AAP National Conference: Pediatricians challenged to raise HPV vaccination rates
CoreyNason Reese, Correspondent
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
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.
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
“Your role is critical,” he said. “The strongest reason for vaccination is your strong