Preventing HPV-Related Cancer in WNY

On May 25th the Buffalo March for Science hosted Gale Burstein, MD, MPH, FAAP at the Western New York Center for Inquiry for a discussion on Human Papillomavirus Virus (HPV) Disease and Prevention. Dr. Burstein works at the Erie County Department of Health and Jacobs School of Medicine in Buffalo after working in Baltimore and at the Centers for Disease Control and Prevention on sexually transmitted infection prevention.

We were joined by a crowd of thirty in person and hundreds streaming the event in real time and participating in the question and answer session.

Ken Rogers joined the conversation as well. In 2016, 64 year old Ken was diagnosed and successfully treated for HPV-related mouth and throat related cancer.

Dr. Burstein explained that HPV is the most common sexually transmitted pathogen in males and females. Around 80% of people will contract an HPV infection and first infection occurs soon after onset of sexual activity.

She emphasized that the highest risk types of HPV are responsible for nearly all cervical cancer. Adding that these types are also responsible for 50-70% of other genital related cancers in men and women and more than 60% of cancers related to the mouth and throat. Men who experience HPV-related cancer will most likely have cancer related to the mouth or throat. Women who experience HPV-related cancer will most likely have cervical cancer. The lower risk types of HPV should be avoided as well. They cause genital warts.

Dr. Burstein introduced the audience to the best tool we have to fight HPV infections and resulting cancer: the HPV vaccine. She cited recent research studies and displayed charts showing the safety and decreased prevalence of genital warts and precancerous lesions in the age groups who have had access to the vaccine.

Ken Rogers spoke about his experience with HPV-related mouth and throat cancer. He shared openly about the toll of chemotherapy and how he had been lucky because he was able to swallow during treatment. Many of his fellow patients and peers in recovery required feeding tubes. He told the room, “I wish I had the vaccine.”

When HPV vaccines first became available they targeted the two most high risk types of HPV and later two lower risk types as well. Now there is a vaccine approved for women and men between the ages of 9 and 26 that targets nine types of high and low risks types of HPV.

Dr. Burstein showed the room data from clinical trials demonstrating that the HPV vaccine has some of the highest efficacy rates among vaccines in the United States. She stressed that the vaccine is incredibly well tolerated where the most common adverse event is mild to moderate pain at the injection site.

As of 2015, only 48% of girls and 32% of boys in New York State have received all three doses of the HPV vaccine. It was recently determined that if the vaccine is started before age 15, only two doses are required.

Dr. Burstein was frank with the crowd about the challenges of getting people vaccinated on time, “the link between HPV and sex.” She explained that the immune system becomes less effective as it ages. Young adolescents create the most antibodies to fight HPV in response to vaccination compared to adults. Everyone should get the HPV vaccine between the ages of 11 and 12, but the vaccine is FDA-approved for anyone age 9 to 26.

She repeated throughout the presentation, as a parent, that parents of 11 year old kids, “are not ready to see their children as sexually active.” However, “HPV can be transmitted with deep throat kissing.” Parents that hope to see their children one day become parents understand that their children will one day become sexually active, even if they have one partner for life. Unlinking the HPV vaccine from sexual behavior and addressing it as another routine vaccine is critical for boosting vaccination rates.

Dr. Burstein also spoke as a physician about the role health care providers play. Lack of health provider recommendation is the main reason patients and parents cite for not getting themselves or their children vaccinated. She noted, “why would anyone want a shot presented as optional?” If the HPV vaccine were strongly recommended to patients at other vaccination visits, vaccination levels could approach 100% within a few years.

Dr. Burstein ended her presentation by asking the members of the audience to vaccinate, advocate, and circulate credible information (links below).

In the Question and Answer session with Ken Rogers she compassionately addressed a wide array of concerns. No, she and Ken had not been paid by the companies that produced the vaccines. Yes, pregnant women can get the vaccine. No, Ken cannot get the vaccine now. Yes, the preservatives in the vaccine are safe. No, there are no links between autism and any vaccine.

The event has since been viewed online over 15,000 and can be viewed at
https://www.facebook.com/march4sciencebuffalo/videos/1894859757449550/.

In Erie County the HPV vaccine is covered by insurance. The Erie County Sexual Health Clinic at 608 William Street offers the HPV vaccine. Minors can consent to an HPV vaccine to protect themselves from cancer causing infections. The Vaccines for Children program covers HPV vaccine costs for uninsured and under insured persons 18 years and younger.

Dr. Burstein has generously made her slides from the presentation available here
https://drive.google.com/file/d/0B3Wzafdui3xfNUw2V2RPUng4VXc/view?usp=sharing

Credible information you can spread as an advocate for HPV vaccination:

Vaccine information.org
http://www.vaccineinformation.org/

Centers for Disease Control and Prevention Vaccines for Teens
https://www.cdc.gov/vaccines/parents/protecting-children/index.html

American Academy of Pediatrics HPV Toolkit
https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/Pages/HPV-Champion-Toolkit.aspx

HPV and Cervical Cancer Prevention Resource Center
http://www.path.org/vaccineresources/details.php?i=1339

Cervical Cancer-Free America (CCFA)
http://www.cervicalcancerfreeamerica.org/

National Cervical Cancer Coalition
http://www.nccc-online.org/

Centers for Disease Control and Prevention Human Papillomavirus Questions and Answers
https://www.cdc.gov/hpv/parents/questions-answers.html

The Children’s Hospital of Philadelphia: Prevent HPV
http://www.chop.edu/centers-programs/vaccine-education-center/vaccine-details/human-papillomavirus