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First-Year HPV Vaccination Rates 'Very Good'


 

A survey providing the first estimates for human papillomavirus vaccination found that 25% of girls aged 13–17 had received at least one dose of the vaccine, according to a briefing by the Centers for Disease Control and Prevention.

"This was very good for a first-year measurement for a new vaccine," said Dr. Lance Rodewald, director of the division of immunization services at the CDC's National Center for Immunization and Respiratory Diseases.

But while coverage rates for routinely recommended vaccines among U.S. teens are increasing, the number of adolescents fully immunized against diseases such as pertussis and meningitis is not yet at the 90% goal set by a government-led initiative.

The Healthy People 2010 initiative set goals for youths 13–15 years of age with three doses of hepatitis B vaccine, two doses of measles, mumps, and rubella vaccine, one dose of tetanus-diphtheria or tetanus, diphtheria, and acellular pertussis vaccine, and one dose of varicella vaccine for those who had not had chickenpox.

Healthy People 2010 did not include a goal for the HPV vaccine because it is still so new. The quadrivalent human papillomavirus (HPV4) is complete at three doses. Dr. Rodewald said an estimated 2.5 million 13- to 17-year-old girls have received the vaccine to date.

Dr. Rodewald presented results from the second National Immunization Survey (NIS-Teen), which he described as a national "report card on the implementation of the vaccines." During the last quarter of 2007, parents of children between the ages of 13 and 17 were interviewed about their child's vaccination history. The survey included 3,000 adolescents as participants, split almost evenly between boys and girls. The 13- to 17-year-old age group was selected because, according to Dr. Rodewald, the vaccines are targeted to 11- and 12-year-olds.

For HPV in particular, Dr. Rodewald said, 11- and 12-year-olds have a "very strong and robust" immune response that adds further protection that will last through the later, riskier periods. He also said that the HPV vaccine can provide up to 6 years of protection.

"You always want to vaccinate before the period where there could be disease, and so it's very important to vaccinate before the onset of sexual activity, and 11- and 12-year-olds, of course, is before the onset of sexual activity, so this provides protection in anticipation of exposure later on in life," he said.

The numbers for the Tdap were also particularly encouraging, Dr. Rodewald said. Vaccinations increased from 10.8% in 2006 to 30.4%. For a "new vaccine in its second year of recommendation," he said, 30.4% "is very good because it usually takes 6–9 years to achieve the desired 90% coverage."

Compared with the 2006 estimates, Dr. Rodewald said, other areas of improvement included the following:

▸ Vaccination coverage levels for three or more doses of hepatitis B and two or more doses of MMR vaccine were more than 80%, very close to the Healthy People 2010 goal.

▸ The one dose coverage of varicella vaccine, which protects against chickenpox, was 75.7%, but coverage with the new recommended two doses was low at 18.8% among preteens and teens without previous history of the disease.

▸ Of the adolescents surveyed, 32.4% received the meningococcal conjugate vaccination, compared with 11.7% in 2006.

To further emphasize the seriousness of these diseases if young people are not vaccinated, Dr. Rodewald noted that while pertussis is well controlled among young children, it is on the rise in teens and young adults. Prior to the 2005–2006 recommendations, he said that meningococcal disease, which is the leading cause of bacterial meningitis, and HPV have not been preventable through routine vaccination. He also mentioned that 4,000 women die from cervical cancer a year—most of those cases being caused by HPV strains.

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