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HPV Vaccine

HPV Vaccine. Jonathan Fanburg , MD, MPH First Steps – 2/10/12. Outline. Facts about the Virus Facts about the Vaccine Giving HPV in practice Discussion about the Reality. Teens Have Sex. SEXARCHE 2-4% by age 11yrs old 13% of 7 th graders (12yr old) 18% of 8 th graders (13yr old)

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HPV Vaccine

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  1. HPV Vaccine Jonathan Fanburg, MD, MPH First Steps – 2/10/12

  2. Outline • Facts about the Virus • Facts about the Vaccine • Giving HPV in practice • Discussion about the Reality

  3. Teens Have Sex • SEXARCHE • 2-4% by age 11yrs old • 13% of 7th graders (12yr old) • 18% of 8th graders (13yr old) • 27% of 9th graders • 40% of 10th graders • 53% of 11th graders (16yr old) • 63% of 12th graders Maine Integrated Youth Health Survey 2009

  4. Most Parents Do Not Know That Their Children Have Had Sex • Only 1/3rd of parents of sexually experienced 14 yr olds believe that their child has had sex. • Only ½ of parents of sexually experienced 8th-11th graders are aware that their child has started having sex. Bruckner, 14 and Under, sexual behaviors of young teenagers.2003. Blum, Center for Adol Health, Minnesota 2002.

  5. Teens Get HPV From Sex • 60% of females get HPV before age 24yr. • Ages 14-19, 35% are positive • Ages 20-29, 29% are positive • Ages 30-39, 13% are positive • Ages 40-49, 11% are positive • Ages 50-59, 6% are positive Prevalence of HPV (2003-05) (CDC STD surveillance document)

  6. HPV Causes Cancer and Warts • 40 strains of HPV exist, (15 are oncogenic) • Gardasil vaccine covers 4 strains, 70% cervical cancer, 90% warts • 12,000 people are dx with cervical cancer, 4000 people die yearly • 500,000 people are dx with genital warts yearly

  7. The Vaccine is Very Effective • Genital warts – 90% effective (3 doses), 67% effective (1 dose) (at 2.3yrs). • Cervical infection – 100% vaccine efficacy against HPV 16+18 precancers. 99% had antibody response within 1 month of completing 3 doses. • Anal cancer – 75% efficacy in preventing anal cancer

  8. You Need to Get the Vaccine Prior to Getting the Virus • Vaccine has no benefit for strains once already infected. • If you have 1 strain of HPV, there is a 93% chance that you don’t have all 4 strains of HPV. Ref: Merk studies

  9. The Vaccine Has Minimal Risks • 40 million doses have been given (as of 9/11) • Redness or swelling at site of injection • Similar percent as has been seen in other vaccines. • Slightly higher risk of syncope. • Blood clots – VAERS with slight increased clots – of 31 people with clots, 28 had known risk factor (clotting disorder, family history of clotting disorder, estrogen birth control). Monitored. CDC website. Slade, JAMA 2009; 302:750.

  10. Patients Care What the Doctor Thinks About the Vaccine • Predictors of Initiating Vaccine • Provider Recommendation (HIGHEST PREDICTOR – OR 2.6) • Older age • Having a 11-12yo preventative visit • Insured • Younger maternal age • Mother never married • Not receiving all vaccines at a public facility • Reasons for not initializing the vaccine • Lack of knowledge about the vaccine (19%) • Vaccine was not needed (18%) • Daughter was not sexually active (18%) • Provider did not recommend vaccine (13%) Pediatrics, Oct 2011

  11. Video Clip Link -The Children’s Hospital of PhiladelphiaPrevent HPV www.prevent-hpv.com

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