Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The collective failure of the HPV vaccine is ours

Jason V. Terk, MD
Conditions
June 11, 2016
315 Shares
Share
Tweet
Share

A couple of years ago, “epic fail” was the phrase my teenage son used as I unsuccessfully attempted to beat him in a game we were playing. At the time, I thought to myself it was a harsh but accurate assessment of my performance. And I was certainly motivated to practice on my own so that the next time, things would be different.

That same phrase came to mind as I read through an October 2015 article published in Cancer Epidemiology, Biomarkers & Prevention titled, “Quality of Physician Communication about Human Papillomavirus Vaccine: Findings from a National Survey.” The article describes well the poor performance of the medical community (primarily pediatricians and family physicians) in providing this vaccine. Another source, the most recent National Immunization Survey-Teen 2014, reports another alarming trend: HPV vaccine series initiation and completion continues to lag far behind what it should be.

It came as no surprise to me that the Cancer Epidemiology, Biomarkers & Prevention article clearly showed what I have suspected for some time and what has been hinted at by previous studies. The epic failure in providing what is essentially a cancer-prevention vaccine to the recommended population of 11- and 12-year-old boys and girls lies not at the feet of the antivaccine movement or hesitant parents. Rather, the failure belongs to us.

The article describes findings from an online survey sent to 2,368 pediatricians and family physicians in 2014. Respondents self-reported their own performance on strength of endorsement (saying the vaccine is important), timeliness (recommending it at ages 11 and 12), consistency (recommending it routinely vs. using a risk-based approach), and urgency (recommending same-day vaccination).

More than one-quarter stated they did not strongly endorse the HPV vaccine, and a similar number reported they did not recommend it be given at 11 to 12 years of age. Amazingly, 59 percent stated they used a risk-based approach vs. a routine approach to recommending the HPV vaccine, and only half of the respondents recommended giving the vaccine at the current encounter when discussing the HPV vaccine. And because this is self-reported data, these results represent a best-case scenario because respondents would be unlikely to paint an unflattering picture of their own performance.

Clearly, we have a major problem with physicians struggling with their own discomfort in discussing the HPV vaccine and who erroneously believe that parents do not value it. The physicians’ lack of competency in communicating effectively overtly and covertly leads to a lack of an affirmative recommendation that is so important in any preventive intervention. The narrative must remain consistent and effective for the successes of preventive interventions to endure.

Another factor that likely contributes to pediatricians’ underperformance on providing the HPV vaccine is one that we should be quite acquainted with: Pediatricians’ lack of experience and familiarity with the diseases that the HPV vaccine prevents.

It is human nature to consider those things we have a direct experience with to be more important. That is why the public’s acceptance of vaccines, in general, has waxed and waned as the public’s experiences with the diseases they prevent have waxed and waned. So it is with the HPV vaccine: It is the first routinely recommended vaccine that is given in the pediatric patient to prevent diseases that appear later in adulthood. Since HPV-associated cervical dysplasia/cancers, genital cancers and oropharyngeal cancers are not diseases that pediatricians treat or have a professional experience with, we unconsciously feel less of an imperative to perform with the vaccine that prevents these diseases. We will not likely be witnesses to our personal failures in our patients who do not get the HPV vaccine.

In fact, we are at risk for being the generation of pediatricians and family physicians who collectively failed to protect our patients from a preventable cause of cancer. The cohort of patients that we have cared for who should have received the HPV vaccine and did not are left vulnerable to cancers that cause incredible suffering and disfigurement. Only we can fix what it wrong with us. Only we can turn around this epic failure.

Physicians and other providers of medical care to adolescents can access resources to help themselves improve their provision of the HPV vaccine to their patients. One of the best collections of resources can be found online at the AAP’s Champion Toolkit. This includes material from the CDC and AAP as well as some illuminating video vignettes that illustrate the do’s and don’ts of communicating with families about HPV vaccination. This must become part of our mission!

Jason V. Terk is a pediatrician.

Image credit: Shutterstock.com

Prev

A Periscope interview after my AMA Medical Student Section keynote

June 11, 2016 Kevin 0
…
Next

Physicians are society's scapegoats

June 12, 2016 Kevin 5
…

Tagged as: Pediatrics

Post navigation

< Previous Post
A Periscope interview after my AMA Medical Student Section keynote
Next Post >
Physicians are society's scapegoats

More by Jason V. Terk, MD

  • The dimming of the shining city

    Jason V. Terk, MD

Related Posts

  • No, the HPV vaccine isn’t optional

    Chad Hayes, MD
  • How to increase your HPV vaccination rates

    Elizabeth Copeland, MD
  • School vaccine exemptions must be for medical conditions only

    Shetal Shah, MD
  • The basics of the MMR vaccine from a pediatrician

    Roy Benaroch, MD
  • A view from Canada: Defending vaccine passports

    Bryan Thomas and Colleen M. Flood
  • Major medical groups back mandatory COVID vaccine for health care workers

    Molly Walker

More in Conditions

  • Misinformed claims and the offensiveness of discrediting COVID-19 vaccine development

    Angel Garcia Otano, MD
  • Family support is pivotal in the treatment of schizophrenia

    Frank Chen, MD
  • Exploring disfigurement and self-worth

    Kathleen Watt
  • Are we doing enough to help chronic pain sufferers?

    Adam Strohl, MD
  • Lessons taught by Bell’s palsy

    Alexander Rakowsky, MD
  • Unthinkable choices in childbirth emergencies

    Kim M. Puterbaugh, MD
  • Most Popular

  • Past Week

    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • Unveiling excessive medical billing and greed

      Amol Saxena, DPM, MPH | Policy
    • Misinformed claims and the offensiveness of discrediting COVID-19 vaccine development

      Angel Garcia Otano, MD | Conditions
    • Dying is a selfish business

      Nancie Wiseman Attwater | Conditions
    • Navigating medical decision-making: Embracing limits and growth

      Benjamin Wade Frush, MD | Physician
    • Empathy and compassion in palliative care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Navigating the broken medical system: challenges faced by foreign medical graduates

      Anonymous | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • The essence of medicine: genuine connections in practice

      Jennifer Tillman, MD | Physician
  • Recent Posts

    • Misinformed claims and the offensiveness of discrediting COVID-19 vaccine development

      Angel Garcia Otano, MD | Conditions
    • Bitcoin’s role in diversified portfolios [PODCAST]

      The Podcast by KevinMD | Podcast
    • 1 in 5 doctors will become disabled. Are you prepared?

      Amarish Dave, DO | Finance
    • The pros and cons of whole life insurance for high-income earners

      Shane Tenny, CFP | Finance
    • Family support is pivotal in the treatment of schizophrenia

      Frank Chen, MD | Conditions
    • Is emergency medicine your calling? [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 18 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Reduced Mortality Seen in Cancer Survivors Who Meet Exercise Guidelines
  • CDC Advisors Endorse Maternal RSV Vax to Protect Newborns
  • Amoxicillin Alone for Acute Sinusitis Holds Up Against Broad-Spectrum Cousin
  • Despite Taboo, Med Students, Doctors Use Substances Too
  • White House Opens Gun Violence Prevention Office

Meeting Coverage

  • Loneliness Needs to Be Treated Like Any Other Health Condition, Researcher Suggests
  • Stopping Medical Misinformation Requires Early Detection
  • AI Has an Image Problem in Healthcare, Expert Says
  • Want Better Health Outcomes? Check Out What Other Countries Do
  • ERS Roundup: Cell Transplant Boosts Lung Function in COPD Patients
  • Most Popular

  • Past Week

    • I’m a doctor, and I almost died during childbirth

      Bayo Curry-Winchell, MD | Physician
    • Unveiling excessive medical billing and greed

      Amol Saxena, DPM, MPH | Policy
    • Misinformed claims and the offensiveness of discrediting COVID-19 vaccine development

      Angel Garcia Otano, MD | Conditions
    • Dying is a selfish business

      Nancie Wiseman Attwater | Conditions
    • Navigating medical decision-making: Embracing limits and growth

      Benjamin Wade Frush, MD | Physician
    • Empathy and compassion in palliative care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Medical gaslighting: a growing challenge in today’s medical landscape

      Tami Burdick | Conditions
    • Balancing opioid medication in chronic pain

      L. Joseph Parker, MD | Conditions
    • I want to be a doctor who can provide care for women: What states must I rule out for my medical education?

      Nandini Erodula | Education
    • Navigating the broken medical system: challenges faced by foreign medical graduates

      Anonymous | Physician
    • Mourning the silent epidemic: the physician suicide crisis and suggestions for change

      Amna Shabbir, MD | Physician
    • The essence of medicine: genuine connections in practice

      Jennifer Tillman, MD | Physician
  • Recent Posts

    • Misinformed claims and the offensiveness of discrediting COVID-19 vaccine development

      Angel Garcia Otano, MD | Conditions
    • Bitcoin’s role in diversified portfolios [PODCAST]

      The Podcast by KevinMD | Podcast
    • 1 in 5 doctors will become disabled. Are you prepared?

      Amarish Dave, DO | Finance
    • The pros and cons of whole life insurance for high-income earners

      Shane Tenny, CFP | Finance
    • Family support is pivotal in the treatment of schizophrenia

      Frank Chen, MD | Conditions
    • Is emergency medicine your calling? [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The collective failure of the HPV vaccine is ours
18 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...