What if I told you that there was a cancer vaccine that could potentially spare your child not one, but six kinds of cancer? You’d jump at the chance, right?
That already vaccine exists — it’s the shot for human papillomavirus, an extremely common sexually transmitted infection that can cause multiple types of cancers. Each year, HPV causes over 21,000 cases of cancer in women and 16,000 cases of cancer in men.
But despite evidence of the vaccine’s efficacy, many parents continue to eye it with suspicion. The roots of their fears are complex, and doctors need to play a bigger role in alleviating them.
The narrative around HPV vaccinations has typically centered on their ability to prevent cervical cancer in women. But a new study, presented last weekend at a major cancer meeting, reinforces the notion that these shots directly benefit men, too.
Researchers examined the electronic health records of people who were or were not vaccinated against HPV between 2010 and 2023 and found vaccination lowered men’s risk of developing any HPV-related cancer by 54%, while their head and neck cancer risk fell by 56%.
Unfortunately, numbers alone don’t change minds. But trusted health care providers can. And every new piece of evidence ought to help doctors convince parents of the benefits of vaccination — for both girls and boys.
We’ve long known of the benefits of these shots in girls. Enough time has passed since their introduction to show they can practically wipe out cervical cancer. They work so well that Australia believes it can eliminate the disease by 2035. And last year, data from Scotland found no cancer cases — that’s right, zero — among women who had been vaccinated when they were 12 or 13 years old.
But HPV doesn’t only cause cervical cancer. It’s the culprit behind most penile, anal, vaginal and vulvar cancers, as well as a growing number of head and neck tumors. Incidence of oral cancers have now surpassed the number of cervical cancers — and most of those cases are in men. And while overall cancer deaths in the U.S. have been on a steady decline, the mortality rate for HPV-associated oral cancers has continued to rise by 2% per year.
That’s a sobering message for parents of boys. In 2022, just 35% of boys between the ages of 9 and 17 had received at least one HPV vaccine dose.
It’s also a wake-up call for pediatricians. Conversations about vaccine hesitancy tend to focus on parents’ attitudes, but it’s worth asking whether progress also is being held back by physician hesitancy — to the vaccine itself or simply a reluctance to bring up a vaccine related to sexually transmitted infections.
A ton of research has been done to pinpoint the reasons vaccine uptake has stalled at just over 60% among all teens — well below the U.S. government’s target of achieving an 80% HPV vaccination rate among teens by 2030. The studies find a few common themes, including ongoing worries over the safety of the shots (despite more than 500 million people around the world having been safely vaccinated against HPV) or claiming their child isn’t sexually active so doesn’t need it.
But in surveys probing hesitancy, parents also regularly cite a lack of knowledge or lack of a recommendation about the vaccine as a factor in their decision to opt out of it. It seems many pediatricians aren’t recommending the vaccine or offering enough education about its benefits.
More conviction would help. A strong health care provider recommendation “is the single most important predictor right now of whether or not someone was vaccinated,” says Heather Brandt, Director, HPV Cancer Prevention Program at St. Jude Children’s Research Hospital.
In Mississippi, the state with the worst HPV vaccination track record in the country, a group of community stakeholders is working under the coordination of a broader American Cancer Society-led effort to get more shots in arms. A big part of that push involves providing pediatricians with a template for how to broach the topic of vaccination and respond to parents’ concerns. That might sound very basic, but clearly pediatricians and their staff need it.
Mississippi also is training dentists and OB-GYNs to have those conversations, too. The rising rate of HPV-related oral cancers gives dentists a natural opening to talk about the benefits of prevention when they are doing an exam, says Amy Ellis, associate director of state partnerships at the ACS.
Those conversations also need to begin earlier. Kids benefit most from vaccination by the age of 13, but the first shot can be given as young as 9. A parent might not be receptive during that initial chat, but opening the dialogue at 9 gives a longer window to draw them in. “It might take several conversations, but not talking about it at all is a missed opportunity,” said Nosayaba Osazuwa-Peters, a head and neck surgeon at Duke University School of Medicine, who studies HPV vaccine hesitancy.
Yet there are some frustrating technical barriers to shifting shots earlier in childhood. When a child has their annual check-up, their provider pulls up the state-level immunization recommendations — and in nearly every state, the HPV vaccine doesn’t make that list until age 11. In 2023, Washington State lowered the age to 9, and other states should follow suit.
Doctors have a lot on their plates, and of course many other factors — including access to a doctor, particularly in rural communities or among those without health insurance — influence vaccine attitudes. But health care providers are in the best position to convince parents that these life-saving shots are worthwhile.
Lisa Jarvis is a Bloomberg Opinion columnist covering biotech, health care and the pharmaceutical industry. Previously, she was executive editor of Chemical & Engineering News.
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