New studies released today confirm the effectiveness of HPV vaccine and explore the best ways to communicate the benefits to parents.
The Academy and Centers for Disease Control and Prevention recommend HPV vaccine, which protects against several types of cancer, as part of routine immunization for males and females at age 11 or 12 years. It can be started as early as 9 years. HPV vaccination rates have been rising but fall short of national goals.
Vaccine effectiveness
To take a closer look at HPV vaccine effectiveness, researchers analyzed health data on 1,580 women ages 13-26 from hospital-based or community health clinics. Data were collected in four waves from 2006-’17.
Throughout the study, HPV vaccination rates rose from 0% to 84.3%. Nearly all of those who had been vaccinated received the 4-valent vaccine.
Among vaccinated women, 4-valent type HPV infections decreased 81% from 35% to 6.7%. Compared to the first wave in 2006-’07, vaccine effectiveness was 90% in wave 3 (2013-’14) and 80% in wave 4 (2016-’17), according to “Human Papillomavirus Vaccine Effectiveness and Herd Protection in Young Women” (Spinner C, et al. Pediatrics. Jan. 22, 2019, https://doi.org/10.1542/peds.2018-1902).
“This degree of effectiveness is remarkable given the fact that vaccination was defined as having received ≥1 dose (ie, was not defined as having completed the vaccination series) and that women in this study were likely at a substantially higher risk for preexisting HPV infection than those in the HPV vaccine clinical trials because of their reported sexual behaviors,” authors wrote.
Vaccinated women also saw declines in infection with the five additional HPV types in the 9-valent vaccine that was licensed in 2014. Researchers said there may have been some cross-protection as some of the types are genetically related.
Among unvaccinated women, infections from 4-valent HPV types dropped 40% from 32.4% to 19.4%, which may be due to herd protection, according to the study. However, researchers saw an increase in the five additional types covered by the 9-valent vaccine. They said this may be due to the women engaging in more risky behavior.
Vaccine communication
In another study, researchers surveyed nearly 1,200 parents of children ages 9-17 years who had not completed the vaccine series to determine how best to communicate about the vaccine.
Based on their expressed interests, the parents watched four of 28 video messages that showed a pediatrician discussing the vaccine.
Many of the parents said they felt more confident about the vaccine after watching the videos, according to the study “Questions and Concerns about HPV Vaccine: A Communication Experiment” (Shah PD, et al. Pediatrics. Jan. 22, 2019, https://doi.org/10.1542/peds.2018-1872).
Parents whose children had not started the vaccine series felt most confident after hearings messages about diseases HPV vaccine can prevent and the need to vaccinate both boys and girls. Parents whose children had started the series felt most confident after hearing messages about the recommended age for vaccination.
Results showed messages that were longer or required a higher level of comprehension also boosted confidence.
Based on the findings, authors recommend providers emphasize the vaccine’s ability to protect against cancer and avoid expressing urgency when parents have concerns.
“One reason may be that hesitant parents feel inappropriately rushed or that their concerns are not being treated with appropriate care,” authors wrote.
They also suggest providers be prepared for longer discussions, and their paper includes seven messages that may aid these talks.
“Interventions used to increase parents’ confidence in and motivation to get HPV vaccine alone may not increase vaccine uptake; however, they could be used to increase uptake in combination with clear, strong provider recommendations to get the vaccine, as other studies have shown,” authors wrote.
