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Stethoscope and syringe in an exam room at the Brooklyn Center Health Resource Center.

David Brewster, Dml - Star Tribune

Mayo doctors: Too few kids are getting the HPV vaccine

  • Article by: JEREMY OLSON
  • Star Tribune
  • March 18, 2013 - 7:31 AM

 

More adolescents are getting vaccinated for human papillomavirus, the sexually transmitted virus that causes cervical cancer, but use of the HPV vaccine continues to lag behind expectations, and doctors are growing worried about a building public backlash.

Dr. Robert Jacobson of the Mayo Clinic in Rochester reported Monday that more parents have become worried about potential side effects and the possibility that providing teens protection against sexually transmitted diseases may encourage them to become sexually active.

In an article published in the medical journal Pediatrics, Jacobson and colleagues reported that even though the vaccine is widely considered safe and effective, four in 10 families have decided they will not vaccinate their children on the recommended schedule, usually when boys and girls are 11 or 12. The rate of parents concerned about side effects increased from 4.5 percent in 2008 to 16.4 percent in 2010, according to their research.

“Here we have this effective vaccine against a terrible disease and the public has the wrong view of it,” Jacobson said.

Although nearly a third of girls ages 13 to 17 had received the full series of three doses of HPV vaccine in 2010, up from 18 percent in 2008, Jacobson said he would have expected a vaccination rate closer to 60 percent by now. More than 80 percent of teens ages 13 to 17 had received a booster shot for tetanus and pertussis in 2010, and more than 60 percent had received shots to protect against viral meningitis.

“It went up but, frankly, not as much as we expected or hoped that it would,” Jacobson said of the HPV vaccine rate.

The vaccine was politically controversial long before U.S. Rep. Michele Bachmann, R-Minn., repeated a claim during her 2012 presidential campaign that it had caused mental retardation in a girl. The American Academy of Pediatrics and other medical groups have roundly disputed that claim.

Pascha Derkevics of Chaska declined the HPV vaccine for her daughter, now 12, because she is suspicious of its ingredients. Merck, the manufacturer of Gardasil, one of two HPV vaccines on the market, lists fainting and then falling as one possible side effect.

“There are no parents raising their eyebrows and saying, ‘Huh, why the heck would this make my kid faint?’ ” she said.

Much of the continuing concern centers on the idea that giving a vaccine against a sexually transmitted disease to adolescents might tacitly signal to them that they can be sexually active.

That fear helped prompt the Minnesota Family Council to oppose 2007 efforts in the Legislature to mandate the vaccine for all youngsters.

“We’re not taking a position on the vaccine, that people should or shouldn’t do it,” said Tom Prichard, the council’s president. “We think it should be left up to the parents.”

Minnesota is among 41 states that have contemplated legislation on the vaccine. Mandates were passed in Virginia and the District of Columbia. A mandate was enacted by executive order in Texas, too, until it was overturned by legislation. Most states have elected to study the vaccine or create educational campaigns in favor of vaccination.

A Kaiser Permanente study, released in 2012, disputed the contention that the vaccine could somehow promote promiscuity. The study of more than 1,200 girls in Georgia found no difference in the rates of pregnancy or STD treatment between vaccinated and unvaccinated girls.

The vaccine was initially recommended in three doses for girls ages 11 to 12, but more recently has been recommended for boys in that age group as well. The vaccine protects against the viral strains that cause 70 percent of cervical cancers, which kill 4,000 women in the United States each year. It also protects against some other cancers linked to the virus, as well as against genital warts.

Recommending the vaccine at an early age takes advantage of the fact that many adolescents have to see the doctor then for school or sports physicals. Jacobson said the vaccine appears to be most effective and last longest when given at that age and before children become sexually active.

“For the most part, almost every child becomes an adult who then has sexual activity,” Jacobson said. “Frankly, for parents to look at me and say, ‘My children won’t have sex and my children’s grandchildren won’t have sex’ just doesn’t make any sense.”

 

Jeremy Olson • 612-673-7744

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