The use of the vaccine to prevent human papilloma virus (HPV) was found to be very low in the United States in a study conducted by Amanda Dempsey, M.D., PhD, MPH, of the University of Michigan and published in the journal Vaccine.
Dr. Dempsy analyzed factors associated with adolescent HPV vaccine use and reports variation by insurance type, race, type of visit, and whether the health care provider was a pediatrician, gynecologist or family medicine doctor.
These are Dr. Dempsey’s results verbatim:
Researchers looked at HPV vaccination rates among nine to 18 year-old patients seen at 20 university-affiliated outpatient clinics in southeast Michigan in three medical specialties family medicine, pediatric and gynecological clinics.
The study found:
Overall HPV vaccine use was low among adolescents. Among girls who were eligible to have received all three doses in the vaccination series, only 15 percent did so. This finding is consistent with a national study showing low vaccine series completion among 13 to 17 year-olds in 2007.
Even though overall uptake of the vaccine among adolescents was low, once the vaccine series was initiated there was a relatively high likelihood they would receive all three doses, with more than three quarters of those eligible getting second and third doses.
Despite recommendations from the Advisory Committee on Immunization Practices for universal vaccination of all 11-12 year old females against HPV, this age group was significantly less likely to initiate the vaccine series when compared to 13-15 year-olds, or those over the age of 16. However, among girls that did initiate the series, all three age groups had a similar likelihood of being fully vaccinated with all three doses.
Gynecologists were less likely to initiate the vaccine series than pediatricians or family practitioners. However, after the three-dose series began, there were no statistical differences in series completion among patients seen at each medical specialty.
Most adolescents received the first dose of vaccine at a "well child check up." Subsequent doses of vaccine were typically provided at "immunization only appointments," where the patient receives the vaccine from a nurse and has no interaction with a doctor. However, this pattern varied by age. The older an adolescent, the more likely they were to receive second and third doses at a "sick visit" with the doctor.
Researchers also found disparities in series completion by race and insurance status. The fact that minorities and those with public health insurance were less likely to be completely vaccinated raises questions about the degree to which HPV vaccination will impact cervical cancer rates in the U.S. since these groups are already known to be at higher risk for developing cervical cancer, Dempsey says.
Additional authors: Lisa Cohn, M.S., Vanessa Dalton, M.D., M.P.H., Mack Ruffin, M.D., M.P.H., all of the University of Michigan
Funding: Clinical Science Scholars Program at the University of Michigan
Disclosures: Dempsey is a consultant for Merck on male HPV vaccination
Journal reference: DOI is 10.1016/j.vaccine.2009.10.133
http://www2.med.umich.edu/prmc/media/newsroom/details.cfm?ID=1395
One should note recent reports have indicated a lack of interest in adolescent males in the prevention of the spread of HPV. This is tantamount to murder. It is a long slow cruel murder. Just as surely as not getting the HPV vaccine is a long slow murder.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1403306/?page=6
Let us leave the concept of morality to the individual and be entirely pragmatic. Cervical cancer costs too much each year and is preventable to a large extent with a vaccine that costs $360. The alternative burden on insurance payers is $200,000 minimum if the patient dies and can be millions if the patient lives. Thinking with your wallet might be a good thing in this case.
http://content.nejm.org/cgi/content/full/356/19/1908
http://www.ncbi.nlm.nih.gov/pubmed/9496581
http://www.allacademic.com/meta/p_mla_apa_research_citation/0/9/3/3/1/p93316_index.html
Some particular group will doubtless claim this finding as a "victory." Who won and who are you bleeding kidding?
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