About the surveys
Surprisingly, according to the study published in Pediatrics, about 24% of parents whose 13- to 17-year old sons had not received the HPV vaccination stated that the reason they didn’t get the shot was because their health care provider didn’t recommend it.
Let that sink in for a minute or two. One-quarter of kids who did not receive a long-term cancer preventing vaccine were not advised to do so by a physician. Pardon me, while I hit my head against the desk.
Admittedly, there were a number of other reasons why parents didn’t have their children vaccinated against HPV. About 19% of parents believed that the vaccine was unneeded (and I contend that if physicians were willing to discuss the vaccine that number would be quite a bit lower). About 16% didn’t know enough about the vaccine (again, physicians could lower this rate). And finally, about 7% had safety concerns.
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About that last point. Almost all of the myths about the HPV cancer preventing vaccine (and Gardasil specifically) have been thoroughly debunked. But once again, the pediatrician or family physician could have reduced or eliminated the parental concerns about these myths.
It’s clear that the physician is the weak link in the chain of support for getting children vaccinated. This survey indicates that the bulk of the reasons for parents not insisting on the vaccine lies with the physician.
Now, let’s be clear that the HPV vaccine uptake is going up, though not as fast as it should be. The CDC reports that the uptake increased by over 8% from 2013 to 2014 in boys who received at least one HPV vaccine dose (out of the recommended 3 doses). That adds up to around 42% of boys 13-17 years old who have at least one dose.
The numbers are improving, but they’re not great.
There was one really great piece of news in the study. The researchers found that boys are more likely to be vaccinated against HPV if they are black, Hispanic, or in a single-mother or poorer family.
Part of the reasons for this higher uptake in those groups may because of the Vaccines for Children Program or the Affordable Care Act (commonly known as Obamacare), both which provide scheduled vaccines for free to low-income families. However, this is just a bit of a strawman argument, since most health insurance plans, whether for privileged upper classes or for working class individuals, cover the cost of childhood vaccinations.
Nevertheless, even though it’s for free, it’s impressive that some parents reject the myths surrounding the HPV vaccine, and prefer that their children be protected against future cancers. Maybe they have better physicians more willing to provide accurate information.
Because the research also show some doctors may be reluctant to recommend the HPV cancer preventing vaccine because they fear of offending parents. I’m troubled by this reason, because sometimes physicians should offend the parents. What if the parents reject an appropriate treatment for a disease? Or not provide adequate nutrition? Wouldn’t the physician “offend” the parents in those cases? So why wouldn’t they “offend” them to recommend a cancer preventing vaccine?
Debbie Saslow, director of breast and gynecologic cancer for the American Cancer Society, stated that “providers have this perception the HPV vaccine is different than other vaccines. They think parents are more concerned about it, and they’re worried parents aren’t going to bring their kids back if they recommend it.”
I hope that’s not the case. Concern about the long-term health of the child should trump a desire to keep a patient. This is troubling thought.
We have tons of evidence that the cancer preventing HPV vaccine is safe and effective. Parents should understand this. But physicians should be leaders in medicine, and make it their goal to stop this deadly disease.
- Gilkey MB, Malo TL, Shah PD, Hall ME, Brewer NT. Quality of Physician Communication about Human Papillomavirus Vaccine: Findings from a National Survey. Cancer Epidemiol Biomarkers Prev. 2015 Oct 22. [Epub ahead of print] PubMed PMID: 26494764.
- Lu P-J, Yankey D, Jeyarajah J, O’Halloran A, Elam-Evans LD, Smith PJ, Stokley S, Singleton JA, Dunne EF. HPV Vaccination Coverage of Male Adolescents in the United States. Pediatrics. 2015 October 26. DOI: 10.1542/peds.2015-1631.