NEW THIS MONDAY: TWO ON THE IMPACT OF HUMAN PAPILLOMAVIRUS VACCINE

Saturday, 22nd of June 2013

·       NEW THIS MONDAY: TWO ON THE IMPACT OF HUMAN PAPILLOMAVIRUS VACCINE

·       A SURPRISINGLY SUCCESSFUL HPV VACCINE

Editorial

By THE EDITORIAL BOARD

Published: The New York Times, June 21, 2013

A vaccine to protect teenage girls against dangerous strains of the human papillomavirus, or HPV, that are a leading cause of cervical cancer has proved to be enormously effective.

A study published Wednesday by the Centers for Disease Control and Prevention found that the prevalence of high-risk strains in teenage girls dropped by half after the vaccine was introduced in 2006, from 7.2 percent in 2006 to 3.6 percent in 2010.

Unfortunately, many parents still resist having their daughters immunized. A study published in March found that 44 percent of parents said in 2010 that they did not intend to vaccinate their daughters, up from 40 percent in 2008.

Some parents fear that vaccination might promote promiscuity (the new study found no sign of that); some see no need to vaccinate girls before they become sexually active, even though vaccination beforehand offers the best protection.

Health officials were surprised at the steep decline in infection rates because only about a third of American teenage girls have received the full course of three doses. In other advanced countries and even in a developing nation like Rwanda, vaccination rates have reached 80 percent or higher. Increasing the vaccination rate to 80 percent in this country could prevent an additional 53,000 cervical cancers and 17,000 deaths among girls now 13 years old and younger over the course of their lives.

Doctors need to recommend, and parents need to accept, a vaccine that can save thousands of lives.

A version of this editorial appeared in print on June 22, 2013, on page A18 of the New York edition with the headline: A Surprisingly Successful HPV Vaccine.

From the CDC homepage: 

·       NEW STUDY SHOWS HPV VACCINE HELPING LOWER HPV INFECTION RATES IN TEEN GIRLS

A new study looking at the prevalence of human papillomavirus (HPV) infections in girls and women before and after the introduction of the HPV vaccine shows a significant reduction in vaccine-type HPV in U.S. teens. The study, published in [the June issue of] The Journal of Infectious Diseases  reveals that since the vaccine was introduced in 2006, vaccine-type HPV prevalence decreased 56 percent among female teenagers 14-19 years of age.

About 79 million Americans, most in their late teens and early 20s, are infected with HPV. Each year, about 14 million people become newly infected.

“This report shows that HPV vaccine works well, and the report should be a wake-up call to our nation to protect the next generation by increasing HPV vaccination rates,” said CDC Director Tom Frieden, M.D., M.P.H.  “Unfortunately only one third of girls aged 13-17 have been fully vaccinated with HPV vaccine.  Countries such as Rwanda have vaccinated more than 80 percent of their teen girls. Our low vaccination rates represent 50,000 preventable tragedies – 50,000 girls alive today will develop cervical cancer over their lifetime that would have been prevented if we reach 80 percent vaccination rates.  For every year we delay in doing so, another 4,400 girls will develop cervical cancer in their lifetimes.”

According to CDC, each year in the United States, about 19,000 cancers caused by HPV occur in women, and cervical cancer is the most common.  About 8,000 cancers caused by HPV occur each year in men in the United States, and oropharyngeal (throat) cancers are the most common.

The study by Dr. Lauri Markowitz and colleagues at the CDC used the National Health and Nutrition Examination Survey (NHANES) data to compare prevalence—or proportion of girls and women aged 14-59 years with certain types of HPV—before the start of the HPV vaccination program (2003-2006) with the prevalence after vaccine introduction (2007-2010). As expected from clinical trials before the vaccine was licensed, the study also showed that the vaccine is highly effective.

“The decline in vaccine type prevalence is higher than expected and could be due to factors such as to herd immunity, high effectiveness with less than a complete three-dose series and/or changes in sexual behavior we could not measure,” said Dr. Markowitz. “This decline is encouraging, given the substantial health and economic burden of HPV-associated disease.” 

Through these promising results, public health experts and clinicians look forward to more people getting vaccinated for HPV. Routine vaccination at age 11-12 for both boys and girls is recommended, but according to recent national immunization surveys, only about half of all girls in the U.S.—and far fewer boys—received the first dose of HPV vaccine. A series of three shots is recommended over six months.  HPV vaccination is also recommended for older teens and young adults who were not vaccinated when younger.

The journal article will be available on The Journal of Infectious Diseases website (http://jid.oxfordjournals.org/content/early/recent) after the embargo lifts. For additional information on HPV, visit http://www.cdc.gov/hpv/.