Concerning Trends: Lack of HPV Vaccination in the United States
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Published 2024-07-24
www.medscape.com/viewarticle/1000624?src=soc_yt
-- TRANSCRIPT --
Hello. I'm Dr Maurie Markman, from City of Hope. I want to briefly discuss two papers that appeared in the literature which are both sobering and, in my opinion, distressing. The issue I'm going to discuss needs to become a very high priority within the American public health community and, quite frankly, by regulators, government officials, and individuals who are responsible for deciding funding.
The first paper is "Human Papillomavirus Vaccination Among Young Adults Before and During the COVID-19 Pandemic." This paper was published in JAMA Network Open. In this survey looking at individuals from 18 to 26 years of age, and looking at 2018, 2019, and 2022 to see what happened during the pandemic, overall, 47% of the individuals who were surveyed noted one or more vaccine doses.
This is a vaccination that we know today can almost certainly dramatically reduce, if not completely eliminate, the risk for cervical cancer. Of those aged 18-26, this vaccine has been available for over a decade, so this is a population that should have availed itself to it, but only 47% of the individuals surveyed did.
Even more concerning than that is when breaking this down by individuals who had insurance vs not. In the individuals in this age group who were uninsured, only 20% of males were vaccinated with at least one vaccine dose and only one third of females.
Again, this is a vaccine that can essentially eliminate, as far as we can tell today, HPV-associated cancers — cervical cancer and the majority of head and neck cancers. Only 1 in 5 uninsured males and 1 in 3 females were vaccinated. The percentages were higher, fortunately — but really only approximately double this — in the insured.
How are we going to get individuals vaccinated? How are we going to pay for this? If you simply look at the cost issue, the cost of treating one's cervical cancer or HPV-associated head and neck cancer would be dramatically higher. The risk for death adds to this burden immensely.
The second paper I wanted to mention really gets into the question of what's actually happening related to cervical cancer. This paper was recently published in the International Journal of Cancer, entitled "Recent Trends in Cervical Cancer Incidence, Stage at Diagnosis, and Mortality According to County-Level Income in the United States, 2000-2019." I won't go through the details, but this is very sobering.
Looking specifically at counties that one would define as lower socioeconomic, obviously more difficult access to healthcare, the incidence — this is the United States of America — of stage IV metastatic cervical cancer at diagnosis increased significantly: by 4.4% per year over this period of time. There was an increase in distant-stage cancer in the population in the lower socioeconomic groups.
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