Parental Attitudes on Sex, Costs Stymie HPV VaccinationsNicole Ostrow
Parental concern that getting vaccinated for the human papillomavirus may increase teenagers’ sexual activity is among the attitudes discouraging use of the inoculation to prevent cervical cancer, researchers found.
Seven years after the Merck & Co.’s Gardasil vaccine was approved in the U.S. for girls to prevent the sexually transmitted virus, barriers ranging from parents’ views to cost to lack of information have held back vaccination against HPV, the report said. The research, an analysis of 55 studies from 2009, was published in JAMA Pediatrics.
The study is one of the first to try to better understand the obstacles to HPV vaccination across multiple race and ethnic groups, said Dawn Holman, the lead study author. Parents need information about the shots that is easier to understand and doctors must be provided additional support so they, too, can provide a more compelling case for the vaccine, she said.
Parents should “think of this as another vaccine we are providing for their child so they have a safe and happy adolescence and adulthood,” Holman, a behavioral scientist at the U.S. Centers for Disease Control and Prevention in Atlanta, said in a telephone interview.
The HPV vaccine targets adolescents because it must be given before a person becomes sexually active to prevent cervical cancer as an adult. Merck introduced Gardasil against HPV in 2006 for 11- or 12-year-old girls, and it was subsequently also recommended for boys ages 11 and 12.
While use of the HPV vaccination has increased since its introduction, the rates remain well below other shots given to teens, Holman said.
About 54 percent of girls in 2012 received one or more doses of the HPV vaccine, while only 33 percent received all three recommended shots, Holman said. For boys, 21 percent got one or more doses and only 6.8 percent received all three. That compares with about 85 percent of those 13 to 17 years old receiving the tetanus, diphtheria and whooping cough vaccine and 74 percent getting the meningitis vaccine, she said.
A recommendation by doctors is “critically important” in a parent’s decision to have their child vaccinated for HPV, said Pam Eisele, a Merck spokeswoman.
“‘Offering’ the HPV vaccine is not the same as ‘recommending’ the HPV vaccine in the same manner as the other important adolescent vaccines,” she said in an e-mail. “A true vaccine recommendation is more accepted by parents than a vaccine offering.”
About 79 million people in the U.S. are currently infected with HPV and about 14 million are newly infected each year, according to the CDC. HPV is the main cause of cervical cancer, with about 10,000 women in the U.S. getting the disease each year, the CDC said. GlaxoSmithKline Plc’s HPV vaccine Cervarix was approved in the U.S. in 2009.
Several papers analyzed showed doctors thought the decision to vaccinate adolescents was beyond their control and parent attitudes were a barrier to the shots being administered to their patients.
Other studies looking at parents and caregivers found that parents didn’t vaccine their children because their doctor didn’t recommend the shot or they thought their kids were too young. Some of the papers also showed that parents thought the cost of the vaccine was too high. Holman said many insurance companies cover the cost of the vaccine.
Researchers also found that boys don’t get the vaccine as often as girls because of a lack of a perceived benefit for males along with little awareness that the shot could be given to boys, the authors wrote. For minority and poor populations, barriers to the vaccine included limited knowledge about HPV and the vaccine and lack of insurance coverage.
A July report by the CDC found the number of girls getting vaccinated in 2012 hadn’t increased from the previous year.
Merck’s Gardasil, which protects against four strains of the virus linked to genital warts and cervical cancer, generated more than $1.6 billion in 2012 sales for the Whitehouse Station, New Jersey-based company, while Cervarix had about $428 million in 2012 sales for London-based Glaxo, according to data compiled by Bloomberg.