Cancer centers endorse shortened HPV vaccine series, emphasize need for physician advocacy
The 69 NCI–designated cancer centers today endorsed the CDC’s revised guideline that calls for administration of the HPV vaccine in two doses rather than the previously prescribed three-dose series.
The institutions issued a joint statement showing their support for the guideline in hopes the reduced vaccination schedule will help increase national HPV vaccination rates.
“The public has been wanting something that can prevent cancer for a long time and we have a vaccine, but it is being underutilized,” Electra Paskett, PhD, co-program leader of the cancer control program and associate director for population sciences at The Ohio State University Comprehensive Cancer Center, told HemOnc Today.
Approximately 79 million people in the United States are infected with HPV, according to CDC statistics.
An estimated 14 million new infections occur annually. These include several high-risk types that are responsible for about 39,000 new HPV–associated cancers each year.
The HPV vaccine can prevent nearly all cervical, oropharyngeal, anal and other genital cancers. However, less than 42% of girls and only 28% of boys in the United States have completed the recommended three-dose HPV vaccine series.
Consequently, the CDC recommended last fall that adolescents and children aged 14 years or younger receive two doses of the 9-valent HPV vaccine at least 6 months apart.
The agency based its recommendation on data from clinical trials that showed children aged 9 to 14 years experienced a similar or higher immune response to the vaccine after two doses as young adults who received three doses.
In addition to comparable efficacy, it should be easier to get children and parents to comply with a two-dose series, Paskett said.
Teens and young adults who start the vaccination series at ages 15 through 26 years should continue to receive the three-dose series, according to CDC.
Studies have proven HPV vaccination to be safe and effective for the protection of HPV infection before transmission contact occurs.
However, formidable barriers to increased vaccination uptake remain. They include a lack of consistent, strong recommendations from physicians to parents about the benefits of HPV vaccination, as well as a lack of understanding among parents that the vaccine protects against many cancer types.
Paskett emphasized the importance of dispelling the misconception that HPV vaccination is associated with sex, or that vaccination encourages sexual promiscuity.
“This is a cancer vaccine used for cancer prevention, and that is all,” she said.
The joint statement recommends the following:
- All parents and guardians should have their sons or daughters complete a two-dose 9-valent HPV vaccine series before age 13 years or complete a catch-up vaccine series as soon as possible in older children. Anyone who starts vaccination at age 15 years or later should receive three doses.
- Parents and guardians should talk to their health care providers to learn more about the HPV vaccine and its benefits.
- Men and women up to age 26 years who were not vaccinated as preteens or teens should complete a three-dose vaccine series to protect themselves against HPV.
- All health care providers should be advocates for cancer prevention by making strong recommendations for childhood HPV vaccination. They also should educate parents, guardians and colleagues about the importance and benefits of HPV vaccination.
The NCI–designated cancer centers also have organized efforts to raise awareness of HPV vaccinations. These include a series of national summits to share new research, discuss best practices and identify strategies designed to increase vaccination rates.
“We focus on the need for health care providers to make strong recommendations, especially when the children are coming in for their other childhood vaccinations,” Paskett said. “Those are really missed opportunities to also vaccinate children against HPV.” – by Kristie L. Kahl