May 24, 2018
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Maine parents urged to vaccinate teens against cancer-causing HPV

Dr. Stephen Sears, Maine state epidemiologist
By Jackie Farwell, BDN Staff

Some health experts are encouraging Maine parents to vaccinate their teenagers against a sexually transmitted infection that causes cancer.

With school winding down and many youths required to undergo physical exams to participate in summer camps and sports travel teams, the summer break is an ideal time for boys and girls in their preteens and early teens to get vaccinated against the human papillomavirus, according to Dr. Jonathan Fanburg, medical advisor of child health initiatives at MaineHealth and a pediatrician and adolescent medicine specialist with Maine Medical Partners Pediatrics in South Portland. The HPV vaccine can be administered at any time of year, but physical exams are a convenient time to start the vaccine series, which involves three shots over six months, MaineHealth officials said in a recent press release.

HPV is the most common sexually transmitted infection in the United States, and the cause of almost all cases of cervical cancer.

The vaccine, available since 2006, has dramatically decreased the prevalence of HPV in teenage girls, according to a study publicized last week by the U.S. Centers for Disease Control and Prevention. Infections from the four strains of HPV targeted by the vaccine plunged by more than half among girls ages 14-19.

Federal health officials said the results were unexpected, since only about one in three girls in that age group in the U.S. has received all three doses of the vaccine. The findings should serve as a wakeup call to the nation to boost America’s low vaccination rate, CDC officials said.

By comparison, HPV vaccination rates in other countries, including Rwanda, have reached 80 percent, the CDC pointed out.

Maine’s HPV vaccination rate of 56 percent in 2011 ranks the state 18th nationally and just above the national average of 53 percent, according to state epidemiologist Dr. Stephen Sears. That rate reflects girls who have received at least the first dose. The rate among girls who have received all three shots is estimated at closer to 42-45 percent, he said.

While Maine’s HPV immunization rate tops those in other states, there’s still plenty of room for improvement, Sears said.

“This is an anti-cancer vaccine,” he said. “That’s an incredible development in our vaccine repertoire.”

The vaccine has proven controversial, with some parents concerned that immunization could promote promiscuity and others seeing no need to vaccinate their children before they become sexually active. Health officials recommend girls get the vaccine at age 11 or 12, before they start having sex and are exposed to the virus, when the vaccine offers the best protection.

The vaccine does not cure the virus after exposure.

The recommendation is similar for boys, “silent carriers” who can develop penile, anal and other cancers from HPV.

Health officials recommended in 2007 that all girls get vaccinated against HPV, and broadened the recommendation to include boys in 2011.

Young women up to age 26 and men up to age 21 are advised to get the HPV vaccine if they weren’t immunized at a younger age. The vaccine is also recommended for gay and bisexual men and men with compromised immune systems through age 26, if they did not get fully vaccinated when they were younger.

Despite doctors’ efforts to encourage vaccination against HPV, a study published in March found that 44 percent of parents said in 2010 that they didn’t intend to vaccinate their daughters, a rise from 40 percent in 2008. Many cited potential health risks.

CDC officials say HPV vaccines — Merck’s Gardasil and GlaxoSmithKline’s Cerverix — have a safe track record. Japanese health officials recently suspended their recommendation to vaccinate girls against HPV after some reports of pain and numbness following injection, though the CDC said its research suggested no link to the vaccine.

The CDC also has investigated 42 reports of deaths among recipients of HPV vaccines, but found no reason to believe the vaccine was responsible.

Increasing America’s low vaccination rate to 80 percent could prevent 50,000 cases of cervical cancers in girls, according to the CDC. About 19,000 cancers caused by HPV occur in women in the U.S. each year, most commonly cervical cancer. In men, about 8,000 cancers caused by HPV occur each year, most commonly throat cancers.

Some strains of HPV are responsible for most cases of genital warts in men and women. The virus is easily spread by skin-to-skin contact during sex and it’s possible to have HPV without knowing it.

About 79 million Americans, most in their late teens and early 20s, are infected with HPV and each year about 14 million people become newly infected.

A full course of the vaccine can cost several hundred dollars, but as of a year ago Maine began including the immunization in state program that pays for childhood vaccinations, according to Sears.

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