The Role of the Healthcare Provider
The Human Papillomavirus Vaccine Decision: The Role of the Healthcare Provider Thesis statement: Healthcare providers should educate the parents of 11-12 year old boys and girls about human papillomavirus (HPV) infection and the HPV vaccine because HPV infection is prevalent and the chance of an adolescent being infected is high, persistent infection with the high-risk types 16 and 18 can cause serious health problems, and in order to assure effectiveness, the vaccine must be administered prior to contact with the virus. Introduction: Though it had been suspected for some time, in 1999 research concluded that virtually all incidences of cervical cancer were caused by the human papillomavirus (HPV), a sexually transmitted infection. In 2006, a vaccine was licensed to protect against HPV 16 and 18 which are the high-risk virus types most likely to cause cancer of the cervix, and HPV 6 and 11, the low –risk types that cause non-cancerous genital warts (Conroy, Rosenthal, Zimet, Jin, Bernstein, Glynn, et al. 2009). The Centers for Disease Control (CDC) initially recommended that girls 11-12 be vaccinated with the quadrivalent vaccine, and that girls and women 13 to 26 receive “catch up” doses (Hitt, 2010). Later recommendations expanded to included vaccination for females and males ages 9 to 26 years old to prevent HPV caused anal cancer (Gamble, Klosky, Parra, Randolph, 2010). One might expect that a vaccine to prevent the infection that causes cervical cancer, genital warts, and anal cancer would be well received, but that has not been the case. The CDC reported in 2010 that of young women age 13 to 17 years old, only 25% initiated vaccination and only 11% received all three doses of the series (Hitt, 2010). Studies have shown that parents decline HPV vaccine for their 11-12 year olds because they feel they do not have enough information about HPV infection, they feel that their children are too young to receive a vaccination against a sexually transmitted infection, and they do not perceive their own child as likely to get the infection (Gamble et al., 2010). It is probable that parents who decline the vaccination for these reasons are not making informed medical decisions, and this causes their children to miss the best opportunity to be protected against some serious diseases. Therefore, healthcare providers should educate the parents of 11-12 year old boys and girls about human papillomavirus (HPV) infection and the HPV vaccine because HPV infection is prevalent and the chance of an adolescent being infected is high, persistent infection with the high-risk types 16 and 18 can cause serious health problems, and in order to assure effectiveness, the vaccine must be administered prior to contact with the virus. I.Prevalence and risk of infection:
A. HPV infection is the most common sexually transmitted disease in the United States. (Sandfort & Pleasant, 2009). 1. At any one time there are 20 million infected (Sandfort & Pleasant, 2009). 2.There are 6.2 million new cases of HPV in the United States annually (Sandfort & Pleasant, 2009). B.Acquired soon after first sexual experience (Gamble et al., 2010) C. A sexually active individual has a 75-80% chance of infection in a lifetime (D'Urso, Thomson-Richardson, & Chandler, 2007) (Jones & Cook, 2008). II.Transmission:
A.Spreads skin to skin and mucous membrane and by kissing. Intercourse is not required (Sandfort & Pleasant, 2009). B.Condoms may decrease transmission and are recommended, but they cannot prevent the transmission of the virus. (Sandfort & Pleasant, 2009). C.An individual can have the infection for many years and it usually has no symptoms (McPartland, Weaver, Lee, & Koutsky, 2005). III.Possible Consequences:
A.70%-90% of the time the body clears the virus
B. Persistent HPV infection causes...