So, what can we do?
Educate our patients, families, friends and colleagues about HPV-related risks.
Risk perception has been defined as reality plus emotional factors. Risks that are perceived as involuntary, and those threatening children, raise the emotional ante. This may be why parents act quickly to vaccinate their children when faced with a case of meningitis. But while HPV infection can be acquired in adolescence, later stage manifestations often don't develop until adulthood. As a result, perceived risk is minimized.
As pediatricians, we need to help educate our patients, families and colleagues on the real risks of HPV-associated cancers. The American Cancer Society has developed a video series, "HPV Survivor Stories," that features patients who battled head and neck, and cervical cancers. I use these short video clips in presentations to residents and colleagues and am working on playing them in waiting rooms.
Give a strong, clear, recommendation for the HPV vaccine at every 11- and 12-year-old visit.
I say something like this: "Great, Michael is 11 years old now, so we can go ahead and do his tetanus/diphtheria/whooping cough vaccine, his HPV vaccine, and his meningitis vaccine today." This announcement lets parents know that all three adolescent vaccines are needed, and are equally important. Research shows this type of communication results in higher uptake of vaccines.
Use other evidence-based strategies in our practices to increase HPV immunization rates.
Standing orders also have been shown to increase HPV immunization rates. Using standing orders for adolescents helped Denver Health Medical Center achieve HPV vaccination series completion rates of more than 60 percent, as described in a recent
Pediatrics article. That's 30 percentage points higher than the national average.
The American Academy of Pediatrics has tools, including the HPV Champion
Toolkit, "Making a Change in Your Office," to help implement these strategies into practice (and ways to get continuing education credit for it, too!).
Parents still may be more likely to seek our protection from more immediate disease threats, but we can take the opportunity to protect their children from the more common HPV-related cancers. The more often we do, the sooner death from cervical and oropharyngeal cancer can become a rare event, too.
The views expressed in this article are those of the authors, and not necessarily those of the American Academy of Pediatrics.
Kristin Oliver, MD, MHS, FAAP, a member of the American Academy of Pediatrics, serves on the AAP's HPV expert physician panel and the American Cancer Society's National HPV Vaccination Roundtable. She is a pediatrician and preventive medicine specialist at the Icahn School of Medicine at Mount Sinai in New York.