HPV vaccination rates fall short of goal

Health officials are disappointed by the number of children in some provinces getting vaccinated against HPV to prevent certain cancers.

Infection with human papillomavirus (HPV) can cause cervical, anal, vaginal and penile cancers among others. Starting in 2007, federal funding was announced and provinces and territories started rolling out HPV vaccinations for school girls and set goals for uptake rates.

•  HPV vaccine: The growing campaign for including boys 

But the vaccination rates vary widely with some jurisdictions falling short of expectations. For example, while the Canadian Cancer Society's Ontario division's goal is 90 per cent, the provincial average is estimated at 80 per cent and down to an estimated 65 per cent in Toronto. 

The Canadian Partnership Against Cancer reported on HPV vaccination rates across the country in its 2015 performance report.

It's estimated about 370 Canadian women will die this year of cervical cancer.

"If that number of people were dying of meningitis and there was a vaccine that could prevent about three quarters of cases, everyone would be lined up for that vaccine," said Dr. Joan Robinson, a pediatrician in Edmonton.

"The problem here is simply the whole association between the vaccine and sexual activity and the reluctance of parents to accept the fact that their children are highly likely to eventually become sexually active."

Many pediatricians and family doctors in the U.S. also communicate about HPV vaccination to parents in ways that may discourage uptake, according to a study published this week in the journal Cancer Epidemiology, Biomarkers & Prevention.

 "Physicians have a lot of influence on whether adolescents receive the HPV vaccine. Our findings suggest that physicians can improve their recommendations in three ways: by recommending HPV vaccination for all 11- to 12-year-olds and not just those who appear to be at risk; by saying the HPV vaccine is very important; and by suggesting vaccination on the day of the visit rather than at a later date," the study's senior author, Prof. Melissa Gilkey of Harvard Medical School in Boston, said in a release from the American Association for Cancer Research, the journal's publisher.

If family physicians recommend the vaccine, the vast majority of parents will agree, Robinson said.

Another step is to vaccinate boys, too. The Canadian Cancer Society says vaccinating males will go far in eliminating HPV, in part because HPV-related cancers are on the rise in men.

"It may actually in the long run improve uptake rates because parents will see it's a vaccine that is being recommended for everyone," Robinson said.

Currently British Columbia, Alberta, P.E.I., Nova Scotia and Manitoba offer HPV vaccines to some or all boys. 

The U.S. study was funded by the Cancer Control Education Program at UNC Lineberger Comprehensive Cancer Center, the U.S. National Cancer Institute, and an unrestricted educational grant from Pfizer. Brewer has received HPV vaccine-related grants from or been on paid advisory boards for GlaxoSmithKline PLC, Merck, and Pfizer.

The Canadian Cancer Society's Ontario division launched a public education campaign to help boost HPV vaccination rates for this week's Cervical Cancer Awareness Week.