The HPV Vaccination: A Lifesaving Tool

According to the Center for Disease Control and Prevention (CDC), the human papillomavirus, better known as HPV, is the most common sexually transmitted infection in the country. The CDC believes nearly 79 million Americans—predominantly individuals in their late teens and early 20s—are infected. Less aggressive types of HPV cause warts, and the most aggressive types of HPV can cause cancers of the cervix, vagina, vulva, penis, anus and oropharynx (tongue and tonsils).

Cervical cancer is the most common cancer caused by HPV in women and approximately 14 different types of HPV can lead to a diagnosis. “The relationship [between HPV and cervical cancer] was recognized several decades ago, and since the development of a vaccine in the last decade, there has been a heightened awareness within the medical community about the need to address HPV and get more children vaccinated in order to prevent long-term health issues,” says Rebecca Perkins, MD, MSc, a gynecologist at Boston Medical Center and cervical cancer prevention researcher.

The HPV vaccine, FDA-approved in 2006, is currently recommended for all boys and girls at ages 11 and 12. The vaccine is given as a two-dose series for younger adolescents, and as a three-dose series for adolescents who receive their first shot at 15 or older, or those who have weakened immune systems. The vaccine series can be started as young as age nine, and can be administered to men as old as 21, women as old as 26, and 26 years old for men at high risk of HPV infection. “The vaccination has the ability to stop six different types of cancer,” states Perkins. “The benefit is tremendous, even beyond cervical cancer.”

“We all recognize we are in a very exciting place in that we now have the tools available with vaccination for adolescents and improved screening tests for women to essentially eliminate cervical cancer.” — Rebecca Perkins, MD, MSc

The currently available nine-valent vaccine is designed to prevent 85 percent of cervical cancers, and the majority of other HPV-related cancers. Since nobody wants cancer, the HPV vaccination would seem like a “no brainer,” but convincing families vaccinating is critical for their children’s long-term health and well-being has come with its challenges. Initial concerns about the safety of a new vaccine designed to protect against a sexually transmitted infection led to low vaccination rates at first.

Now, a decade after HPV vaccination became available in the United States, vaccination is finally the new normal, with more than 60 percent of adolescents starting the series in 2016 according to national data. “There were definitely more concerns in the past which have diminished a bit, for both the patients’ families and their providers,” says Perkins. “We now have great, long-term data that the vaccine is safe, it works to prevent serious diseases, and the immunity does not seem to wear off. Parents and providers are motivated to get kids protected early.”

Perkins recognized the importance of promoting vaccinations within clinics, and launched a program within several BMC health centers to improve vaccination rates. The initiative, called DOSE-HPV, focuses on providers and health systems. “We developed a program to help providers within the clinic systems do a better job at encouraging HPV vaccination within the CDC-recommended age group,” explains Perkins. “We designed DOSE-HPV to help busy providers improve care for their patients while fulfilling time-consuming administrative requirements needed to maintain their board certification credentials.”

“The credits are a motivation for providers to participate in the program,” continues Perkins. “But then they become excited about being able to do something pretty easy that can protect their patients from cancer in the future. We’ve seen many clinics continue to do additional work after the program is done to continue to improve their vaccination rates.”

Education and training are key factors to the success of the program. DOSE-HPV also provides feedback to providers on their vaccination rates in order to ensure vaccination is top of mind and that they are properly communicating the importance of vaccination to parents. Since its inception, the program has expanded to other partnering clinics, as well as Boston Medical Center proper. “Participating providers understand the reward of program is twofold—it benefits patients and helps providers reach ongoing mandatory certification,” concludes Perkins. “We all recognize we are in a very exciting place in that we now have the tools available with vaccination for adolescents and improved screening tests for women to essentially eliminate cervical cancer.”