MDHHS Update: January is Cervical Health Awareness Month – Protect Your Patients with HPV Vaccine

MDHHS Update: January is Cervical Health Awareness Month – Protect Your Patients with HPV Vaccine

Alyssa Strouse, MPH, Adult and Adolescent Immunization Coordinator, MDHHS Division of Immunization

Every year, approximately 34,800 men and women are diagnosed with a cancer caused by the human papillomavirus, commonly known as HPV.1 Cervical cancer is just one of six types of cancer caused by HPV, but it is the most common HPV-associated cancer in women.4 Even with effective screening methods, such as the pap test and the HPV test, HPV causes approximately 10,900 cases of cervical cancer in the United States every year. Further, nearly 4,000 women die of cervical cancer every year.1 In addition to cervical cancer, there are an estimated 196,000 cases of cervical precancers each year in the United States. Treatment for both cervical cancers and precancers can cause additional health issues and can limit a woman’s ability to have children.4

The HPV vaccine is the best and most effective way to protect patients from all HPV-attributable cancers, including cervical cancer. The HPV vaccine is recommended at ages 11-12, but the vaccine can be given as early as age 9. Children who start the vaccine series at the recommended age, prior to their 15th birthday, will only need two doses separated by 6-12 months. Children who start the HPV vaccine series on or after their 15th birthday will need three doses over the course of 6 months. Immunocompromised children will need three doses of HPV vaccine regardless of the age at which they start the HPV vaccine series. Further, HPV vaccination is recommended for males and females through age 26 years, if not previously vaccinated. Although vaccination is not recommended for everyone older than age 26 years, some adults age 27 through 45 years may be vaccinated based on a discussion with their healthcare provider.2

HPV vaccination is safe, effective and provides long-lasting protection against cancers caused by HPV. Since the vaccine was introduced in 2006, over 120 million doses of HPV vaccine have been distributed and ongoing safety monitoring and research by CDC and the U.S. Food and Drug Administration (FDA) continue to illustrate that the vaccine is safe and effective. Further, among teen girls, infections with HPV types that cause most HPV cancers and genital warts have dropped by 71% since the vaccine has been in use. Finally, studies suggest that protection provided by the HPV vaccine is long-lasting and there has been no evidence of the protection decreasing over time.2

Although research has illustrated that HPV vaccine is safe, effective, offers long-lasting protection and prevents cancer, the vaccine is still extremely underutilized. According to recent National Immunization Survey-Teen (NIS-Teen) data, nationally, only 48.7% of males and 53.7% of females age 13-17 years have completed their HPV vaccine series.3 In Michigan, according to the Michigan Care Improvement Registry (MCIR) and as of September 30, 2019, only 42.7% of males and 45.3% of females age 13-17 years have completed their HPV vaccine series. 5 This data illustrates that approximately half of our adolescents are left unprotected and at risk for developing an HPV infection and/or HPV-attributable cancer at one point in their lifetime. According to CDC, increasing coverage of HPV vaccination at the routine age of 11-12 years and catch-up vaccination through age 26 years will contribute to further reduction in cervical precancers.4

It is imperative that all healthcare professionals, including physicians, physician assistants, nurse practitioners, nurses, medical assistants, pharmacists, dentists, dental hygienists and even additional staff in provider offices must advocate for and strongly recommend the HPV vaccine. There are several practical and proven strategies to increase HPV vaccination rates. One strategy is to bundle your recommendation and recommend the HPV vaccine in the same way and on the same day as you do the other adolescent vaccines. Another strategy is to ensure a consistent message and train all office staff on how to successfully communicate with parents and patients about HPV vaccination. Finally, it is encouraged to provide personal examples on how and why you support the HPV vaccine for your family and friends. The healthcare community must come together to increase HPV vaccination rates and protect all patients from HPV-attributable cancers and diseases.

 

 

1 CDC (2019), HPV and Cancer. Retrieved from https://www.cdc.gov/cancer/hpv/statistics/cases.htm

2 CDC (2019), Human Papillomavirus (HPV). Retrieved from https://www.cdc.gov/hpv/index.html

3 CDC (2019). TeenVaxView. 2018 Adolescent Human Papillomavirus (HPV) Vaccination Coverage Dashboard. Retrieved from https://www.cdc.gov/vaccines/imz-managers/coverage/teenvaxview/data-reports/hpv/dashboard/2018.html

4 McClung NM, Gargano JW, Park IU, et al. Estimated Number of Cases of High-Grade Cervical Lesions Diagnosed Among Women — United States, 2008 and 2016. MMWR Morb Mortal Wkly Rep 2019;68:337–343. DOI: http://dx.doi.org/10.15585/mmwr.mm6815a1external icon.

5 MDHHS (2019). Michigan’s Statewide Quarterly Immunization Report Card. Retrieved from https://www.michigan.gov/documents/mdhhs/State_Level_ReportCard_621826_7.pdf

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