiatives,
clinician-to-clinician education sessions,
education of staff within healthcare practices practice,
public media campaigns, and
use of registries or information systems to send reminders to patients.
"Instead of just patchwork progress, we have the chance to blanket the country with protection from HPV-associated cancers," Dr Schuchat concluded.
Dr Schuchat has disclosed no relevant financial relationships.
I voted other. I don't believe there has been enough research on the vaccine to have given it to my daughter. Our Dr agrees with us. Many doctors agree with us...
Daughter hasn't gotten it as an adult...
__________________
America guarantees equal opportunity, not equal outcome...
I voted other. I don't believe there has been enough research on the vaccine to have given it to my daughter. Our Dr agrees with us. Many doctors agree with us...
Daughter hasn't gotten it as an adult...
I'm on the fence about it. DD is almost the age for it. I turned it down at her 10YO check up because of the lack of data on results and issues some may have with the vaccine. I really need an education on it.
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Sometimes you're the windshield, and sometimes you're the bug.
A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.
Wait, isn't the disease a result of unprotected sex? Sure blame the doctors, they can only recommend it not force parents to agree.
I believe the Human Papiloma virus can be transferred by kissing, and causes what are usually called "cold sores" in the mouth. So even 11 year olds are at risk.
And once it's in the body, it's too late. (Or is that Herpes? Now I'm confused. Again.)
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The Principle of Least Interest: He who cares least about a relationship, controls it.
Wait, isn't the disease a result of unprotected sex? Sure blame the doctors, they can only recommend it not force parents to agree.
I believe the Human Papiloma virus can be transferred by kissing, and causes what are usually called "cold sores" in the mouth. So even 11 year olds are at risk.
And once it's in the body, it's too late. (Or is that Herpes? Now I'm confused. Again.)
That's herpes or gonorrhea.
__________________
A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.
I voted other. I don't believe there has been enough research on the vaccine to have given it to my daughter. Our Dr agrees with us. Many doctors agree with us...
Daughter hasn't gotten it as an adult...
I'm on the fence about it. DD is almost the age for it. I turned it down at her 10YO check up because of the lack of data on results and issues some may have with the vaccine. I really need an education on it.
This. I was all for it, and then did more research, and there really isn't quite enough. We're probably going to do it - but, I'm waiting until she's 12 or 13. I do think that emotionally and mentally, parents are not ready to think about this for their 11 year olds.
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LawyerLady
I can explain it to you, but I can't understand it for you.
But that's exactly where this country is headed if we don't stop giving government control.
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A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.
I want the schools to be as little involved as possible in my kids lives.
I don't think there should be any medical care that isn't necessary.
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A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.
Meh. Sometimes, it's easier. When I was in school, the health department came to school to give us our tetanus boosters in 10th grade. We all needed them, and it was convenient. Of course, I lived in a really small town where the entire high school was 400 students.
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LawyerLady
I can explain it to you, but I can't understand it for you.
I voted other. I dont' believe in running out and getting every new vaccine that comes down the Pike. I would rather wait a bit and see how it plays out. Then, I will consider it after it is time tested.
I also remember the SS administration coming to my middle school to register kids for their numbers. I already had mine, so we didn't do it - but other parents took advantage of it.
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LawyerLady
I can explain it to you, but I can't understand it for you.
You seem proud of that. It's rather disturbing. Kinda like a horror movie. Ve vill do as ve please vith your children, parental choice ve damned.
Proud? Where did you get that from? Which particular word? There aren't a whole lot of them. I was stating a fact.
Don't be absurd. Parental consent is required, unless the child is of age to give medical consent.
Then state that next time. Your post came across as if you were proud of the fact that the Gov't/school takes care of all that, and you indicated no reference to parental consent.
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Sometimes you're the windshield, and sometimes you're the bug.
Meh. Sometimes, it's easier. When I was in school, the health department came to school to give us our tetanus boosters in 10th grade. We all needed them, and it was convenient. Of course, I lived in a really small town where the entire high school was 400 students.
One of my jobs is in Community Health, for the CLSC (centre local de services communautaires) It's much easier to go to the schools to give Twinrix, DpT, MMR boosters and Gardasil that way. Some parents put off getting boosters, or forget, or misplace the paperwork or don't know because we have a lot of immigrants or whatever. This way, we send info sheet, and consent forms home, and then do all the vaccinations for the whole school in a day or two. I live in a really big city, though.
Just for the record I'm not being proud, horrified, guilty, disgusted, flummoxed, elated, or joyous, etc. I'm stating a fact, in case some are easily confused.
Around where I live there is a new surge of anti vaxxers taking place. UGH.
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“You may shoot me with your words, you may cut me with your eyes, you may kill me with your hatefulness, but still, like air, I'll rise!” ― Maya Angelou
Meh. Sometimes, it's easier. When I was in school, the health department came to school to give us our tetanus boosters in 10th grade. We all needed them, and it was convenient. Of course, I lived in a really small town where the entire high school was 400 students.
One of my jobs is in Community Health, for the CLSC (centre local de services communautaires) It's much easier to go to the schools to give Twinrix, DpT, MMR boosters and Gardasil that way. Some parents put off getting boosters, or forget, or misplace the paperwork or don't know because we have a lot of immigrants or whatever. This way, we send info sheet, and consent forms home, and then do all the vaccinations for the whole school in a day or two. I live in a really big city, though.
Just for the record I'm not being proud, horrified, guilty, disgusted, flummoxed, elated, or joyous, etc. I'm stating a fact, in case some are easily confused.
I do not think the Gardisil vaccine should be given at school. That's a personal decision that parents need to make for their girls.
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LawyerLady
I can explain it to you, but I can't understand it for you.
I do not think the Gardisil vaccine should be given at school. That's a personal decision that parents need to make for their girls.
HPV effects over 50% of the population. It might be a personal decision that parents need to make NOW, but if we as a society want to wipe out this disease,
we're going to have to treat it like Polio (and smallpox when I was little), and vaccinate ALL the children.
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The Principle of Least Interest: He who cares least about a relationship, controls it.
I do not think the Gardisil vaccine should be given at school. That's a personal decision that parents need to make for their girls.
HPV effects over 50% of the population. It might be a personal decision that parents need to make NOW, but if we as a society want to wipe out this disease,
we're going to have to treat it like Polio (and smallpox when I was little), and vaccinate ALL the children.
It's not going to wipe it out even if everyone gets it. The vaccine only covers some of the strains, when HPV is like the flu - it has tons of different strains and it mutates. And it's new - it is not yet proven enough for some people, and that is their decision to make.
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LawyerLady
I can explain it to you, but I can't understand it for you.
I do not think the Gardisil vaccine should be given at school. That's a personal decision that parents need to make for their girls.
HPV effects over 50% of the population. It might be a personal decision that parents need to make NOW, but if we as a society want to wipe out this disease,
we're going to have to treat it like Polio (and smallpox when I was little), and vaccinate ALL the children.
TOTALLY different circumstance. This is not airborne. This is transmitted a certain way. Through sexual intercourse.
__________________
America guarantees equal opportunity, not equal outcome...
It's not in the same class of disease as, say, measles or pertussis which are much more easily communicable.
At the same time, many parents are stunningly naive. They say things like, well, I don't have to worry about it for my daughter because she would "never" have premarital sex--and then she does.
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I'm not arguing, I'm just explaining why I'm right.
Well, I could agree with you--but then we'd both be wrong.
While I do not have daughters to worry about it, I am on the fence about this issue. I know four people, one of which died from cervical cancer, the other three agonize each time they get a pap/vag exam because they have the HPV. Each one of these women "caught" HPV from their husbands. My MIL caught it from FIL, and sMIL has it as well. If...and because there is not enough information on this vaccine it's a big if.....it safely prevents contraction of HPV without any side effects, then I'm all for it. But like others have said, not enough information is known about the long term ramifications of vaccination.
Women are going to have sex. Probably some unprotected sex as well, so why not arm them?
PLENTY is known about long term effects of vaccination. They work nearly EVERY time at preventing the disease they are supposed to. They are effective and safe.
To say this one is different than that one just isn't an argument. They all work basically the same way.
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I'm not arguing, I'm just explaining why I'm right.
Well, I could agree with you--but then we'd both be wrong.
PLENTY is known about long term effects of vaccination. They work nearly EVERY time at preventing the disease they are supposed to. They are effective and safe.
To say this one is different than that one just isn't an argument. They all work basically the same way.
Most vaccines have been around for decades, if not a century. The Human Services Vaccine Registry acknowledges 88 injuries and 8 deaths related to recieving the Gardisil vaccine and as of only 2010, more than 18,000 complaints were recieved about side effects. I was ALL for this vaccine until adverse reactions started occurring. More research is needed. And Gardisil, btw, only covers 4 strains. There is another vaccination that covers another 2 strains. But there are 100 types of HPV. And the body, in most cases, will clear HPV on its own within 2 years.
So, yes, asking if the risks outweigh the benefits is something that parents should do. There is no reason a parent cannot question things and make a decision themselves.
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LawyerLady
I can explain it to you, but I can't understand it for you.
I'm hoping more info will be available by the time Bunny is old enough for this vaccine. Some estimates put HPV infection rates as high as 80% of the population, but as LL says most infections clear on their own and the vaccine certainly does not protect against all strains.
I understand it was designed to protect against the most likely to cause cancer strains, though and I do think that is important.
PLENTY is known about long term effects of vaccination. They work nearly EVERY time at preventing the disease they are supposed to. They are effective and safe.
To say this one is different than that one just isn't an argument. They all work basically the same way.
Most vaccines have been around for decades, if not a century. The Human Services Vaccine Registry acknowledges 88 injuries and 8 deaths related to recieving the Gardisil vaccine and as of only 2010, more than 18,000 complaints were recieved about side effects. I was ALL for this vaccine until adverse reactions started occurring. More research is needed. And Gardisil, btw, only covers 4 strains. There is another vaccination that covers another 2 strains. But there are 100 types of HPV. And the body, in most cases, will clear HPV on its own within 2 years.
So, yes, asking if the risks outweigh the benefits is something that parents should do. There is no reason a parent cannot question things and make a decision themselves.
But they are by far the most common strains, covering approximately 96% of all HPV cases.
__________________
I'm not arguing, I'm just explaining why I'm right.
Well, I could agree with you--but then we'd both be wrong.
So? Most cases clear up by themselves. 10 years worth of data is NOT enough to mandate a vaccine. You have no idea the long term side effects. No thank you. DD will not be getting it for her daughter either...
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America guarantees equal opportunity, not equal outcome...
PLENTY is known about long term effects of vaccination. They work nearly EVERY time at preventing the disease they are supposed to. They are effective and safe.
To say this one is different than that one just isn't an argument. They all work basically the same way.
Most vaccines have been around for decades, if not a century. The Human Services Vaccine Registry acknowledges 88 injuries and 8 deaths related to recieving the Gardisil vaccine and as of only 2010, more than 18,000 complaints were recieved about side effects. I was ALL for this vaccine until adverse reactions started occurring. More research is needed. And Gardisil, btw, only covers 4 strains. There is another vaccination that covers another 2 strains. But there are 100 types of HPV. And the body, in most cases, will clear HPV on its own within 2 years.
So, yes, asking if the risks outweigh the benefits is something that parents should do. There is no reason a parent cannot question things and make a decision themselves.
But they are by far the most common strains, covering approximately 96% of all HPV cases.
Where are you getting that number?
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LawyerLady
I can explain it to you, but I can't understand it for you.
Look, the diseases that are transmitted through social and nondirect contact, I have no problem getting vaccinations.
And isn't HPV a form of cancer?
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A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.
PLENTY is known about long term effects of vaccination. They work nearly EVERY time at preventing the disease they are supposed to. They are effective and safe.
To say this one is different than that one just isn't an argument. They all work basically the same way.
Most vaccines have been around for decades, if not a century. The Human Services Vaccine Registry acknowledges 88 injuries and 8 deaths related to recieving the Gardisil vaccine and as of only 2010, more than 18,000 complaints were recieved about side effects. I was ALL for this vaccine until adverse reactions started occurring. More research is needed. And Gardisil, btw, only covers 4 strains. There is another vaccination that covers another 2 strains. But there are 100 types of HPV. And the body, in most cases, will clear HPV on its own within 2 years.
So, yes, asking if the risks outweigh the benefits is something that parents should do. There is no reason a parent cannot question things and make a decision themselves.
But they are by far the most common strains, covering approximately 96% of all HPV cases.
Where are you getting that number?
From information I read about HPV.
Plus, not all forms of HPV not accounted for would cause health issues.
-- Edited by huskerbb on Monday 3rd of August 2015 11:50:45 AM
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I'm not arguing, I'm just explaining why I'm right.
Well, I could agree with you--but then we'd both be wrong.
Two HPV vaccines are licensed by the Food and Drug Administration (FDA). The bivalent HPV vaccine (Cervarix) prevents the two HPV types, 16 and 18, which cause 70% of cervical cancers.
You have to understand the % is the few strains that vaccine is for.
Not all strains.
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A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.
So it may have a 70% success rate for strains A,B, & C. But a 100% failure for the other 23 strains.
Or 97 strains.
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A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.
And not everyone who gets a flu shot is 100% immune to the flu.
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A flock of flirting flamingos is pure, passionate, pink pandemonium-a frenetic flamingle-mangle-a discordant discotheque of delirious dancing, flamboyant feathers, and flamingo lingo.
You have to understand the % is the few strains that vaccine is for.
Not all strains.
But not all strains even cause health issues.
Not any of the strains cause health issues all the time. That's part of the weighing pros and cons. There are side effects reported, even deaths, and it is not always a huge problem even when you get it. That's why is it a personal decision.
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LawyerLady
I can explain it to you, but I can't understand it for you.