- Commentary
- Copyright © 2013 by the American Academy of Pediatrics
- Larry K. Pickering, M.D., FAAP
- Dr. Pickering is editor of the 2012 AAP Red Book.Comments:India has a far higher number of Cervical Cancer cases than any other country in the world (including China!) We are the Cervical Cancer capital of the world, and unfortunately there is a very high level of resistance against Cervical Cancer vaccine. Neither the ob/gyn nor many pediatricians are convinced about the need for the vaccination. This along with parental & adolescent hesitation regarding any vaccination leads to abysmal rates of HPV (& other adolescent) vaccination. More than a lakh women (hundred thousand) are going to die every year due to this disease in India, and many of these deaths can be easily prevented by this vaccine. It is my humble submission to advise & use it freely in practice.
Why HPV vaccination can’t wait
A vaccine is available that prevents cancer, but only 50% of eligible adolescent girls and far fewer adolescent boys have been provided this protection. Rates of human papillomavirus (HPV) vaccine uptake for adolescent females during 2012 have not changed from rates in 2011.
Research indicates that pediatricians anticipate a “difficult” conversation when talking with parents of an 11- or 12-year-old about the HPV vaccine because it may involve a discussion of sexual issues.
However, this does not need to be the case. Research shows that HPV vaccine acceptance, like any childhood or adolescent vaccine, is influenced predominantly by your strong recommendation. This means not just suggesting that parents consider HPV vaccine, or mentioning casually that it’s available, but presenting the vaccine with the conviction and urgency that it deserves — that HPV vaccine will prevent several types of cancer, and this prevention should begin today.
“A conversation about HPV vaccination isn’t difficult. A difficult conversation is one I have nearly every week — when I have to look a young woman in the eye and tell her she may no longer be able to have children — or even worse, that she may die from cervical cancer. That’s a difficult conversation,” said Daron Ferris, M.D., professor in the Department of Obstetrics and Gynecology at Georgia Regents University Cancer Center.
HPV vaccine is cancer prevention — and it can’t wait. Not only does the immune system respond better at the recommended 11- to 12-year-old range when initiating the HPV vaccine series, but protection begins immediately after the recommended doses are given.
For each year HPV vaccine rates stay at 30% coverage instead of achieving 80%, 4,400 future cervical cancer cases and 1,400 cervical cancer deaths will occur. Let’s remove HPV vaccination from the realm of sexuality and place this childhood vaccine where it belongs — as cancer prevention. Just like any other vaccine, HPV vaccine needs to be given well before exposure occurs.
Don’t let your patients become an oncologist’s patients in 20 years. We have a powerful tool to prevent cancer now, and we must not fail to protect the children in our care.
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