Failures to vaccinate produce the very results that anti-vaxxers fear (2 stories)

An HPV vaccination is administered. (Joe Raedle/Getty Images)

August 23, 2018

Cancers linked to the human papillomavirus have increased significantly over the last 15 years in the United States, with throat cancer now the most common HPV-related malignancy, the Centers for Disease Control and Prevention reported Thursday.

More than 43,000 people developed HPV-associated cancer in 2015, compared with about 30,000 in 1999, the CDC said.

At the same time, the CDC said, HPV vaccination rates are rising — a trend that could eventually curb the increase in cancer cases. But the vaccine rate is not rising fast enough, experts say. Nearly half of adolescents ages 13 to 17 in 2017 had received all the “To not take advantage of a vaccine that can prevent cancers is a lost opportunity and a tragic one,” he added.

HPV is the most common sexually transmitted infection, with almost 80 million Americans infected with the virus. In the vast majority of cases, the body’s immune system clears out the infection. But in some cases, certain strains of HPV persist and can cause cervical cancer, as well as some throat, vaginal, penile and anal cancers.

The agency said the inoculations could prevent 90 percent of HPV-caused cancer cases — those that can be directly attributed to HPV — every year. Since the vaccine’s introduction a decade ago, HPV infections and cervical precancers have fallen significantly. But it can take a long time to see the vaccine’s benefits because many cancers take several years to develop after HPV infections take hold.

The agency recommends that children ages 11 to 12 get two doses of the HPV vaccine, six to 12 months apart. Those who get the first dose after their 15th birthday should get three shots.

Outside experts welcomed the increased HPV vaccination rates but said much more improvement is needed.

Larry Copeland, a gynecologic oncologist at The James, The Ohio State University Comprehensive Cancer Center, agreed, saying it was “not satisfactory at all” that more than 50 percent of adolescents have not completed the HPV vaccine series.

“The medical community has to accept some blame here,” Copeland said, adding that some patients with HPV-related cervical cancer tell him that the vaccine wasn’t recommended by their doctors. “We have to look in the mirror. Pediatricians, primary-care doctors, come on, let’s get with the program.”

The report showed that fewer adolescents in rural areas, compared with those in urban areas, are getting the HPV vaccine as well as a recommended meningitis vaccine. And boys still lag girls in getting the HPV vaccine; about 53 percent of girls have gotten all recommended doses while 44 percent of boys have received them.

Between 1999 and 2015, rates of throat cancer rose in men and women, but more in men, the CDC said.

Anti-vax fears drive a measles outbreak in Europe

Immunity rates in parts of Europe are lower than in some African countries

Print edition of The Economist | Europe

EACH year, as the summer winds down across Europe, so do measles cases—which tend to peak in late spring. August is, therefore, a good time to take stock of the measles season for the year. The tally for Europe, published on August 20th by the World Health Organisation, shows that cases in the first six months of 2018 exceeded the annual total for each of the past five years. About half of the 41,000 cases this year were in Ukraine. Infection rates also jumped in Serbia, Greece and Georgia. In recent years big outbreaks have erupted in Italy, Romania, France and Germany.

None of this is a surprise. In the past decade, measles-vaccination rates in some European countries have often fallen below those in parts of Africa. Italy, France and Serbia, for example, have lower child-vaccinations rates than Burundi, Rwanda and Senegal. In some years, vaccine shortages were to blame, especially in parts of eastern Europe. Both Ukraine and Serbia have had irregular supplies of the MMR vaccine (which protects against measles, mumps and rubella) since 2014. Even after recent outbreaks, they were not able to procure enough doses to cover older cohorts, health-workers and other groups at risk of becoming infected.

But suspicion of vaccines is also partly to blame. Unlike America, Europe does not have an organised “anti-vax” movement, but in many countries fears are much higher. Two-fifths of people in France—a country whose people pop antibiotics like sweets—believe that vaccines are unsafe. A quarter of Greeks and Ukrainians are also hostile. During recent outbreaks, some countries had dozens of health-workers coming down with measles—which suggest that they, too, may have a dim view of vaccines. A survey of French doctors in 2014, for example, found that nearly a quarter believed that some of the officially recommended vaccines were not useful.

Each country has “bespoke issues of concern”, says Heidi Larson of the London School of Hygiene and Tropical Medicine. In Serbia and Ukraine mistaken beliefs that the MMR vaccine is linked with autism have led some doctors to delay the first dose (usually given at 12 months of age) in order to be sure the child is developing normally. In some countries parents worry about several vaccines being given at the same time, so they space out jabs. France has a long history of vaccine rows. One reflected wrong ideas about the effects of the Hepatitis B vaccine. Some French doctors objected to a combined vaccine for infants, and to the HPV vaccine, which protects against cervical cancer.

Europe’s drive to end measles by 2015 was pushed back to 2020. Some hope.

2 thoughts on “Failures to vaccinate produce the very results that anti-vaxxers fear (2 stories)

  1. WIth 3 teens, I am aware if the HPV vaccine issue – and all 3 of mine are vaccinated. But, I am surprised at how low-key their doctors were – as in, I had to ask for the vaccines. Our doctors are open-minded with the kids – they initial discussions about drugs, smoking, sex – but they didn’t suggest to me that the kids be vaccinated. Shouldn’t adolescent medicine be more forthcoming to parents?


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