The April 2021 edition of Gynecologic Oncology features, “Overcoming the barriers to HPV vaccination in high-risk populations in the U.S.: A Society of Gynecologic Oncology (SGO) Review,” which examines strategies that countries can use to achieve the US and World Health Organization (WHO) targets for human papillomavirus (HPV) vaccination over the next decade. This review is an update to “Overcoming the barriers to HPV vaccination in high-risk populations in the US,” which was published in 2010.
The strategies outlined in the new review article include:
- Public health education with media campaigns centered around HPV health risks and vaccine safety
- Public health funding allowing widespread access for all adolescents and young adults
- Education and incentives for primary healthcare providers to vaccinate
- HPV vaccine mandates or school-based vaccination
Lead author Levi Downs, MD, and co-authors Deanna Teoh, MD, and Emily Hill, MD, noted that the countries with the highest HPV vaccination coverage have school-based vaccinations (i.e., the vaccine is administered in the school with an opt-out provision) and this has worked well in a wide range of cultural and socio-economic settings, including countries such as Australia, United Kingdom, India, Peru, Uganda, Rwanda and Vietnam. Often these school-based efforts have been combined with coordinated community outreach and education efforts, which increase parental acceptance and community buy-in. To date, no state in the United States has school-based vaccination, and very few states even have school mandates.
The authors added that it is important that gynecologic oncologists promote the HPV vaccine as a cancer vaccine.
“It is also our responsibility to raise awareness about cervical cancer, which does not get as much press as breast cancer or even ovarian cancer,” they said. “With the growing prevalence of referrals to gynecologic oncologists for non-malignant but complex surgeries, we have an opportunity to provide additional education to our patients about the importance of HPV vaccination if they are age-eligible and not already vaccinated. For our patients who may already have a diagnosis of cervical or other HPV-associated cancer, we also have an opportunity to encourage our patients to vaccinate their age-eligible children and grandchildren, and to spread awareness to others in their family and their community.”
In addition to promoting the HPV vaccine as a cancer vaccine, the authors noted that health care providers can also raise awareness of the association between HPV infection and oropharyngeal cancer, which is currently the most prevalent HPV-associated cancer, especially among males.
“We need to promote HPV vaccination for all genders and stress the safety and efficacy of this vaccine,” they said.
Drs. Downs, Teoh and Hill explained that it is rare to have a single intervention that can prevent cancer so effectively.
“Although we are primarily asking primary care providers to administer the vaccine, as gynecologic oncologists we need to actively promote the vaccine as a cancer vaccine and combat misinformation about HPV vaccination,” they said. “When we see a patient with locally advanced or metastatic cervical cancer, we should think ‘Where has the system failed this woman?’ and try to get involved on a broader level promoting and advocating for primary and secondary prevention.”