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HPV vaccination causes concern for many parents

Monday March 18, 2013
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A rising percentage of parents say they wonít have their teen daughters vaccinated to protect against the human papilloma virus, even though physicians are increasingly recommending adolescent vaccinations, according to a study.

More than 2 in 5 parents surveyed believe the HPV vaccine is unnecessary, and a growing number worry about potential side effects, researchers reported in an article published March 18 on the website of the journal Pediatrics.

Researchers with the Mayo Clinic and other sites examined three vaccines routinely recommended for U.S. teens: a vaccine to protect against sexually transmitted HPV; Tdap, for tetanus, diphtheria and acellular pertussis; and the meningococcal conjugate vaccine, or MCV4 vaccine.

Although the up-to-date immunization rates rose for all three vaccines, the proportion of girls fully immunized against HPV (three doses over six months) was substantially lower than the proportion for the other two vaccines.

Five years ago, 40% of parents surveyed said they would not vaccinate their girls against HPV. That proportion rose to 41% in 2009 and 44% in 2010. "Thatís the opposite direction that rate should be going," Robert Jacobson, MD, a senior researcher on the study and a pediatrician with the Mayo Clinic Childrenís Center, said in a news release.

Parents concerned about HPV vaccine safety rose from 5% in 2008 to 16% in 2010, while less than 1% worried about the safety of the Tdap and MCV4 vaccines, according to the study.

During the same years, more and more studies showed how safe and effective the HPV vaccine is in this age group, said Jacobson, who has taken part in the safety review committees for two such studies. The vaccine prevents cervical cancer and other genital cancers by preventing the HPV infections that lead to those cancers, he said.

Researchers analyzed vaccination data for teens ages 13 to 17 in the 2008-10 National Immunization Survey of Teens. They found that as of 2010, 8 of 10 teens had the Tdap vaccine and roughly 63% had the MCV4 vaccine. Only about a third of girls were immunized against HPV.

The HPV vaccination rate did rise from a 2008 rate of 16%. But at the same time, more parents reported they did not intend to have their daughters vaccinated for HPV. Among the reasons they gave: the vaccine was not recommended; lack of knowledge; it is unnecessary; the vaccine is inappropriate for the childís age; worry about safety/side effects; and the child is not sexually active.

According to parents surveyed, more clinicians are recommending the HPV vaccine, but nonetheless advise it to only about half of all patients. The facts show the vaccine is necessary, Jacobson said.

"HPV causes essentially 100% of cervical cancer, and 50% of all Americans get infected at least once with HPV," he said. "Itís a silent infection. You cannot tell when youíve been exposed or when you have it. While most HPV infections clear, a percentage linger and start the process of cancerous changes. The HPV vaccine is an anti-cancer vaccine."

Jacobson, the medical director of the Employee and Community Health Immunization Program at Mayo Clinic, said the vaccine is more effective in younger adolescents than older teens. Mayo Clinic routinely starts the series for patients at age 9.

The study abstract is available at http://pediatrics.aappublications.org/content/early/2013/03/12/peds.2012-2384.abstract.


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