Human papillomavirus vaccines offer public health opportunity for Texas
The state of Texas should create a policy that encourages adolescents to obtain the full series of shots for the human papillomavirus (HPV) vaccine, according to a new paper from Rice University's Baker Institute for Public Policy. HPV is a sexually transmitted virus known to cause cancer.
"Human Papillomavirus Vaccine: A Public Health Opportunity for Texas," co-authored by Kirstin Matthews and Monica Matsumoto, proposes a set of policy recommendations for increasing vaccine coverage, including school-entry mandates and educational campaigns targeting parents and physicians. Matthews is the Baker Institute's fellow in science and technology policy and Matsumoto is a research analyst in the institute's Science and Technology Policy Program.
"Higher vaccination uptake in Texas will help reduce the rates of HPV-related cancers and other medical conditions, improve overall population health and cut long-term health care costs," Matthews said. "The state should focus on addressing the barriers to widespread vaccination by promoting public awareness, increasing provider recommendations and lowering financial burdens on both individuals and health care clinics—all of which are achievable goals."
The HPV vaccine is given in three shots. The second shot is given one or two months after the first shot; the third shot is given six months after the first shot.
In the United States, annual HPV infections affect more than 79 million men and women and account for more than 4,000 deaths from cervical cancer. Globally, an estimated 530,000 new cases of cervical cancer—almost always caused by HPV—are diagnosed annually. In 2006, the U.S. Food and Drug Administration licensed the first HPV vaccine to prevent the spread of four prevalent forms of the virus associated with cervical cancers and genital warts. Because there is currently no cure for HPV-related cancers, these vaccines hold the potential to save thousands of lives, according to Matthews and Matsumoto. However, the political controversy that has erupted regarding the HPV vaccine has limited its acceptance and use among the public, they said.
HPV infections and associated cancers are a major issue in Texas, the authors said. Cervical cancer rates in the state are notably higher than the national average. Despite these statistics, only 32 percent of 13- to 15-year-old girls in Texas received all three doses of the HPV vaccine in 2011. The data show that the lowest coverage rates in 2011 were centered around the state's two most populous cities, according to the Centers for Disease Control and Prevention: Houston (27 percent) and Dallas (23 percent). In comparison, El Paso County's strong public HPV vaccination program appears to be effectively boosting local coverage rates, with 75 percent receiving one dose and 45 percent receiving three doses, Matthews and Matsumoto said.
Political controversy has reduced the HPV vaccine discussion from a medical breakthrough to a political scandal, the authors said. Merck, the maker of one of the major HPV vaccines, Gardasil, has suspended its state lobbying efforts throughout the country, and although the safety and efficacy of the vaccine continue to be supported by research studies, public skepticism about the vaccine has persisted, Matthews and Matsumoto said.
"With the current low national levels of coverage, routine HPV vaccination for both boys and girls will quickly provide the highest level of immunity until widespread vaccinations for girls can be achieved," Matthews said. "The vaccine is an effective means to reduce the risk of contracting a host of potential health problems, and both scientists and public health experts recognize its safety and efficacy. The administration of the vaccine during early adolescence is a well-informed preventive health measure."