ONS Connect - October 2008 - (Page 27)

STRaiGHTTalK HPV Vaccines: Are We Ready to Protect Our Children? [By hanan saca-hazboun, RN, MSN, Contributing Editor] V accines are considered among the most efficient and cost-effective tools in medicine. The development of a vaccination for human papillomavirus (HPV) has become the key for cervical cancer prevention (Ogilive et al., 2007). In 2006, the U.S. Food and Drug Administration (FDA) approved Gardasil® (Merck & Co., Inc.), a vaccine that prevents some strains of HPV infection, for use in young women. Growing controversy and questions from the public have revolved around the use of the vaccine in preteen girls and at the suggestion that administration of the vaccine become state mandated. HPV vaccination has to overcome several hurdles: the state mandate, the healthcare team, the parents, and the religious community. State mandate Full enforcement of the HPV vaccine as public health policy regarding its implementation has not yet been defined at the national and global levels. Policymakers also are questioning how much to spend on the vaccination, because it will be necessary to maintain relatively expensive cervical cancer screening programs for decades after the vaccination is mandated (Wright, 2006). Legislators in 23 states and the District of Columbia have introduced bills to mandate the vaccination (Rubin, 2007). South Dakota, one of the states requiring the vaccine, was the first to endorse legislation to create and provide funding for an HPV vaccination initiative. At this point, Vermont, New York, Michigan, Ohio, Indiana, Illinois, Florida, and California have introduced legislation for vaccinating preteens for HPV (Dowling, 2008). In Texas, Governor Rick Perry issued an executive order in February 2007 to mandate HPV shots for preteens entering sixth grade, although parents will be able to opt out “for reasons of conscience” (Rubin). Texas became the first state to require the vaccine. attitudes and Barriers to vaccination Several studies show that few individuals have a clear understanding of HPV and its significance to cervical infection and cancer. According to Mayeaux (2005), the three major barriers to the administration of the HPV vaccination are access to medical care, cost, and lack of knowledge. To conquer these barriers, Mayeaux said that resources should be focused on education for the target group to be vaccinated—adolescent girls—and their parents (or guardian medical decision makers), so that they understand HPV and its impact on cervical cancer and the benefits and protection that the vaccine can provide. Future research should analyze whether the benefits of HPV vaccines— reducing the rate of cervical cancer and genital warts—outweigh the disadvantages—the high cost of the shots, possibility of adverse reactions, reduction of safe practices, and misconceptions that the vaccine protects recipients against other sexually transmitted diseases. ✱ Dowling, T.S. (2008). Mandating a human papillomavirus vaccine: An investigation into whether such legislation is constitutional and prudent. American Journal of Law and Medicine, 34(1), 65–84. Mayeaux, E. (2005). Overcoming barriers to HPV vaccine acceptance. Journal of Family Practice, 54(Suppl.), S17–S22. Ogilive, G., Remple, V., Marra, F., McNeil, S., Naus, M., Pielak, K., et al. (2007). Parental intention to have daughters receive the human papillomavirus vaccine. Canadian Medical Association Journal, 177(12), 1506–1512. Rubin, R. (2007, February 7). Vaccines: Mandate or choice? USA Today. Retrieved September 12, 2008, from http://www.usatoday.com/ news/health/2007-02-07-vaccines_x.htm Wright, T.C. (2006, July). Introducing HPV vaccine into current cervical cancer control efforts in developed countries. Presented at the UICC World Congress, Washington, DC. Contributing Editor Hanan Saca-Hazboun, RN, MSN, is a lecturer in the Faculty of Nursing and Health Science at Bethlehem University in West Bank, Palestinian Authority. ONS’s position statement on HPV vaccination, “The Human Papillomavirus Vaccine and Prevention of Cervical Cancer,” can be found at www.ons.org/publications/posi tions/HPV.shtml. OctOber 2008 ONS CONNECT 27 http://www.usatoday.com/news/health/2007-02-07-vaccines_x.htm http://www.usatoday.com/news/health/2007-02-07-vaccines_x.htm http://www.ons.org/publications/positions/HPV.shtml http://www.ons.org/publications/positions/HPV.shtml

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ONS Connect- October 2008 Contents Editor's Note Just In Up Front You Tell Us Up Close &�Professional Web Connect Five-Minute In-Service Capitol Connection Caregiver Care Straight Talk New Treatments, New Hope Working for You Calendar of Events Staying on Top

ONS Connect - October 2008

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