The University of Kansas Cancer Center recently joined nearly 70 other cancer centers across the country to sound an alarm about the HPV vaccine.
Many children still are not getting the recommended vaccine for human papillomavirus, which causes head and neck cancer in men and women, cervical cancer in women and a host of other cancers in both.
In Kansas and Missouri, less than 49 percent of girls have received the vaccine, according to the Centers for Disease Control and Prevention. Kansas ranks dead last in the nation, and Missouri is near the bottom. Both states rank low for the number of boys who are vaccinated too.
The public call from KU’s cancer center was blunt: The vaccine prevents cancer. What’s the problem?
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“It absolutely breaks my heart,” said Terry Tsue, physician-in-chief at the University of Kansas Cancer Center. “We have two vaccines against cancers that are caused by virus, the hepatitis B vaccine and the HPV vaccine. Otherwise, we don’t have a vaccine that prevents cancer.
“There are thousands and thousands of people dying annually from this disease that could have been prevented had we had this vaccine 30 years ago. We didn’t have it and were so slow in adopting it that for the next 30 years we’re going to lose the same number of people, and more, because it’s spreading.”
The nation’s cancer centers banding together to issue a collective statement was a rare move for those involved in cancer research and prevention.
The low HPV vaccination numbers represent a public health threat, said cancer center officials, who asked health care providers and parents to take advantage of the vaccine.
Considering President Barack Obama’s new “moonshot” efforts to cure cancer, “this is one example of actions that can be taken today to make a very big difference in the future cancer burden,” said a statement from Ernest Hawk, vice president and division head of cancer prevention and population sciences at the University of Texas MD Anderson Cancer Center.
Tsue is stunned by what people don’t know about HPV. For instance, about 70 percent of parents apparently don’t know that the vaccine is recommended for boys as well as girls.
The vaccine not only prevents “female” cancers — cervical, vaginal, vulvar — but it also prevents cancer in the throat, known as oropharyngeal cancers. And three times as many men as women get throat cancer from HPV, says Tsue.
Twenty percent of patients with HPV-related throat cancers die within five years.
“Our practitioners aren’t aware of the magnitude and this kind of tsunami of cases,” said Tsue, a head and neck surgeon. “Throat cancer related to HPV is growing up to 5 percent a year. No other cancer is growing like that. And it will surpass cervical cancer caused by HPV by 2020.”
According to the CDC, HPV infections are responsible for about 27,000 new cancer diagnoses each year in the U.S.
So the CDC recommends that all boys and girls get a three-dose round of HPV vaccine shots at the ages of 11 or 12. The vaccine can be up to 93 percent effective when it’s given at that optimal time, CDC officials say.
But vaccination rates are low. The U.S. Department of Health and Human Services set a goal to have 80 percent of American girls ages 13 to 15 fully vaccinated by the year 2020. But four out of 10 girls remain unvaccinated, according to CDC statistics, and fewer than six out of 10 boys have been vaccinated.
Tsue says that health professionals are battling a lot of misinformation and misconception among the public. Surveys of parents, for instance, show that many mistakenly think HPV has something to do with HIV.
Tsue thinks another issue is that parents equate the vaccine with sex because the virus is most commonly sexually transmitted, though it can sometimes be transmitted without sexual contact.
Parents tells survey takers that their children don’t need the vaccine because their kids aren’t having sex.
However, most men and women in the United States will be infected with at least one type of HPV at some time in their lives.
“Eighty percent of adults get HPV in their lives — 80,” said Tsue. “So this isn’t for the hooker on the corner of the red light district. This is 80 percent of the U.S. population will have HPV sometime in their life.”
Tsue thinks that some parents also believe that having their children vaccinated will somehow give them free rein to have sex or will promote promiscuity, though studies have shown that getting the vaccine doesn’t make kids more likely to have sex at a younger age.
“So your 10-year-old who has no idea what the shot they’re getting is will subsequently go out and have sex the next week because they got a shot that prevents the HPV virus?” said Tsue. “That’s (what) we’re dealing with.”
Though the vaccine is not known to cause serious or long-term side effects, questions about its safety linger for some parents, particularly those who have sworn off childhood vaccines. Five years ago, then-congresswoman Michele Bachmann of Minnesota charged during a presidential debate that the vaccine was “very dangerous” and caused “mental retardation.”
A study published in Pediatrics in 2013 showed that among the most frequent reasons parents gave for not having their children vaccinated was fear of the vaccine’s safety.
The website VacTruth.com — run by a father who says his son was harmed by childhood vaccinations — published a story last month charging that reports of serious side effects and deaths linked to HPV vaccines are being kept secret from the public.
Thousands of young girls, the story claims, “have fallen seriously ill, have had their health completely ruined after these vaccines and many have died.”
It cited records from the website Judicial Watch, which describes itself as “a conservative, nonpartisan educational foundation,” claiming that one of the HPV vaccines, Gardasil, is linked to “thousands of serious adverse reactions and debilitating side effects, including seizures, blindness, paralysis and dozens of deaths.”
Judicial Watch, which has been investigating the vaccine for the last few years, has dubbed the HPV vaccine “a large-scale public health experiment.”
The medical community considers the vaccine one of the safest around.
“All this bad press about vaccines, how it kills people, how it causes autism, all false,” said Tsue.
Tsue talks to small groups of health care professionals about HPV-related cancers on his quest to promote the vaccine. He believes that more pediatricians and family practitioners should start talking to parents about it too.
“We need to help providers to make a strong cancer prevention recommendation for vaccinating 11- and 12-year-old boys and girls with the HPV vaccine,” Anna Giuliano, director of the Center for Infection Research in Cancer at Moffitt Cancer Center in Tampa, Fla., told NPR earlier this month.
“If all the pediatricians and family practice doctors were making that strong recommendation, I think we would see a strong increase in the rate of uptake in that vaccine.”
Tsue and other cancer experts would like to see the HPV vaccine added to the lineup of regularly scheduled vaccines schoolchildren already receive: tetanus, diphtheria, whooping cough and meningitis, among them.
Tsue supports mandatory vaccination too — neither Kansas nor Missouri mandates the vaccine — but that’s been a hard sell already.
In 2011, Gov. Rick Perry of Texas had to reverse his decision to make the vaccine mandatory when conservative parents in his state revolted.
The Rhode Island General Assembly faced the same objections last year after it required the vaccine for all seventh-graders. The Rhode Island Center for Freedom & Prosperity held a rally protesting the mandate on the vaccine with parents who said their children got sick from it.
Parents also argue that they should be allowed to make the vaccination decision themselves, a point that the American Civil Liberties Union supports Rhode Island parents on.
Meanwhile, public health officials in Massachusetts itching to do something to raise the rate of HPV vaccinations there are watching Rhode Island’s success with the mandate, according to The Boston Globe.