Human Papilloma Virus vaccine with syringe in vial at a clinic.

Human papilloma virus (HPV) vaccines are designed to prevent infection by certain types of human papilloma virus. The currently available vaccines generally protect against two, four, or nine types of HPV infection. But all vaccines protect against at least HPV type 16 and 18 that cause the greatest risk of cervical cancer.

The human papilloma virus, a group of more than 150 related viruses, is very common. The invection caused by HPV is also common. According to the U.S. Centers of Disease Control and Prevention, HPV is simply transmitted through intimate skin-to-skin contact. Most people may become infected by having vaginal, anal, or oral sex with someone who has the virus. This infection is so common that nearly all men and women will be infected at some point in their lives.

In the United States nearly 80 million people ? roughly one in four ? are currently infected with HPV. In addition, about 14 million people, including teens, become infected each year.

HPV infection can be passed even when an infected person has no signs or symptoms. Furthermore, symptoms can develop many years after being infected, making it hard to know when someone first became infected. But in most cases most HPV infections (9 out of 10) go away by themselves within two years.

However, in some instances, HPV infections will last longer, and may cause certain cancers and other diseases, including cancers of the cervix, vagina, and vulva in women, cancers of the penis in men, and cancers of the anus and back of the throat, including the base of the tongue and tonsils (oropharynx), in both women and men.

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A major concern is that every year in the United States, HPV causes 32,500 cancers in men and women. HPV vaccination can prevent most of the cancers (about 30,000) from ever developing.

Photo 1.0: Melissa B. Gilkey, Ph.D, assistant professor of Health Behavior at the University of North Carolina Gillings School of Global Public Health in Chapel Hill.

Persuasive reason
Results from a study supported by a grant from the National Cancer Institute and published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research (AACR), the world?s first and largest professional organization dedicated to advancing cancer research and its mission to prevent and cure cancer, suggest that parents of adolescents believed that the potential to prevent certain types of cancer is the best reason for their children to receive the human papilloma virus (HPV) vaccine, whereas other reasons health care providers often give were far less persuasive.

In this study, Melissa B. Gilkey, Ph.D, assistant professor of Health Behavior at the University of North Carolina Gillings School of Global Public Health in Chapel Hill, and colleagues developed a best-worst scaling experiment to evaluate 11 reasons health care providers typically give for HPV vaccination. The experiment was administered in 2016 via a national, online survey of 1,177 parents of adolescents ages 11-17. Fifty-seven percent of the parents had initiated HPV vaccination.

?It can prevent some types of cancer? was for most parents the best reason to get the HPV vaccination. Parents also felt that ?it can prevent a common infection;? ?it has lasting benefits;? and ?it is a safe vaccine? were persuasive reasons. In contrast, the worst reasons providers could give included ?it is a scientific breakthrough;? ?I got it for my own child;? and ?your child is due for it.? Finally, messages ranked in the middle were ?it works best at this age;? ?it should be given before sexual contact;? ?getting it on time may mean fewer shots;? and ?I think it is important.?

HPV causes over 40,000 cancers in the U.S. each year, including cancers of the cervix, vagina, vulva, penis, anus, and back of the throat. Most of these cases are potentially preventable through HPV vaccination,? said Gilkey.

The Centers for Disease Control and Prevention (CDC) currently recommends that boys and girls receive two doses of the HPV vaccine, beginning at age 11 or 12. As of 2016, about 60 percent of teenagers had received the first dose, but only about 43 percent were up to date on all recommended doses, according to the CDC.

?We still have work to do on improving the timeliness of those doses and on reaching the remaining 40% of young people who have not started HPV vaccination,? Gilkey noted.To increase uptake, we need to more effectively communicate the value of HPV vaccination to parents.?

Stratified analyses
The researchers used stratified analyses to evaluate whether the parents? opinions would vary depending on their overall confidence in vaccines. Gilkey said she was surprised to discover that vaccine confidence did not appear to significantly affect parents? perceptions of physicians? messages, and cancer prevention was the most effective message for both groups.

The study augments previous research that suggested the way in which physicians discuss the HPV vaccine may affect parents? decisions on whether to have their children get the vaccine.

Our prior research indicates that providers give many different reasons for HPV vaccination, and the findings of this study suggest that they may do better to streamline their communication. Gilkey explained.Cancer prevention is likely to be your best bet no matter who you?re talking to.

Cancer prevention was clearly the most convincing reason for HPV vaccination. Reasons that have to do with sexual activity, scientific novelty, or providers? decisions for their own children may ultimately be distractions that are best avoided,? she continued.

Gilkey pointed out that the study evaluated parents? perceptions about what would motivate them to vaccinate their children, and may not fully reflect real-life conversations during an office visit. Also, because the reasons were ranked, those that were ranked lower may have been less persuasive than the top-ranked messages, but are not objectively ?bad? messages to use in discussing HPV vaccination, she concluded.

Last Editorial Review: June 14, 2018

Featured Image: Human Papilloma Virus vaccine with syringe in vial at a clinic. Courtesy: ? 2010 ? 2018 Fotolia. Used with permission. Photo 1.0: Melissa B. Gilkey, Ph.D, assistant professor of Health Behavior at the University of North Carolina Gillings School of Global Public Health in Chapel Hill. Courtesy: ? 2010 ? 2018 AACR. Used with permission.

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