So why aren’t more people getting this vaccine?

According to NPR, a new analysis from the Blue Cross Blue Shield Association found only 29 percent of the teens its members insure receive a first dose of the human papillomavirus (HPV) vaccine by their 13^th birthday. The CDC found that nationally only 43 percent of teens are up-to-date on all the recommended doses of the vaccine.

Another recent study found that Texas ranks 47^th in the cancer-preventing vaccine. Out of the 50 states and the District of Columbia, Texas only ranked higher than Utah, South Carolina, Wyoming and Mississippi for HPV vaccination coverage.

“A simple vaccination can mean the difference between getting a deadly cancer or not. Unfortunately, not enough people are getting the importance of this message,” said Jason V. Terk, a Cook Children’s pediatrician.

HPV infection can cause cervical, vaginal and vulvar cancers in women and penile cancer in men. HPV can also cause anal cancer, throat cancer and genital warts in both men and women.

The HPV vaccine is recommended for preteen boys and girls at age 11 or 12 so they are protected before ever being exposed to the virus. The CDC recommends that 11 to 12 year olds receive two doses of HPV vaccine at least six months apart.

Teens and younger adults who start the series later, at ages 15 through 26 years, will need three doses of HPV vaccine to protect against cancer-causing HPV infection.

The Texas System Offices of Health Affairs states that about 90 percent of men and 85 percent of women in the United States will contract HPV at some point in their lives. HPV is the most common sexually transmitted virus in the United States. Most sexually active people will have genital HPV at some time in their lives.

By the year 2020, experts believe head and neck cancer will surpass cervical cancer as the most common cancer caused by HPV.

Across the country, the number of children who receive the HPV vaccine is very low compared to other vaccines they are scheduled to receive at the same time. This is despite the fact that meningitis and pertussis are much less common than HPV.

Dr. Terk wonders if there’s a disconnect when parents think about their child receiving the HPV vaccination.

“One of the major problems with HPV is that it may be 20 or 30 years before a person develops cancer due to an infection that happens in the teen years,” Dr. Terk said. “Waiting until you think HPV is a risk is too late. We have to make every effort to provide our patients the HPV vaccine so we can put an end to the thousands of teens who move through Cook Children’s without ever gaining this indispensable protection.”

That’s what Dr. Terk wants parents to know: HPV infection can be prevented.

The vaccine is most effective when given in early adolescence.

The FDA has approved vaccines that prevent the HPV strains that are associated with cancers of the cervix and head and neck.

"This is a relevant issue for all parents,” Dr. Terk said. “We have a vaccine that can prevent cancer. Parents should start the vaccination process as soon as their pediatrician recommends.”

More Resources:

• Vaccines and Immunizations
• HPV Vaccines: Vaccinating Your Preteen or Teen
• What is HPV?
• HPV Questions and Answers
• CDC approves 2-dose HPV vaccine schedule

“Epic fail.”

A couple of years ago, this was the phrase that my teenage son used as I unsuccessfully attempted to beat him in a game we were playing. At the time, I thought to myself that it was a harsh but accurate assessment of my performance. And, I was certainly motivated to practice on my own so that the next time, things would be different.

That same phrase came to mind as I read through an alarming article of interest to physicians. The article, published in Cancer Epidemiology, Biomarkers & Prevention is titled Quality of Physician Communication about Human Papillomavirus Vaccine: Findings from a National Survey.

Bottom line: Physicians (primarily pediatricians and family physicians) do poorly in providing the Human Papillomavirus (HPV) vaccine to patients.

Another source, the most recent National Immunization Survey-Teen for the year 2014, reports another alarming trend. The survey shows the number of patients who start the shots – and also complete them – lags far behind what it should be. (The HPV vaccine is given as a series of shots.)

So, it came as no surprise to me that the first article clearly showed what I have suspected for some time and which has been hinted at by previous studies. The epic failure in providing what is essentially a cancer-prevention vaccine to the recommended population of 11-12 year old boys and girls lies not at the feet of the anti-vaccine movement or hesitant parents. Rather, the failure belongs to we physicians!

The article describes findings from an online survey sent to 2368 pediatricians and family physicians in 2014. The 776 respondents self-reported their own performance on strength of four criteria: Endorsement (how strongly they recommend the vaccine); timeliness (whether they recommend it at 11-12 years of age, which is the most beneficial age); consistency (recommending it routinely vs using a risk-based approach); and urgency (whether they recommend the patient receive the vaccination that day). More than a quarter stated they did not strongly endorse the HPV vaccine, and a similar number reported that they did not recommend it be given at 11-12 years of age. Amazingly, 59 percent said they used a risk-based approach versus a routine approach to recommending the HPV vaccine, and only half of the respondents recommended giving the vaccine then and there, while the doctor discussed the HPV vaccine with the patient and parent. And these results represent a best-case scenario because respondents would be unlikely to paint an unflattering picture of their own performance.

Clearly, we have a major problem with physicians struggling with their own discomfort in talking about the HPV vaccine and who erroneously believe parents do not value it. Physicians who can’t communicate the importance of this cancer-preventing vaccine in turn fail to recommend it, which is so important to protect our patients. We are at risk of being the generation of pediatricians and family physicians who collectively failed to protect our patients from a preventable cause of cancer. Only we physicians can fix what it wrong with us: Only we can reverse this epic failure!