Thursday, February 22, 2018
Opinion

Column: Too few Florida kids receive HPV vaccine

As a pediatrician, I feel that one of my main roles is disease and injury prevention. I spend time at every well visit talking to parents about age-appropriate issues, from infant pool safety to teen driving habits. But our most successful area of prevention has been in the vaccinations we give our patients.

For decades we have been preventing polio, tetanus, whooping cough, diphtheria, measles, mumps and rubella. Since I graduated from medical school 18 years ago, we have added vaccines for chickenpox, rotavirus, hepatitis B and certain types of meningitis and pneumonia. And now, amazingly, we have a vaccine that prevents cancer: the HPV (Human Papilloma Virus) vaccine.

The HPV vaccine protects against cervical cancer, mouth and throat cancers, penile and anal cancers, and genital warts. It is a simple three-shot series given over six months, preferably starting during a child's 11- 12-year-old well visit. Sadly, Florida has the lowest HPV vaccination rate in the country.

A Centers for Disease Control, or CDC, report from 2012 showed that the rate of completing all three HPV vaccinations was 33.4 percent for the country and only 25.3 percent for Florida. Compare that to rates in Australia, which has a 73 percent completion for its 12- 13-year-old girls, and Rwanda, where 90 percent of its sixth-grade girls are fully vaccinated.

While Australia and Rwanda have school-based vaccination programs, I think a number of other factors contribute to our low numbers. We find misinformation in the media and on the Internet about the safety of the HPV vaccine. Furthermore, parents who know that HPV is a common virus spread through sexual contact may fear that giving the vaccine to their children encourages sexual activity.

Other parents falsely believe that children shouldn't get the vaccine until they are sexually active. Sometimes pediatricians miss the opportunity to educate parents about the vaccine. Other times, parents simply refuse to allow the vaccination.

We need more parents to know the truth about the HPV vaccine. For example, the CDC reported in July that there have been no serious safety concerns linked to the HPV vaccine. The CDC actually recommends that we give the vaccine to boys and girls at the 11- 12-year-old well visit when they receive other potentially lifesaving vaccines.

Furthermore, studies have found that getting the HPV vaccine does not make kids more likely to be sexually active or to start having sex at a younger age. The vaccine provides children with the best protection when given at 11 to 12 years old, before the initiation of sexual activity. When parents tell me they worry that their children will perceive getting the HPV vaccine as receiving permission for sexual activity in their 11- and 12-year-old children, I say we do not need to discuss the sexually transmitted nature of the disease with their child.

Instead, I suggest they explain that it is one more disease that we are protecting them from like tetanus and meningitis (the other shots that we give at the 11- 12-year-old visit). I have very few parents who refuse the hepatitis B vaccine, which is a three-shot series given in the first year of a baby's life and also protects against a sexually transmitted disease.

I think parents don't realize that HPV is so common that almost everyone who is not vaccinated will be infected at some point. Most infections are without symptoms, and it is estimated that 79 million Americans are currently infected with HPV. So waiting until kids are sexually active to give them a vaccine that takes six months to complete for an extremely common disease is not a good plan to protect them.

Given the pediatrician's huge focus on disease prevention, it is extremely disheartening to me when parents refuse to vaccinate their child. I hope that parents take time to truly understand the benefits of the HPV vaccine and take steps to protect their children.

Personally, I made sure my daughter got all three of her HPV vaccines when she was 12 years old. I hope that parents will work together with me to help protect their children against cancers that are now preventable, and to get Florida off the bottom of the list for HPV vaccination rates.

Dr. Marcy Solomon Baker is assistant medical director for pediatrics for the BayCare Medical Group in Tampa. She wrote this exclusively for the Tampa Bay Times.

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