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Most NM teens not vaccinated for HPV

ALBUQUERQUE, N.M. — Teenagers don’t often visit doctors. When they do, getting a vaccine to prevent cervical cancer often is not high on the agenda.

SUSSMAN: Recommends "bundling" vaccines

SUSSMAN: Recommends “bundling” vaccines

That helps explain why fewer than half of New Mexico girls and only one in five boys are fully immunized against a virus that causes about 80 percent of cervical cancers in the United States, according to a new study co-written by University of New Mexico researchers.

In addition, many New Mexico clinics lack systems designed to alert adolescents and their parents when it’s time to get vaccinated for human papillomavirus, or HPV, a sexually transmitted disease that infects about 80 million people in the U.S.

“Clinics don’t do a good job of tracking vaccination status and then having a reminder system in place,” said Andrew Sussman, assistant professor of family and community medicine at the UNM School of Medicine.

The study recommends that clinics improve their systems for tracking a child’s compliance with HPV vaccines and for notifying parents when the child is due for a vaccination.

“Few clinics have a trigger to remind patients to bring in kids for follow-up doses,” said Sussman, the study’s lead author.

It also recommends that physicians “bundle” the elective HPV vaccine with school-required vaccinations, encouraging adolescents to get all the vaccines at the same time.

“Not many clinics in New Mexico are bundling adolescent vaccines together,” Sussman said. “It would be a system change for practices.”

The study also recommends that the HPV vaccine be offered in more venues, including school-based health centers, “to offload some of the burdens on health care providers,” Sussman said.

The study, published in the July-August issue of The Annals of Family Medicine, was based on surveys with 98 New Mexico clinicians and interviews with 25 of them.

Health officials recommend that adolescent boys and girls get three doses of HPV vaccine. In 2013, the rates of New Mexico children ages 13 to 17 who had received all three doses was 44.3 percent for girls and 19.2 percent for boys, according to New Mexico Department of Health data.

Those rates lag far behind those of other vaccines recommended for adolescents. The state’s coverage rate in 2013 was 85.6 percent for the meningococcal vaccine and 77.8 percent for the Tdap vaccine, which protects against tetanus, diphtheria and pertussis.

While the meningococcal and Tdap vaccines are required for school admission, the HPV vaccine is elective. Schools send out reminders to parents for required vaccines, “but not for HPV,” Sussman said. As a result, responsibility falls largely on parents and healthcare providers to get kids vaccinated.

Each shot costs $130 to $150, for a total of around $390 to $450 for the series, according to the Association of Reproductive Health Professionals. Many health insurance companies pay for the cost of all three shots. HPV vaccination is included in the federally funded Vaccines for Children Program for boys and girls up to age 18.

Clinicians also have limited opportunities to vaccinate adolescents because most are healthy, Sussman said. Teenagers typically visit a doctor only for an acute condition, such as a broken bone or a strep throat.

“The kid has a specific problem that needs to be addressed immediately,” and the issue of vaccinations may not come up, he said.

Clinicians surveyed also said that few parents object to HPV vaccines on religious or moral grounds.

“Early on, there was a sense that (the vaccine) may send the wrong signal to adolescents” and encourage premarital sex, Sussman said. “What we found is that that has not emerged as a strong concern either among families or health care providers. They are not worried that the vaccine is a license for risky sexual behavior.”