UTMB physician Dr. Abbey B. Berenson, who is the Ruth Hargrave M.D. Professor of Obstetrics and Gynecology, as well as director for the Center of Interdisciplinary Research in Women’s Health
, has conducted research on why adolescent girls who begin vaccinations for Human Papillomavirus do not complete the series of three that is required for protection from anogenital cancers, including cervical cancer.
“Our most recent study looked at insured females because data from other centers stated that if you had medical insurance you were more likely to accept and complete the HPV vaccine,” Berenson said in an interview with Guidry News Service. “However, in our nationally based study on insured females we found a very low rate of vaccine completion among those who initiated the first dose.”
Berenson said that the vaccine is 96 to 100 percent effective if all three doses are given, even for those who are already sexually active.
“It is recommended for anyone nine to twenty-six years of age, regardless of sexual activity,” she said. “Why they initiate and don’t complete isn’t well understood yet.“
She said the reason could be due to a number of factors.
“First of all we are not sure that physicians have mechanisms in place to remind patients to get subsequent vaccinations, especially if they miss an appointment; secondly, we know there are many logistical barriers to getting all three doses which could be related to cost, co-pays, difficulty with transportation to the clinic, not understanding that all three doses are needed or just finding a facility that is available in your area,” she said.
Berenson noted that Texas Governor Rick Perry, who had mandated the vaccine for young girls, later withdrew the mandate for political reasons.
“Texas is not one of the states that require HPV vaccines for school enrollment,” she said. “That is one of the reasons that we are having a very difficult time disseminating information about the importance of this vaccine to families of adolescents,” she said, stressing the importance of the vaccine to young people, including boys as well as girls. “It could make all the difference in the world if you are somebody that is going to end up with an anogenital cancer or warts due to HPV.”
There have been concerns that administering the vaccine to a young woman might encourage her to be sexually active. However, Berenson dismisses that concern because a woman who had never been sexually active before marriage still could contract the disease from her husband who may have had only one partner previous to the marriage.
“There are no data whatsoever suggesting that an adolescent would decide to become sexually active because she now is protected against the HPV virus,” she said. “In fact given an adolescent’s tendency to consider themselves invulnerable, this is highly unlikely.”
She stressed that the vaccine should also be given to adolescent boys.
“This is a great opportunity for this generation to avoid anogenital cancers, including vulvar cancer, vaginal cancer, cervical cancer, anal cancer, genital condyloma and, we think, oropharyngeal cancers,” she said. “With so many cancers that can lead to devastating consequences, I think that everyone should try to protect their children and get them vaccinated.”
Berenson said that young people and their parents should discuss the HPV vaccine with their physicians.
“It is covered by the Vaccines for Children Program,” she said. “If your child gets all three doses before 18 years of age, even if your insurance does not cover it, or you do not have insurance, the federal government will pay for it.”
Orignally published in the Guidry News, June 18, 2012.