A decade ago, the first vaccine against human papilloma virus was administered in Australia to help prevent several deadly cancers, including cervical, anal and throat and tongue cancer. Since then, the HPV vaccine has been introduced in 130 countries, and the number of new cervical cancer cases has been cut in half worldwide.
“In Australia there’s already been a 90 percent reduction in infections in the 10 years the program has been running,” Ian Frazer, chief executive of the Translational Research Institute, told the BBC. Cervical cancer in Australia is also dropping, according to the Australian Institute of Health and Welfare.
Despite the clear public good done by this and other vaccines, a new study reveals that in the United States, a separate pattern is emerging: More parents are refusing to vaccinate their children. According to a recent survey published in the journal Pediatrics, 87 percent of pediatricians reported parental vaccine refusal in their practice in 2013 ― up from 75 percent of pediatricians who reported vaccine refusal in 2006.
This attitude manifests not only in pediatrician’s offices, but also in things like the notoriously low rates of HPV vaccination. Though the vaccine is strongly recommended for 11- and 12-year-old kids of both sexes by the U.S. Centers for Disease Control and Prevention, only 28 percent of boys between the ages of 13 and 17 were fully vaccinated in 2015 ― and only 50 percent had received at least one dose of the three-course vaccine.
Vaccination rates for teenage girls were slightly better, but still well below rates of other common vaccines recommended for teens: 81 percent of boys and girls received the meningococcal conjugate vaccination the same year, and 86 percent of teens received a Tdap vaccination.
One of the biggest reasons pediatricians cited for parental vaccine refusal is the misconception that immunizations are unnecessary. That couldn’t be further from the truth. Immunizations are one of our best defenses against infectious diseases, and in the case of the HPV vaccine, against preventible HPV-associated cancers. By eschewing vaccination, we’re actively contributing to the 30,000 HPV-affiliated cancer cases reported in the U.S. each year.
Why kids need the HPV vaccine
As noted above, HPV vaccination rates are notoriously low. And if kids aren’t getting that vaccine, or are getting it too late in life (it’s more effective for pre-teens than for 20-somethings), they’re left vulnerable to the cancers associated with the virus.
In all likelihood, unvaccinated teens and young adults will contract HPV: It’s the single most common sexually transmitted disease in the U.S., according to the CDC.
We could eradicate this virus since humans are the only hosts, but not if U.S. parents refuse to vaccinate their children.
“If we vaccinate enough people we will eliminate these viruses because they only infect humans,” Frazer told the BBC.
Vaccine refusal isn’t a personal choice
Although vaccination is considered one of the top public health achievements of the 20th-century, we may be the victims of our own success. Thanks to vaccination, the United States has been polio-free since 1979, when the last naturally occurring case the infectious disease occurred.
This means that young parents weren’t privy to the polio outbreaks of the 1940s and 1950s, and are prone to underestimating the devastating nature of this and other vaccine-preventable disease. Polio, for example, can cause difficulty breathing and, in severe forms, paralysis and death.
But even if we were to tolerate this ill-informed cost-benefit analysis, the belief that vaccines are unnecessary doesn’t have just a personal or private impact. Instead, choosing not to vaccinate can harm the health of the entire community.
From a population-wide standpoint, a critical number of people in the community need to be immunized for the group at large to be protected from polio or HPV. If that immunization rate slips below that critical percentage (96 percent of the population for measles and 85 percent of the population for polio), everyone is at risk for the disease to come roaring back.
How doctors are combatting the rise of anti-vaxx parents
Increasing vaccine refusal is a frustrating situation for researchers, oncologists, pediatricians, and, quite frankly, health journalists, too.
Understanding parents who choose not to vaccinate their children is especially tricky because different people have different reasons for refusing vaccines. In fact, a 2015 study found that there are four distinct behavioral patterns that typically lead to vaccine refusal: complacency, forgetfulness or not having time to get vaccinated, belief that vaccines are unsafe and personal utility.
Some doctors try to educate their patients who refuse vaccines, but increasingly, others are simply dismissing those patients after repeated refusals. According to the new Pediatrics survey, 6 percent of pediatricians reported always dismissing patients for continued vaccine refusal in 2006. By 2013, that number was up to 12 percent of pediatricians.
One state is leading the push for mandatory vaccination
Rhode Island made the HPV vaccine mandatory for seventh-grade students last year, and the decision sparked protests from parents, according to The Boston Globe. It may be the HPV vaccine’s link to a sexually transmitted disease that has parents bothered: Two adolescent vaccine mandates passed in Rhode Island in 2009 ― for meningitis and diphtheria-tetanus-pertussis ― were implemented without controversy.
For now, public health officials around the country are watching Rhode Island closely. According to the Associated Press, 73 percent of Rhode Island seventh graders received the first dose for the HPV vaccine by the time they started school last September.
That doesn’t mean parents and some local Republican legislators ― who introduced a bill February with the goal of weakening the state’s HPV mandate in February ― were happy about it.
“The HPV vaccine is not a communicably contagious disease through the air,” state Rep. Sherry Roberts (R) told the AP. “These kids shouldn’t be having sexual relations in school, so why should this be mandated? This should be the parents’ choice.”
Others have argued that like wearing a seatbelt, vaccination should be non-negotiable.
“We would never think to just lay that newborn baby down in the front seat and say, ‘I don’t really believe in car seats,’” Patsy Stinchfield, director of Pediatric Infectious Disease Services at Children’s Hospitals and Clinics of Minnesota, previously told The Huffington Post. “We should have the same kind of vigor when it comes to protecting children from vaccine-preventable diseases.”