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Maryland cancer centers pushing for more use of HPV vaccine

SHPH virologist Keerti Shah co-authored the definitive epidemiological study linking cervical cancer to human papilloma.

Sixty-nine top cancer centers from around the country have joined forces to urge more widespread use of the vaccine to treat the human papillomavirus, which can lead to deadly cervical, throat and other cancers.

The centers, including the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins and the University of Maryland Marlene and Stewart Greenebaum Cancer Center, issued a joint statement Wednesday encouraging more parents to bring their children in for what is known as the HPV vaccine. They called the potential spread of the virus a "public health threat" and urged doctors to be advocates on the issue.


The Centers for Disease Control estimates that 79 million Americans are infected with HPV and that the sexually transmitted virus causes 14 million new infections each year. The body's immune system fights off the HPV virus in most cases, but some strains lead to genital cancers, such as cervical and penile. Rates of throat cancers caused by the virus have also been rising in recent years.

"HPV vaccination represents a rare opportunity to prevent many cases of cancer that is tragically underused," said the group's statement, noting that it "is our best defense in stopping HPV infection in our youth and preventing HPV-related cancers in our communities."


The cancer centers, all part of the National Cancer Institute and considered leaders in research, hope that a unified front will emphasize the importance of the vaccine and erase some of the stigma associated with it.

"The cancer centers have come together to make it clear that the evidence is there; that the vaccine is safe and effective," said Elizabeth Platz, who leads the cancer prevention and control programs at the Sidney Kimmel center. "We want to bring greater attention to this intervention."

The vaccine is given to adolescents before they become sexually active to prevent cancer from developing when they become adults. Vaccination against HPV has increased since Merck & Co. introduced the vaccine in 2006, first for girls and later for boys, but its use remains well below what many in the medical community say is effective.

Just 40 percent of girls and 21 percent of boys in the United States are receiving the recommended three doses of the HPV vaccine, according to a 2015 report by the CDC. This falls far short of an 80 percent goal by the end of this decade set by the U.S. Department of Health and Human Services.

The United States is far behind other countries in its use of the vaccine, including Australia, where 75 percent of children are vaccinated, and the United Kingdom, where 84 to 92 percent of kids receive it.

"We all see and treat lots of patients with cancer associated with the human papillomavirus," said Dr. Kevin Cullen, director of the Greenebaum cancer center. "It is entirely preventable at this point but not enough young people are getting the vaccine. The best way to treat a cancer is not to get it."

Surveys have found parents are reluctant to give their children the vaccine because they associate it with sexual activity and think that it could even encourage them to engage in sex. No research has proved this correlation.

Other factors contributing to low usage are lack of knowledge about the vaccine and resistance from groups who generally oppose all vaccines. Others may not see it as a priority when it comes to the health concerns of their children.


Dr. Scott Krugman, chairman of the pediatrics department at MedStar Franklin Square Medical Center, has met resistance from parents. He said some parents have gotten misinformation about bad side effects the vaccine causes.

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It's also hard to get parents to bring their children back for the three shots it takes to get fully vaccinated, he said. He often talks to parents about the vaccine over time so that they become comfortable with it.

The Maryland Chapter of the American Academy of Pediatrics also is trying to get doctors to track more closely the number of their patients that get the vaccine. That way they can deliberately think about how to increase those numbers.

"I think there is potentially varying degrees about how pediatricians present the information," said Krugman, past president of the pediatrics academy's Maryland chapter. "What has been shown is that it works better when doctors talk positively about the benefits of the vaccine. If they are more vague and just ask parents their thoughts, it is not as effective."

In their letter, the cancer centers said that the vaccine passed extensive safety testing before and after being approved by the U.S. Food and Drug Administration and also has been approved by the World Health Organization's Global Advisory Committee on Vaccine Safety.

The statement came as the result of a November meeting attended by many of the doctors and researchers from the cancer centers, who examined reasons for low HPV vaccine rates in their areas before developing the statement.