CDC/MMWR Watch [to 27 July 2013]
CDC Telebriefing on human papillomavirus (HPV) vaccination coverage and vaccine safety monitoring
Thursday, July 25, 2013 at Noon ET
Press Briefing Transcript
Excerpt [Editor’s text bolding]
“…Just last month, I had a chance to share with you really good news that HPV vaccination works even better than we anticipated. The types of HPV, that’s human papillomavirus, that commonly cause cervical cancer in the U.S., had dropped by about half in girls aged 14 to 19 in the seven years since we recommended routinely vaccinating against HPV. I noted at that time that the results were striking, and would serve – should serve as a wake-up call to increase vaccination rates, because we really can protect the next generation of adolescents against cancers caused by HPV. Unfortunately, today we have disappointing news. An article in today’s MMWR shows that HPV vaccination coverage for girls getting the anti-cancer vaccine has not increased at all from one year to the next. Zero. We’re dropping the ball. We’re missing opportunities to give HPV vaccines, and that needs to change to protect girls from cervical cancer. I’ll provide some more detail and then discuss missed opportunities and information about vaccine safety.
But the article published today has data from what’s called the National Immunization Survey on teen vaccinations. This is how we measure how we’re doing. It collects vaccine information for 13 to 17-year-olds using a random digit sample of landlines and, starting in 2011, cellular telephone phones as well. After a teen’s parental guardian gives permission, we contact the vaccination provider, doctor, nurse practitioner or other provider and mail a questionnaire to get the vaccination history. The 2012 survey which we’re reporting about today included vaccination records of about 19,000 teens. And today’s article focuses on HPV vaccination among girls from 2007 to 2012. Next month we’ll share the data we collected last year on other vaccines recommended specifically for preteens and teens, and that will include vaccination coverage estimates for HPV vaccinations among boys, something that’s only more recently been recommended.
These national data show no progress, zero, with HPV vaccine coverage in 2012. We’re used to seeing coverage increases of 10 percent per year when a new vaccine hits the market. Last year we were disappointed at the increase in HPV vaccine was only 4 percentage points. This year, it’s zero percentage points. The HPV vaccine coverage hasn’t kept pace with other vaccines recommended for preteens and teens. One dose does not provide all of the protection that the HPV vaccine series has to offer so we want all girls to get their second and third doses. By 2011, 34.8 percent of teen girls finished their three-dose series. 2012 data is not different. It’s 33.4 percent. Actually, slightly fewer teen girls are given all doses from the previous years. This is a huge disappointment, but I’m confident that we will turn it around. And one of the reasons for that is in the next piece of data that we got from this survey.
We assumed that one of the reasons we had such low rates was that adolescents don’t see the doctor regularly so it’s hard to get a three-dose series in. But actually, we found that – that the data showed that if HPV vaccine were given every single time a young person went to the doctor to get another vaccine, the completion of those series would be at 93 percent. That’s important, because if we get three-dose series to 80 percent, an estimated 53,000 cases of cervical cancer could be prevented over the lifetimes of girls aged 12 and younger. Now there are lots of ways we can work together to increase vaccination rates. A key one is to take advantage of every opportunity to vaccinate against HPV. The teens are in the doctor’s office, they’re getting another vaccination, but they’re not getting the HPV second and third doses.
We also asked parents why they haven’t gotten their daughters vaccinated. And one of the top reasons is that their doctors didn’t recommend it. This is critical. Research consistently showed that a provider’s recommendation to vaccinate is the single most influential factor in determining whether a parent gets their kid vaccinated. So we need to step up our efforts by talking to parents about the importance of this vaccine. Doctors need to recommend this vaccine just as they recommend others, and ensure that they’re given every opportunity. Parents have also told us in other research there are concerns about this – this may be in some way a license or permission to have sex. But multiple studies have found that preteens and teens who receive this vaccine do not have sex any sooner than their peers who have not received the vaccine. HPV vaccine does not open the door to sex. HPV vaccine closes the door to cancer. The vaccine has to be given before onset of sexual activity. We can’t let this opportunity go to waste. And I really would make the analogy to many of our other vaccines. We make sure that people get vaccinations well before they get exposed. We’re not saying they’re going to be exposed immediately after. Just that we want to make sure they get vaccinated well before…”
Human Papillomavirus Vaccination Coverage Among Adolescent Girls, 2007–2012, and Postlicensure Vaccine Safety Monitoring, 2006–2013 — United States
July 26, 2013 / 62(29);591-595
Since mid-2006, the Advisory Committee on Immunization Practices (ACIP) has recommended routine vaccination of adolescent girls at ages 11 or 12 years with 3 doses of human papillomavirus (HPV) vaccine (1). Two HPV vaccines are currently available in the United States. Both the quadrivalent (HPV4) and bivalent (HPV2) vaccines protect against HPV types 16 and 18, which cause 70% of cervical cancers and the majority of other HPV-associated cancers; HPV4 also protects against HPV types 6 and 11, which cause 90% of genital warts.* This report summarizes national HPV vaccination coverage levels among adolescent girls aged 13–17 years from the 2007–2012 National Immunization Survey-Teen (NIS-Teen) and national postlicensure vaccine safety monitoring. Although vaccination coverage with ≥1 dose of any HPV vaccine increased from 25.1% in 2007 to 53.0% in 2011, coverage in 2012 (53.8%) was similar to 2011. If HPV vaccine had been administered during health-care visits when another vaccine was administered, vaccination coverage for ≥1 dose could have reached 92.6%. Safety monitoring data continue to indicate that HPV4 is safe. Despite availability of safe and effective vaccines and ample opportunities for vaccine delivery in the health-care setting, HPV vaccination coverage among adolescent girls failed to increase from 2011 to 2012…