Beginning in 2006, safe and effective vaccines became available to prevent cancers associated with human papillomavirus (HPV), the most common sexually transmitted infection in the U.S. However, just 42% of U.S. teen girls and 28% of teen boys have received all three recommended doses.
“We are the only individuals, as pediatricians, who have the opportunity to protect our patients before they become exposed to this virus, which is an important cause of cancer in the United States and around the world,” Joseph Bocchini Jr., M.D., FAAP, said Sunday during the plenary session “Safe and Effective: HPV Vaccine – the Pediatrician’s Critical Role.”
Dr. Bocchini, former chair of the AAP Committee on Infectious Diseases and member of the Section on Infectious Diseases, challenged pediatricians to be diligent to bring vaccination rates up to the Healthy People 2020 goal of having more than 80% of children vaccinated by the time they are 17.
“My challenge, which is based on information that is available on the safety and effectiveness of the HPV vaccine, is that we need to look in our own practices to determine what we need to do bring that level up to 80% or better,” he said.
Joseph Bocchini Jr., M.D., FAAP, said pediatricians have a key role in implementing new HPV vaccination recommendations.
The Academy and Centers for Disease Control and Prevention (CDC) recommend HPV vaccine as part of routine immunization for females and males at 11 or 12 years of age, but it may be started as early as 9 years.
Last week, the CDC’s Advisory Committee on Immunization Practices recommended that adolescents under age 15 years get only two doses of the vaccine instead of three doses, with the second dose administered six to 12 months after the first dose. Those starting vaccination at age 15-26 should receive three doses. The recommendation will be official after it is published in the Morbidity and Mortality Weekly Report (MMWR). The Academy will review the CDC’s changes and make official policy recommendations of its own.
While most HPV infections are asymptomatic, persistent infection is responsible for cervical, vaginal, vulval, oral, penile and anal cancers, along with genital warts.
In 2015, 9-valent Gardasil 9 vaccine was approved, which also includes five additional serotypes (in addition to the most common 16 and 18) that are responsible for another 14% of cancers in women and 5% of cancers in men. Dr. Bocchini, professor and chair of pediatrics, Louisiana State University Health, Shreveport, noted that with the Gardasil 9 vaccine, over 90% of HPV-related cancers could be prevented.
Additionally, 4vHPV Gardasil will not be produced after October, and 2vHPV, Cervarix, will no longer be distributed in the U.S., leaving only Gardasil 9.
In regard to safety, Dr. Bocchini noted that 79 million doses of 4vHPV vaccine and 12 million doses of 9vHPV have been distributed in the U.S. In post-licensure monitoring, no new significant safety issues have been found related to HPV vaccine.
He stressed the importance of pediatricians talking to patients about the need for HPV vaccination.
“Your role is critical,” he said. “The strongest reason for vaccination is your strong recommendation.”