Compared with most of the country, Texans are lagging behind at protecting their teens against several types of cancer, according to the latest report from the CDC. Nationwide, about 60 percent of teens had received at least one dose of the human papilloma virus (HPV) vaccine, up by about four percentage points, with an encouraging increase among boys as well as girls.
But in Texas, only 49.3 percent of teens have gotten an HPV shot. That big gap leaves far too much room for preventable cancer to afflict our young people.
To be sure, there are bright spots: Cheers for El Paso County, where almost 80 percent of teens have received at least one dose. In rural parts of the state, though, the number is about 47 percent.
This is cause for worry. The vaccine is safe and studies so far have shown it to be remarkably effective at reducing HPV rates in the general population. And it’s now easier than ever to get pre-teens vaccinated; the CDC recently changed the vaccine schedule so that only two doses are needed.
In contrast, nothing about HPV is safe: It can cause cancers of the cervix, mouth, throat, penis and anus. The virus causes virtually all of the 34,000 cases of cervical cancer each year in this country. Parents don’t have forever to wait; the vaccine is less effective in people older than 20.
Some parents think that having their kids vaccinated against HPV would encourage them to have sex. While HPV is a sexually transmitted disease, studies have found that getting the vaccine doesn’t alter sexual behavior among adolescents. It simply protects those who have intimate contact, including sex, now or in their adult lives, from HPV-related cancers.
Another worrisome finding affects teens across the country as well as Texas: The CDC survey discovered that nationwide, teen vaccination rates are lower in rural and urban areas, and not just for HPV. Rural teens were more likely to skip the meningococcal vaccine. Yet vaccine skepticism doesn’t seem to be the issue; rates for the booster vaccine for tetanus, diphtheria and pertussis (whooping cough), Tdap, were about the same in rural and urban areas.
The CDC was at a loss to explain the puzzle, but suggested that differences in health care delivery might be one factor. That fits with the findings of a survey that our organization conducted last year in Texas. Low-income people in rural areas found it hard to bring their kids to the doctor or clinics where vaccinations were available because of the long distances involved; it took many of them the better part of the day to get there and back. That would mean a missed day of work.
It’s worth considering that both the HPV and meningococcal vaccines require boosters; the Tdap vaccine doesn’t. Could that extra appointment be what discourages families? We don’t yet know.
But this much is certain. We have to improve this picture and there are clear pathways for that:
Train doctors on how to improve vaccine acceptance. A recent study found that doctors who acted as if it was a given that kids would get their HPV vaccines had higher success rates than those who asked and went through the entire argument about HPV. Saying, “Kyle is 11 now. At this age, we give him his Tdap and first HPV and meningococcal vaccine” worked better than saying, “Is it OK to give Kyle his HPV vaccine? I know it’s controversial but it’s really important.”
Pass legislation that would require better reporting of HPV immunization rates. The data is available; using it to compile regional reports would allow Texas to use its public health funds more efficiently to target HPV “vaccination deserts” with public information campaigns. This year, a bill that would have accomplished this never even got a hearing in the Capitol; the Texas legislature needs to do better.
Expand the ability of schools and other community settings to provide immunizations to students so that parents don’t have to travel long distances.
We know what needs to be done. It’s not very expensive or difficult, but it does require a commitment from our state’s leaders.
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