Story URL: http://news.medill.northwestern.edu/chicago/news.aspx?id=225692
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HPVvaccine

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One shot of the HPV vaccine could be enough, according to new research from the National Cancer Institute.


Study shows promise for making HPV vaccine easier to get

by Jaclyn Voran
Nov 07, 2013


New research suggests one dose of the HPV vaccine could work as well as the standard three doses, meaning it could get easier and cheaper for people with limited access to health care and insurance coverage to get vaccinated.

The National Cancer Institute’s study showed that women who got fewer doses of the HPV vaccine Cervarix, which protects against some types of cervical and anal cancers, produced similar amounts of antibodies that fight HPV-related diseases to those who got the  three-dose regimen. Study authors and outside experts agree more research is needed to confirm that antibody levels translate to better outcomes.

“If these findings are confirmed by other studies, they would potentially affect cost and logistics of vaccination programs in low-resource settings, where more than 85 percent of cervical cancers – the most common cause of cancer death in these women – occur,” according to the NCI.

A five- to seven-year study comparing the number of women who got an HPV-related disease after receiving fewer vaccinations with the number of women who got an HPV-related disease after three doses, for example, is needed to prove that fewer doses are actually as effective, according to Dr. Kenneth Alexander. Alexander is a University of Chicago infectious disease expert who has studied HPVs for more than 20 years and serves as an advisor to HPV vaccine manufacturers.

Still, this research is a step toward providing easier access in the U.S and globally.

But even in the U.S., completion of all three shots lags. In fact, only 33.4 percent of girls ages 13-17 received three doses of the HPV vaccine, compared with 53.8 percent who received at least one dose in 2012, according to the CDC’s National Immunization Survey-Teen. Chicago performed slightly better than the national average with 37.8 percent of 13- to 17-year-old girls receiving all three shots in 2012.

“It’s hard to get people to show up for three doses,” said Alexander. “People live busy lives, so if we can protect them in one or two doses, then that’s just great. It would be very nice because these are [expensive] vaccines.”

Three doses cost $386.25 in the U.S., according to the CDC, and while most health insurance covers recommended vaccines, some may not.

But Alexander doesn’t think cost is what’s keeping women from getting vaccinated.

“The biggest reason adolescent girls aren’t getting vaccinated is because pediatricians aren’t pushing for immunization and giving strong recommendations,” Alexander said. “They’re letting patients down in a big way.”

Controversy over giving the vaccine to young girls exists in the U.S. because HPV can be spread through sexual contact. Critics argue that the vaccine gives young women permission to have sex.

While some pediatricians may be avoiding the topic, 20-year-old Northwestern student Susie Neilson said she got the vaccination at 16 after her primary care doctor recommended it. With a family history of cancer, Nielson said she likely would have gotten the vaccine even if her insurance hadn’t covered it.

“It would have been annoying, but I would rather not have to worry about paying huge medical bills for cervical cancer or even paying with my life down the road,” Neilson said.

But globally, more than a quarter of a million women pay with their lives every year, according to the World Health Organization. This research provides hope of lowering costs and increasing vaccine delivery in the developing world, where more women are dying of cervical cancer, Dr. Alexander said.