You are the Key to HPV Cancer Prevention

Transcription

1 You are the Key to HPV Cancer Prevention Jim Farrell Director, Division of Immunization Virginia Department of Health Debbie Bridwell Comprehensive Cancer Control Coordinator Virginia Department of Health October 19, 2016

2 Objectives 1. Define the importance of HPV vaccination for cancer prevention and the rationale for vaccinating at ages 11 or List the recommendations for HPV vaccine for girls and for boys. 3. Provide useful and compelling information about HPV vaccine to parents to aid in making the decision to vaccinate. 4. Locate resources relevant to current immunization practice.

3 HPV Infection Most females and males will be infected with at least one type of mucosal HPV at some point in their lives Estimated 79 million Americans currently infected 14 million new infections/year in the US HPV infection is most common in people in their teens and early 20s Most people will never know that they have been infected

4 New Cancers Associated with HPV per Year United States

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7 Cervical Cancer Cervical cancer is the most common HPVassociated cancer among women 500,000+ new cases and 275,000 attributable deaths world-wide in 2008 ~11,000 new cases and 4,000 attributable deaths in 2012 in the U.S. 25% cervical cancers occur in women who are between the ages of 20 and 39

8 HPV Vaccines Currently Licensed in U.S.

9 Updated ACIP Recommendations Age Routine vaccination at age 11 or 12 years* Vaccination recommended through age 26 for females and through age 21 for males not previously vaccinated Vaccination recommended for men through age 26 who have sex with men (MSM) or are immunocompromised (including persons HIV-infected) Formulation by gender (assuming availability)

10 ACIP Recommendations: Timing of the Series 2vHPV, 4vHPV and 9vHPV are each administered in a 3-dose schedule Interval between doses 1 2: 1-2 months Interval between doses 1 3: 6 months The minimum interval between doses 1 and 2 is 4 weeks The minimum interval between doses 2 and 3 is 12 weeks If the vaccine schedule is interrupted, the series does not need to be restarted

11 Vaccine Effectiveness National Health & Nutrition Examination Survey. Determined prevalence of HPV infection before and after HPV vaccine introduction. Prevalence declined 64% in females yoa. Prevalence declined 34% in women Very effective which is what was seen in prelicensure clinical trials.

12 HPV Vaccine Duration of Immunity Studies suggest that vaccine protection is long-lasting; no evidence of waning immunity Available evidence indicates protection for at least 10 years Multiple cohort studies are in progress to monitor the duration of immunity

13 HPV Vaccination Is Safe, Effective, and Provides Lasting Protection HPV Vaccine is SAFE Benefits of HPV vaccination far outweigh any potential risks Safety studies findings for HPV vaccination similar to safety reviews of MCV4 and Tdap vaccination HPV Vaccine WORKS Population impact against early and mid outcomes have been reported in multiple countries HPV Vaccine LASTS Studies suggest that vaccine protection is long-lasting No evidence of waning protection

14 Estimated Vaccination Coverage U.S. Adolescents Years, NIS-Teen,

15 Impact of Eliminating Missed Opportunities by Age 13 Years in Girls Born in 2000

16 Vaccination Coverage, Years, National Immunization Survey (NIS)-Teen, Methodology changed in 2014; 2013 data were revised but other years cannot be directly compared * Females only ^ Among females who began the series and had at least 24 weeks between the 1 st dose and the interview date HP2020 = Healthy People 2020 goal

17 Estimated HPV Vaccination Coverage Among Adolescents aged 13 17, 2015

18 Background ACIP Recommends all adolescents routinely receive three doses of HPV vaccine at age years. HPV recommendation for females published CDC Provider surveys suggest that clinicians often do not strongly recommend or administer HPV vaccine at the recommended age.

19 Most clinicians wait too long to make strong recommendations for HPV vaccine

20 Reasons parents won t initiate HPV vaccination for children

21 Give a Recommendation to Receive HPV Vaccine at Ages 11 or 12 A recommendation from the physician is the main reason parents decide to vaccinate Many moms in focus groups stated that they trust their child s doctor and would get the vaccine for their child as long as they received a recommendation from the doctor

22 What is an EFFECTIVE Recommendation for HPV vaccination?

23 SAME WAY SAME DAY

24 Make an Effective Recommendation Same way: Effective recommendations group all of the adolescent vaccines Recommend HPV vaccination the same way you recommend Tdap & meningococcal vaccines. Same day: RECOMMEND HPV VACCINE TODAY Recommend HPV vaccination the same day you recommend Tdap & meningococcal vaccines.

25 Why so young?

26 HPV Vaccine Recommendation Girls & Boys can start HPV vaccination at age 9 Preteens should finish HPV vaccine series by 13th birthday

27 HPV vaccination works best at the recommended ages of 11 or 12 years. Stronger antibody response Prior to sexual debut

28 Increase the number of target patients who come in & leave vaccinated 1. Know your coverage rates 2. Align office policy with mission 3. VDH support and initiatives

29 1. Know your coverage rates AFIX visits for VFC providers Data from EHR Ordering data

30 2. Align office policy with mission Immunize at every opportunity Standing orders Prompt the person who is supposed to order the vaccine Reminders Recalls Everyone in the office saying the same thing

31 DOI Support and Resources Division of Immunizations - General Support / Resources: Virginia Immunization Information System (VIIS) - VIIS Training for Clinical Office Staff - VIIS Help Desk - viisinfo@vdh.virginia.gov Virginia Vaccines For Children Program - vvfc@vdh.virginia.gov

32 HPV VACCINE IS CANCER PREVENTION And YOU are the key! #WeCanStopHPV