UK hosts national meeting to raise immunization rate for vaccine against cervical and other HPV cancers, in which Ky. leads U.S.

Kentucky Department for Public Health illustration

By Melissa Patrick

Kentucky Health News

Kentucky leads the nation in the rate of cases of and deaths from cervical cancer, a disease that is largely preventable by a vaccine.

The vaccine targets the human papillomavirus, which can cause cancers of the cervix, genitals, anus, neck and head. Kentucky also leads the nation in cancers caused by the HPV.

"The good news is that the HPV vaccine can prevent the vast majority of those cancers, but not everybody knows about it," said Pamela Hull, associate director of population science and community impact for the University of Kentucky's Markey Cancer Center. 

Between the HPV vaccine and cervical screening, cervical cancer could be virtually eliminated, Hull said. The combination wouldn't prevent all cases, she said, but "Within the next few decades, we can eliminate cervical cancer as a public-health threat in this country." 

Cervical cancer screening is done through a pap smear, which looks for cancerous cells on the cervix, which connects the uterus and vagina. It can also find precancerous changes that have not yet developed into cancer. Screenings usually begin at age 21 or three years after the first sexual intercourse.

The HPV vaccine protects against six cancers: cervical, anal, penile, vaginal, vulvar and head or neck. According to the Centers for Disease Control and Prevention, it can prevent over 90% of sexually transmitted cancers caused by the HPV from ever developing, 

Hull said these cancers cause 36,000 new cancer cases every year in the U.S. in men and women, but only about half of Kentucky teenagers have received it because state law does not require it.

The vaccine's greatest obstacle appears to be that that it is associated with a sexually transmitted disease. Researchers have said improving the vaccination rate depands on changing the perception that the vaccine is something that prevents STDs to the knowledge that it primarily prevents cancer.

Conference discusses anti-HPV strategies

Raising awareness about the importance of HPV vaccination was the focus of a national conference held in Lexington on April 16-17 by the Markey center and the National Cancer Institute. 

Hull, who spke with reporters before the conference, said researchers all over the country are collectively working to answer this question: "How can we work with health-care providers and community organizations and parents to make sure more and more kids get vaccinated to protect them from cancer as they grow older?" 

A "social organization" program called "Operation WIPE OUT Cervical Cancer Alabama" aims to do just that through a program that involves a number of community partners, Isabel Scarinci of the University of Alabama at Birmingham told attendees at the conference in Lexington. 

Scarinci said the program first engaged the support of the Rotary Club of Birmingham and the state health department. Together, they launched a program to increase HPV vaccination rates in the Alabama county that had the highest rates of cervical cancer in the state.

She said through the involvement of groups in the county and the local school superintendent, they started an education program in the school system that resulted in the students organizing an HPV vaccination campaign, which has become part of an official plan for the state. 

Scarinci said there is no official funding for the program because they "want this to belong to everybody." Thus, funding comes from a number of sources. 

According to a post on the Alabama health department website, the program offers free HPV immunizations for children and adults; provides free cervical cancer screenings for low-income and uninsured women; and provides follow-up tests for those who need it. All services are offered through county health departments.   

HPV vaccines and Kentucky

While the HPV vaccine is not required in Kentucky, it is given around the time students enter middle school and are required to get an initial vaccine for meningitis and a booster for diphtheria, tetanus and pertussis (more commonly known as whooping cough), collecitvely called TDaP.

The timing of the two required vaccines and the HPV vaccine create a good opportunity to include it in the children's immunizations. "Even though it's not required," Hull said, "we really, really strongly encourage it because it's one tool that parents can use to prevent cancer for their children."  

Two doses of the HPV vaccine are recommended for all 11- and 12-year-olds, but the series can begin at 9. It is also recommended for those 13 to 26 if unvaccinated; three doses are recommended for people who get their first dose at 15 or later, and for people with certain conditions that weaken immunity.

In addition, it is also recommended that anyone between 27 and 45 who is not vaccinated should talk to their health-care provider about their risk of infection and the benefits of getting vaccinated.

Asked why boys and girls as young as 9 should get the vaccine, Hull said they have a better immune response than older chuildren. As a person gets older, she said, they need an extra dose of the vaccine for protection against the cancers because it takes more of the vaccine to build up their immunity.

"We really want to see our rates of HPV vaccination go up in Kentucky," Hull said. "Right now, just over half of teenagers have gotten the vaccine, all the doses of the vaccine, and we really want to get that up to, closer to, 80% or even higher." 

In 2022, Kentucky ranked 44th in HPV vaccination, with only 55% of teens 13-17 having received all recommended doses, according to America's Health Rankings. That was a decline from the 57% reported in 2021 and well below the national average of 63%.

"What I like to explain to a parent is . . . you're not going to put your seatbelt on after you get in a car accident, you have to have it on before," Hull  said. "So age for the vaccine is really important to get it early, build up the body's defenses so then one day when the body is exposed to the virus, it is ready to fight it." 

Hull said there is an emphasis on getting more people vaccinated in rural areas because HPV vaccination rates are lower in rural areas, and they have higher rates of HPV cancers.