Study: Too few teens get cancer-fighting HPV vaccine

A new national study of children covered by Blue Cross Blue Shield health insurance shows that use of the vaccine that protects against cancer-causing human papilloma virus (HPV) has risen, including in the Philadelphia area.

However, the number of youngsters who get the vaccine — proven to help ward off certain cancers in both females and males — is still very low, compared with other adolescent immunizations.

"We really do need to do a better job in getting our kids vaccinated to prevent cancer.," said Anna Baldino, a pediatrician and medical director at Independence Blue Cross, the Philadelphia region's largest private insurer. "This is a cancer-preventing vaccine. Parents should be excited to get their children vaccinated."

Independence Blue subscribers may soon see stepped-up efforts to get them to immunize their teens. Baldino said Independence already mails reminders to parents and guardians about getting their youngsters vaccinated, but the insurer is now looking into a texting campaign to further encourage the adults to get teens protected.

The HPV vaccine, introduced about a dozen years ago, provides immunity against sexually transmitted strains of the virus that has long been known to cause cervical cancer, and also now is linked with head, neck, and anal cancers. The vaccine can also protect against genital warts and helps prevent the spread of strains of the virus.

In the Philadelphia region, the rate for first-dose HPV vaccination — full immunity requires multiple doses — rose from 28 percent for teenagers who turned 13 in 2013 to 37 percent for those who turned 13 in 2016, according to the study released Tuesday.

The rate of teen girls who got vaccinated exceeded the rate for boys locally as well as nationally. Forty percent of the Philadelphia-area girls got a dose of the vaccine in 2016, compared with 34 percent of the boys. Nationally, 37 percent of the girls covered by the insurance company got a dose of the vaccine compared with 32 percent of the boys in 2016.

All those rates lag way behind other adolescent vaccines, especially those required for school enrollment. In Philadelphia, 91 percent of the adolescents covered by the insurer in 2016 got the meningococcal vaccine and 92 percent got the Tdap vaccine for tetanus, diphtheria, and pertussis.

The study's numbers look even worse considering that HPV vaccines should be administered in multiple doses. The Blue Cross Blue Shield Association study found that only 13 percent of Philadelphia teens had completed the recommended three-dose regimen by age 13 in 2016. In fall 2016, the federal Centers for Disease Control and Prevention advised that children under 15 can be given just two doses, while youngsters 15 and older should still get the full three doses.

The Blue Cross Blue Shield Association also conducted an online national survey of 739 parents of children age 10 to 13 who had not yet gotten the vaccine. That survey found 52 percent of parents did not intend to give their children the HPV vaccine. The top reasons were concerns about possible adverse side effects of the vaccine  — though no significant ill effects have been scientifically connected with the vaccine — and the belief that their children were not at risk of getting HPV, so they didn't need the vaccine. (In fact, nearly all sexually active people come into contact with the virus, though most shed it naturally without developing warts or cancer.) The third-most-common reason parents gave for not getting the vaccine for their children was that they did not have enough information about it.

The most common adverse reactions to the shots are mild, including some redness or pain at the injection site.

The Philadelphia Health Department, through the federally funded Vaccines for Children Program, gives doctors and other health-care providers feedback on their practices' overall vaccination rates, as well as advice and resources to help get the word out about the importance of vaccines, according to Amber Tirmal, the city's immunization program manager. The providers in the program include those who care for uninsured children as well those covered by Medicaid or who are eligible for Medicaid.

Adding publicly insured children to the mix boosts the overall HPV vaccination rates, although they remain below the rates for other vaccines.

According to city data, 54 percent of Philadelphia girls ages 13 to 17 in 2016 had completed three doses of the HPV vaccine. The boys' rate was 48 percent, Tirmal said.

The HPV vaccine is available for ages 9 to 26, but it is generally given to children about age 11 through the early teens, preferably before they become sexually active. Research has indicated even one dose may increase antibody production but the multiple doses are advised. The Blue Cross Blue Shield researchers examined the medical claims of more than 1.3 million of their commercially insured adolescent members, who were born between 2000 and 2003.