risk. Some patients’ health plans won’t cover the full amount physicians pay to keep the vaccine in stock. According to Chris Van Deusen,
spokesperson for the Texas Department of State Health Services, all physicians who participate in the Texas Vaccines for Children program carry the HPV vaccine. For more information on the program, visit
www.dshs.state.tx.us/immunize/ tvfc.
“Privately insured patients can call
their local pharmacies or medical pro- viders if their doctor doesn’t have the vaccine,” Mr. Van Deusen said. Dr. Swanson says a television com-
mercial or a social media advertisement that teens could access through YouTube would be a prime way to target the age group recommended for HPV vaccina- tion. An HPV vaccine that requires fewer than three doses would also make pa- tients more likely to get immunized, she says.
“If you could cut it down to two doses, it would help,” Dr. Swanson said. A study released in the May 1, 2013,
issue of the Journal of the American Medical Association suggests two doses of the HPV vaccine could protect against genital warts, but no evidence shows two doses could prevent cervical cancer. Dr. Terk says it’s important for phy-
sicians to learn how to communicate with parents and teens who are hesitant about HPV immunization. “They need to understand their audi-
ence’s world view and their potential preconceptions in order to effectively address their concerns and successfully overcome them,” he said. Dr. Terk says he commonly encoun-
ters parents who are hesitant about many vaccines — not just HPV — be- cause of the alleged connection between vaccines and autism spectrum disorder. He says parents are also concerned about the safety of vaccine ingredients
and about the number of vaccinations recommended for their children. (Read “The Truth About Shots,” January 2014 Texas Medicine, pages 31–36, or visit
www.texmed.org/ShotTruth.) “The first thing I do is ask for specific
reasons a parent has concerns and what resources the parent used to create the concern or reinforce it. Requiring specif- ics is important because it allows me to understand what information I might need to call upon to answer the concern. It also requires the parent to cognitively clarify what may be a nebulous fear,” he said. Dr. Terk says it’s easier to be a reliable
resource for the parent if he understands their concerns, and the conversation al- lows him to disprove any unreliable, non-evidence-based information the par- ent brings to the table. Parents and physicians who are skep-
tical about vaccinating young adults against HPV should also remember a teen doesn’t always choose to become sexually active, Dr. Terk says. “One of the most effective things I tell
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my parents is that, unfortunately, not all of our children will willingly consent to their first sexual experience,” he said. “Our job as parents is to protect our chil- dren as well as we can, and this is a very important way to do that.”
HPV disparities exist HPV vaccination is crucial in the fight against cervical cancer. Some studies suggest women of color could be at greater risk of developing cancer as a result of HPV infection. Research from the Carolina Women’s
Care Study presented at the 2012 meet- ing of the American Association for Can- cer Research (AACR) suggests African- American women’s bodies have more difficulty clearing HPV compared with women of European descent. University of South Carolina profes-
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sor Kim E. Creek, PhD, the lead author of the study, told attendees at the AACR meeting that African-American women are 40 percent more likely to get cervi- cal cancer and twice as likely to die from the disease. The study shows the incidence of infection was about the same among
38 TEXAS MEDICINE April 2014
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