Not enough children get the HPV vaccine, Duke nursing student argues

Not enough children are getting vaccinated for the human papillomavirus, according to a Duke nursing practice student’s recent opinion piece in the Cincinnati Enquirer. 

Haley Schlottmann, a nurse practitioner at the Cincinnati Children’s Hospital and a doctoral student at the Duke University School of Nursing, argued that this poses a serious public health concern.The article noted the low rates of HPV vaccinations, despite the vaccine’s proven effectiveness against the virus—some strains of which cause cancer. 

“As a nurse, I find this topic important because the HPV vaccine is still new in terms of the world of immunizations, and people are not grasping the gravity of the vaccine,” Schlottmann wrote.

According to Schlottman’s article, the HPV vaccine can prevent 31,000 people from getting cancer each year. The earlier a child receives the vaccine, the more effective it is, because the child has most likely not been exposed to the virus. 

Gardasil 9, a HPV vaccine approved by the Food and Drug Administration, prevents against the nine strains of HPV that cause the majority of HPV cancers and reduces the risk of associated cancers by 90 percent. The Centers for Disease Control and Prevention recommends that children receive two doses of the vaccine at least six months apart.

Less than half of adolescents were considered "up to date" on the vaccine in 2017, according to a CDC report

Rhode Island, Virginia and Washington, D.C., have mandated that students be vaccinated before starting school. 

Evan Myers, Walter L. Thomas Professor of Obstetrics and Gynecology in the School of Medicine, said that mandates can help spread the vaccine's reach.

“Highest levels of coverage are in countries that have a school mandate like those in place for other vaccines,” Myers said. “In the U.S., it’s more dependent on the interaction between the provider and the parent, and there's a lot of research going on about best practices to improve uptake.”

In addition to mandates, awareness campaigns like the National HPV Roundtable aim to reduce the incidence and mortality of HPV through leadership and planning. In discussing the latest research and interventions around HPV, the organization promotes HPV prevention efforts. 

Myers, who has worked with Merck as an investigator and consultant on their HPV vaccine program for years, created a mathematical model of HPV transmission. He found that with limited resources, targeted gender specific vaccine approaches are worthwhile.

“If you don't have unlimited resources for a campaign to improve coverage, you'd actually get more bang for your buck if you targeted boys rather than girls,” Myers said.


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