What's Keeping Girls from Getting the HPV Vaccine?
Photo Credit: Adam Gregor/Shutterstock
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For parents around the country, back to school means more than new clothes and school supplies -- it means a trip to the doctor for federally mandated immunizations to protect their children against diseases like whooping cough. But there's another vaccine available to our young people that most parents won't hear about when they take their 7th graders in for a TDAP booster: the HPV vaccine, which protects against the sexually transmitted virus that causes both cervical cancer and genital warts.
According to the Centers for Disease Control and Prevention, the HPV vaccine is greatly underutilized in the United States, thanks to a perfect storm of barriers -- including the way the vaccine has been marketed, as well as its controversial coverage in the media -- that keep families from vaccinating their kids. In other countries, young people have received the vaccine at much higher rates. Denmark and Britain have vaccinated 80 percent of their teenage girls against HPV, while only one third of teenage girls in the U.S. have been vaccinated. And in Australia, the vaccine has already resulted in the sharp decline of genital warts among the 26-and-under population. The same age group in our country has not seen a decline in disease, despite having had the availability of the HPV vaccine for the same amount of time.
It is no coincidence that countries seeing success with the vaccine implemented it as part of a national policy. Or that information disseminated to the public about the vaccine looks much different abroad than it does here in the U.S. In Australia, for example, marketing of the HPV vaccine, as well as media coverage of the country's national vaccine program, has been overwhelmingly positive, unlike in the U.S. Here, the vaccine has consistently, though incorrectly, been referred to as the " promiscuity vaccine" in the media since the FDA first approved Merck's brand, Gardasil, in 2006.
The United States' lack of a collective government effort to first educate and then mandate the vaccine, in addition to the pharmaceutical company Merck's aggressive lobbying to create such a mandate, played into the public's growing distrust of vaccines in general. The news media had a field day exposing Merck's vested interest in funding politicians, including Rick Perry, to push legislation that would require the protective immunization for all girls.
This created fear that the already controversial pharmaceutical company would have a hugely profitable monopoly on a mandated vaccine -- a justifiable fear considering the potential ramifications of such a monopoly on industry accountability, drug safety, costs, and personal choice. The debate surrounding the vaccine from all angles in the media (the right side afraid that getting their daughters vaccinated meant giving them permission to have casual sex and the left side wary of Big Pharma's financial incentives) prevented most efforts to promote and implement the vaccine on a population level.
Another barrier that has contributed to the underutilization of the vaccine in the U.S. is its high cost. At retail, the three-dose vaccine is $390, plus the cost of copayments for the doctor's visits needed to administer the shots. While low-income and uninsured minors 18-and-under have been eligible to pay for the vaccine using the federal Vaccines for Children Program, the need to pay copays for the three required doctors visits has been a barrier. Uninsured young adults over 18 have had to pay for the vaccine out of pocket, and even young adults who are insured have often only had a portion of the vaccine's price covered by their insurance.
Without a sensitive and streamlined national policy supporting a program that provides better information about, access to, and payment for the HPV vaccine, the U.S. risks falling further down the list of health status rankings among developed countries. Rather than reinventing the wheel, however, we have the opportunity to learn from successful programs such as Australia's National HPV Vaccination Program.