vaccination

Three things you might not know about HPV

Source: www.huffingtonpost.ca
Author: Sunnybrook Health Sciences Centre

April 26 to May 2 is National Immunization Awareness week in Canada. One immunization known for raising a lot of questions is the Human Papillomavirus (HPV) vaccination, provided free of charge in Ontario to girls in grades 8-12, and following provincial schedules across the country.

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While there is lots of information online, at school and at the doctor’s office about HPV, there is still a lot of confusion about what it may mean for your loved ones. Dr. Nancy Durand, gynecologist at Sunnybrook, explains three little-known facts about HPV.

1) HPV causes cancer in men, too
When Michael Douglas candidly revealed his oral cancer was caused by HPV, many people expressed surprise.

Even though HPV has traditionally been thought of as a disease that affects women and mainly causes cervical cancer, men are actually at higher risk of being diagnosed with certain types of HPV-positive cancers than women.

“It’s not well understood why men are at higher risk for HPV-positive oral cancer, but it does point out that vaccination in men is even more important than we may have previously thought,” says Dr. Durand. Physicians are learning more and more that HPV can also cause other cancers in both women and men, such as anal cancers and head & neck cancers (cancers of the base of the tongue, tonsils and soft palate).

2) Not all HPV infections lead to cancer
You’ve probably read some of the (slightly scary) statistics about HPV: Three in four Canadians will get HPV in their lifetime. It can lead to a variety of cancers and cause genital warts, and there is no cure. But should this keep you up at night, worrying about the potentially deadly consequences of HPV?

Hardly, says Dr. Durand. “Most people who are infected with this virus will clear it — probably 80 per cent of people. It’s the other 20 per cent of people with a persistent infection who may be at risk of cancer, and it’s still only a very small percentage of those people who may go on to develop cancer,” she says.

Many people never even realize they’ve had an HPV infection, as there are usually no symptoms, and the infection often goes away on its own.

3) You’re never too old to get the HPV vaccine
What if you didn’t get the HPV vaccine back in middle school, and now you think it’s too late to get it?

“Regardless of your age and your onset of sexual activity, we can vaccinate both men and women, and we can see a reduction in disease,” says Dr. Durand.

It’s actually not too late — the vaccine can still be effective, even in adults who’ve already been sexually active. “Many people think vaccination can only be done before the onset of sexual activity. But regardless of your age and your onset of sexual activity, we can vaccinate both men and women, and we can see a reduction in disease,” says Dr. Durand.

Anyone, male or female, over the age of nine can be vaccinated. So, if you’ve put off getting the vaccine because you thought you were too old, it’s not too late!

Note: Co-authored by Sybil Millar, Communication Advisor at Sunnybrook Health Sciences Centre

April, 2015|Oral Cancer News|

HPV Related Cancers Increase in Men

Source: scientificamerican.com
Author: Robin Lloyd

A vaccine to protect against the most dangerous strains of human papillomavirus (HPV), which cause almost all cervical cancers, as well as many cases of other cancers and genital warts in both sexes, won the approval of the U.S. Food and Drug Administration nearly nine years ago. The Centers for Disease Control and Prevention now recommends that all boys and girls aged 11 or 12 receive the shots. Vaccination campaigns, aimed largely at girls and women, have fallen short of expectations. By 2013 just over half of U.S. females aged 13 to 17 had received at least one dose of either the Gardasil or Cervarix vaccine. For males, that figure was a disappointing 35 percent. Now head and neck cancers associated with the virus are on the rise, leading some experts to recommend that a gender-neutral or male-centric approach might be more effective.

HPV is the most prevalent sexually transmitted disease in the U.S. and worldwide, infecting just about all men and women at some point in their lives. Although most people clear the virus naturally, persistent infections with some strains can lead to cancer—usually cervical or oropharyngeal (affecting the back of the throat, tonsils and back of the tongue). HPV-associated cancers make up 3.3 percent of all cancer cases among women and 2 percent of all such cases among men annually in the latest available figures, yet the incidence of virally instigated oropharyngeal and anal cancers is increasing.

Ohio State University medical oncologist and epidemiologist Maura Gillison has studied men with oropharyngeal cancer in three different decades. She and other colleagues first noticed an odd shift in patient profiles in the late 1990s: younger men were showing up in her clinic, often with no significant history of smoking or heavy drinking, which are risk factors for head and neck cancers. She later found that whereas from 1984 to 1989 in the U.S. only 16 percent of oropharyngeal cancers tested positive for HPV, by 2005 that figure had skyrocketed to 73 percent. By 2020 experts project that such cancer diagnoses will exceed those for cervical cancer in the U.S., shifting the burden of HPV-associated cancers from women to men. Gillison reported these findings in October 2014 at the annual ScienceWriters meeting.

Based on these data, Gillison thinks that the female-centric approach to HPV-related cancers in the U.S. should switch to focus on both men and women. Nobel laureate Harald zur Hausen, who discovered 30 years ago that HPV causes cervical cancer, has gone further, saying that males should get the vaccine if only one sex were the focus. The vaccine is currently voluntary in most U.S. states, and only a smattering of vaccination coverage campaigns exist, such as those launched by the New York City Department of Health and the Minnesota Department of Health in the past year. Public health messages and even research literature often fail to mention male vaccination prominently or at all. Unfounded fear of vaccines and claims that the HPV shots would provoke early teen sexuality have hindered efforts to vaccinate broadly in much of the U.S.

No data exist to prove that the vaccines protect against HPV-positive oropharyngeal cancer. But such coverage is probable given that the same strains that cause most cervical, vaginal and vulval cancers also cause most head and neck cancers. If a shift in public health policy were to result in an increase in male vaccinations, experts say, at the very least rates of females’ HPV-associated cancers would decrease as a result of fewer infections acquired from men. And the rise in HPV-associated cancers in men would most likely decelerate, plateau or even reverse. A win for all of us.

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.
February, 2015|Oral Cancer News|

HPV vaccination does not increase promiscuity among adolescents: It’s a vaccine against sexually transmitted cancer

Source: reason.com
Author: Ronald Bailey

On February 3, 2015, libertarian radio host Andrew Wilkow invited me to discuss the risks and benefits of vaccination. We disagreed: Mr. Wilkow is considerably more worried about the risks than is warranted by the scientific evidence. During the segment, Mr. Wilkow stated that he did not plan to have his two-year old daughter vaccinated against the human papilloma virus (HPV).

Infection with human papilloma virus is responsible for about 11,967 new cases of HPV-associated cervical cancer and for about 2,370 new cases of HPV-associated oropharyngeal cancers in women and nearly 9,356 new cases in men each year in the United States. During the radio segment, I mentioned that a male friend had recently died of HPV-associated head-and-neck cancer. I failed to mention that another male friend is being treated for that cancer now.

Mr. Wilkow argued that since the vaccine immunizes against a sexually transmitted disease that he saw no reason to have his daughter vaccinated against it. The series of three HPV injections is recommended to start after age 9, so Mr. Wilkow has time to reconsider.

Mr. Wilkow is, however, not alone in his opposition to HPV vaccination. A 2014 study in Clinical Pediatrics reported the results of a survey of parents’ actions regarding HPV vaccination. The researchers found:

A significantly higher proportion of parents of girls who were non-Hispanic white, lived in households with higher incomes, and had mothers with higher education levels, delayed and/or refused vaccination.

Another of the early concerns by some opponents of HPV vaccine is that it might encourage sexual promiscuity by lessening adolescent fears of getting sexually transmitted diseases. Several studies have looked at this issue and all have found no such link. The latest study just published in the journal JAMA Internal Medicine is reassuring on that account. The researchers compared the sexually transmitted disease incidence (STI) among vaccinated and unvaccinated adolescent females. The study found:

Human papillomavirus vaccination was not associated with increases in STIs in a large cohort of females, suggesting that vaccination is unlikely to promote unsafe sexual activity.

If you could immunize your kids against breast or prostate cancer you would, wouldn’t you? So why not vaccinate against these cancers?

February, 2015|Oral Cancer News|

Oral cancer on rise in young people

Source: www.wwltv.com
Author: Jaclyn Kelley

Alex Dupuy is like most 15-year-old boys, except for one very special talent. Last year he stole the headlines during a bowling tournament for bowling a perfect 300. But that high wouldn’t last long.

“My son came to us one day and said I have an ulcer, and we thought, OK, let’s gargle with some salt water and we kept checking on it and it never went away,” said Nancy Dupuy, Alex’s mother.

When the sore on Alex’s tongue never cleared up, but instead started growing, his mother became concerned and took him to see the doctor.

“It has grown so rapidly that I would really like to have the tumor or whatever it was removed,” she said.

Alex was taken to Children’s Hospital for surgery, and doctors removed the sore and 30 percent of his tongue. Three days later test results came back confirming the Dupuy’s worst fears: It was cancer.

“The word aggressive stuck out to me,” Nancy Dupuy said. “The type of cancer that my son presented with was an adult cancer. It’s not usually diagnosed in young children.”

The doctors said Alex had a rapid form of squamous cell carcinoma of the tongue. Four days later he and his parents were on a plane to MD Anderson Cancer Center in Houston.

Through it all, Alex managed to stay positive.

“I felt nervous, I felt scared and I told myself, I’ll be alright,” Alex said.

In Houston Alex would have yet another surgery before starting six weeks of intense radiation.

“We would wrap his neck because the neck would be burned. The skin, the tissue was burned when it would start to break down,” Nancy Dupuy said.

Dr. Paul Friedlander, the chairman for Tulane’s ear, nose and throat department, said the number of young people with oral cancer is on the rise.

“Most of the cancers we saw were smoking, alcohol related,” Friedlander said. “Right now we’ve seen an increase in a number of people who have not been exposed to cigarettes and alcohol that have these cancers.”

And he said that’s because of the human papaloma virus, or HPV. It’s an orally transmitted virus that he says is easy to get.

“These can be transmitted through oral sexual contact or something as innocuous as an open-mouth kiss,” Friedlander said.

Friedlander said early detection is key.

“If one does have a sore on their mouth, difficulty with swallowing, hoarseness or a neck mass that persists after two or three weeks, it’s a good idea to see your local doctor,” he said.

He recommends parents consider getting their teens the HPV vaccination, which doctors say can help prevent oral cancer.

It’s something Nancy Dupuy did with Alex and his brothers after his diagnosis.

“In our case it wasn’t HPV, but just the thought of oral cancer and that there is maybe something that could have prevented it is just really worth it in the end,” she said.

Several weeks of radiation would take its toll on Alex, but his family says it’s bowling that got him through it.

“On the good days, Alex would bowl and Alex would be in a world that was just perfect, and to me that was the most important thing that helped him get through six weeks of radiation,” Nancy Dupuy said.

Thank to early detection, Alex is now in remission.

“I always thank God I am cancer free.”

December, 2014|Oral Cancer News|

Three shots that could stop cancer

Source: tucson.com
Author: Meredith Wadman

Not so long ago, when my sons still had smooth cheeks and children’s voices, I had them vaccinated against human papillomavirus, the most common sexually transmitted disease. It was late 2011, and the Centers for Disease Control and Prevention had just recommended that boys join girls in being vaccinated at age 11 or 12. I was certainly receptive: HPV, as it’s commonly called, causes cervical cancer, cancer of the tonsils, cancer of the back of the tongue and, less often, cancers of the vulva, vagina, anus and penis. It seemed important to ensure that my kids were protected.

Yet numbers released last month by the CDC show that my sons, now 14 and 15, are among a small minority of adolescent males who have been vaccinated. In 2013, just 14 percent of American boys ages 13 to 17 had received all three recommended doses of the HPV vaccine. (The CDC also recommends “catch-up” vaccination for males up to age 21.)

Not that parents are rushing to have their girls vaccinated either, even though the CDC first recommended the vaccine for prepubescent girls in 2007 and virtually all insurers pay for it. In 2013, fewer than 38 percent of American girls between 13 and 17 had received the full three-dose course.

It is heartbreaking to watch a safe, effective vaccine go unused. Consider this: The CDC estimates that increasing the vaccination rate of American girls to 80 percent would prevent 53,000 cervical cancers during the lifetimes of girls who are now 12 and younger.

When I had my sons vaccinated, it was partly with girls in mind. After all, if fewer young men are infected, fewer young women will be exposed to the virus that causes cervical cancer — currently the most common cancer prevented by the vaccine. But now I am realizing that HPV poses a growing risk to boys.

A new breed of cancer of the back of the tongue and tonsils, caused by HPV, is rising in incidence — likely caused, researchers suspect, by increases in premarital sex and oral sex over the past several decades. These cancers afflict men far more often than women, and at relatively younger ages than do other head and neck cancers, which typically appear in men older than 60. Middle-aged men who don’t die from their HPV-linked cancer often must live for years with the side effects of intensive chemotherapy and radiation delivered to the back of the throat. These can include the permanent inability to swallow and the appearance later of new, aggressive, radiation-induced cancers.

If this trend continues, we are going to see more cancer of the back of the tongue and the tonsils caused by HPV. One recent analysis of 30 studies, conducted by University of Wisconsin researchers, found that the proportion of such cancers caused by HPV rose from 21 percent before 1990 to 65 percent after 2000. Anil Chaturvedi of the National Cancer Institute and his colleagues have estimated, based on recent trends, that by 2020 there will be more new cases of these HPV-induced throat cancers in the United States each year than new cervical cancer cases.

So the actor Michael Douglas did us all a service when he was so frank with Britain’s Guardian newspaper last year. When asked if his throat cancer had been caused by heavy drinking and smoking, which are also risk factors for the disease, the actor replied: “No. I mean, without getting too specific, this particular cancer in tests is caused by something called HPV, which actually comes about from cunnilingus.”

Many parents don’t like to think of their 11- and 12-year-olds as sexual creatures. Ironically, the CDC recommendation assumes not that kids are sexually active at this tender age but rather that they are not: The point of vaccination is to close the door before the horse is out of the barn.

It’s no use telling yourself that your child isn’t “that kind” of kid. The fact is, HPV is so common that almost all sexually active adults are infected at some point. Last year, the CDC estimated that about 79 million Americans were infected, most of them in their late teens and early 20s.

Most people who get HPV have a transient infection that their immune system clears with no lasting damage. But in some people, the virus takes up residence and goes on to cause cancer. I am grateful that, thanks to the HPV vaccine, I will never have to find out if my sons fell into that second, unlucky group.

August, 2014|Oral Cancer News|

President’s panel calls for more girls, boys to get HPV vaccine

Author: Government news release
Source: consumer.healthday.com

Too few American girls and boys are getting vaccinated against the cancer-causing human papillomavirus (HPV), the President’s Cancer Panel reported Monday.

HPV is linked to cervical cancer as well as penis, rectal and oral cancers. One in four adults in the United States is infected with at least one type of HPV. Increasing HPV vaccination rates could prevent a large number of cancer cases and save many lives, the panel said.

“Today, there are two safe, effective, approved vaccines that prevent infection by the two most prevalent cancer-causing types, yet vaccination rates are far too low,” Barbara Rimer, chair of the President’s Cancer Panel, said in a panel news release.

“We are confident that if HPV vaccination for girls and boys is made a public health priority, hundreds of thousands will be protected from these HPV-associated diseases and cancers over their lifetimes,” she added.

Currently, the U.S. Centers for Disease Control and Prevention is recommending that girls aged 11 and 12 receive either the Cervarix or Gardasil vaccines, and Gardasil is recommended for boys of similar age.

In 2012, only a third of girls aged 13 to 17 got all three recommended doses of HPV vaccine, CDC data shows. That’s much lower than the federal government’s goal of having 80 percent of girls aged 13 to 15 fully vaccinated against HPV by 2020, the report said.

The picture is even more disappointing for boys. Less than 7 percent of males aged 13 to 17 completed the recommended HPV vaccination series in 2012. The vaccine was recommended for boys more recently.

Boosting HPV vaccination rates to 80 percent would prevent 53,000 future cervical cancer cases among girls who are currently aged 12 or younger, according to the CDC.

The agency also estimates that increased vaccination would prevent thousands of cases of other HPV-associated cancers in both females and males, the report added.

A number of things need to be done to increase HPV vaccination rates, the panel said. These include public education and other efforts to increase teens’ and parents’ acceptance of the vaccines; encouraging doctors and other health care providers to recommend and give vaccinations; and making sure that the vaccines are available where teens receive health care.

Source: President’s Cancer Panel, news release, Feb. 10, 2014

February, 2014|Oral Cancer News|

Concerned About HPV-Related Cancer Rise, Researchers Advocate Boosting HPV Vaccination Rates

By: Anna Azvolinsky
Source: JNCI Journal of the National Cancer Institute Advance Access
Published:  August 29, 2013

 

Deaths from the major cancers—lung, colorectal, breast, and prostate—continue to decline, a trend that started in the early 1990s. Cancer incidence is also declining, if slightly, for both sexes. That’s the good news from the annual Report to the Nation on the Status of Cancer, a joint research effort by the American Cancer Society, the Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Association of Central Cancer Registries (J Natl. Cancer Inst. 2013;105:175–201).

But the study also shows an uptick in rates of anal and oropharyngeal cancer, a type of head and neck cancer related to infection with the human papillomavirus (HPV), in the 10-year period ending in 2009. Cancer of the oropharynx increased among white men and women (3.9% and 1.7%, respectively). Anal cancer also increased in both sexes, with the greatest increase among black men (5.6%) and white women (3.7%). Rates of vulvar cancer, another HPV-related cancer, also increased among women despite continued lower rates of cervical cancer.

Researchers attribute this rise in HPV related cancers to more HPV infections. “We think that increases in oral–genital sexual practices and increasing number of sexual partners that occurred some 30 years ago as part of the sexual revolution may be implicated in part of the increase in cancer rates we are seeing today,” said Edgar P. Simard, Ph.D., M.P.H., senior epidemiologist of surveillance research. Although rates of HPV infection from three decades ago were not available in the joint report, a trend exists of men and women now in their 50s and 60s having the highest rates of both oropharyngeal and anal cancers.

To directly relate HPV infection with cancer development later in life, epidemiologists are attempting to understand how HPV, the most common sexually transmitted infection in the U.S., is spread and which populations are most at risk. HPV infection of the cervix increases with number of sexual partners and younger age of first sexual experience. Studies now show similar trends for oral HPV infection rates, which can lead to oropharyngeal cancer.

More than 100 strains of the virus are passed through skin contact. Most cause benign warts on the genitals, hands, or face, but about 15 strains can cause cancer of the cervix, vagina, vulva, penis, anus, and oropharynx (tonsils, back of the throat, and base of the tongue). Most people with HPV clear the infection, but those with persistent infection for many years or decades are at risk for these cancers, depending on the site of viral infection.

Screening for Noncervical HPV-Related Cancers

The Pap smear screening test has drastically reduced both cervical cancer incidence rates and deaths. Screening methods for other HPV-related cancers are not so straightforward. “Right now, it is just cervical cancer screening and some anal cancer screening that is done for certain individuals who are high risk,” said Simard. HPV causes an estimated 90% of anal cancers. Anal cancer screenings are offered to HIV-positive men who have sex with men, but not enough research has yet occurred to adapt this type of screening for other cancer sites.

HPV infection causes approximately 60% of oropharyngeal cancers, but screening remains problematic. “We have a serious problem trying to screen for oropharyngeal cancer because we have not clearly identified a premalignant lesions that can be used for screening,” said Douglas R. Lowy, M.D., chief of the NCI Laboratory of Cellular Oncology, who works on HPV. This type of cancer has been studied for a relatively short time, and more research is needed to fully understand whether premalignant lesions caused by HPV could be identified early.

Oropharyngeal Cancer–HPV Link

Oropharyngeal cancers were seen predominantly in older men who had comorbidities and who tended to have a history of drinking or smoking. “What we see now is still more men than women, but these men are younger, in their 40s and 50s, and they don’t have the comorbidities from smoking and drinking and in general are more healthy,”said Everett E. Vokes, M.D., head and neck expert at the University of Chicago.

Researchers now distinguish two types of oropharyngeal cancers—those related to HPV infection, which generally have a better prognosis, and those related to tobacco and alcohol use. At the molecular level,  HPV-related cancers are not only positive for HPV DNA but also express the human p16 gene, induced by the virus’s oncoproteins. Most HPV-positive patients also have detectable antibodies against HPV.

HPV Vaccine Reaching Broader Population

Current HPV vaccination rates will at least partly influence the cancer statistics that will emerge in 20–30 years as a result of current HPV infection rates. Over time, “prevention is the key, and prevention is either abstinence or vaccination,” said Vokes.

The HPV vaccine can reduce the risk of HPV-related cancers that in 10–30 years could affect people who are now teenagers. The vaccine, a series of three shots, is recommended for girls aged 11 or 12 years (with catch-up until age 26 years) and boys aged 11 or 12 years (with catch-up until age 21 years), to protect against HPV infection and HPV related diseases, including cancer. Researchers initially developed the vaccine to protect against cervical cancer and genital warts, and the U.S. Food and Drug Administration has now approved it to protect against anal, vaginal, and vulvar cancers. In principle, the vaccine should also protect against HPV-positive oropharyngeal cancer because as many as 90% of cases are attributed to the two HPV strains that the vaccine targets.

“A critical aspect of the HPV vaccine is that it should reduce the risk of all cancers caused by the HPV types targeted by the vaccine, not just cervical cancer, for which we don’t have another public-health intervention,” said Lowy.

Yet uptake of the vaccine in the U.S. remains low: Only 35% of girls aged 13–17 years were fully vaccinated as of 2011, compared with 18% in 2008—considerably short of the 80% goal of the Healthy People 2020 program.

Studies indicate that physician recommendation is a main determinant of whether a teen will receive the vaccine. Susan T. Vadaparampil, Ph.D., associate member of the Health Outcomes and Behavior Program at the Moffitt Cancer Center in Tampa, Fla., who studies trends in HPV vaccination, said that pediatricians are more likely than family physicians to offer the vaccine (Cancer 2013;119:621–8). Her study also showed that physicians who care primarily for minority groups are more likely to administer the vaccine to these patients. Cost is not necessarily a deterrent because children from families who cannot pay can receive the vaccine free through Medicaid or the Vaccines for Children program.

These findings are consistent with results of a national survey that Vadaparampil conducted to compare rates of physicians’ HPV vaccine recommendations for girls aged 11–12 years from 2010 and 2011. Recommendation rates increased little, and another study focusing on low-income families showed that despite free programs and recommendations, vaccination rates for girls remained low.

“There has been very poor and slow uptake compared with the meningococcal and Tdap [combined tetanus–diphtheria– pertussis] vaccines given to teens,” said Robert M. Jacobson, M.D., a pediatrician at the Mayo Clinic. Jacobson recently found that the number of parents who opt out of vaccinating their teens against HPV is increasing nationally despite recommendations (Pediatrics 2013;131:645–51). “The most alarming finding, frankly more disturbing than the poor uptake, is the increasing concern of parents regarding safety issues and the decreasing number of parents who say they will vaccinate their daughters,” said Jacobson.

To better understand how to improve physician–parent communication, Jacobson and colleagues will, as part of a large national study, go directly to physicians’ offices to analyze the conversations physicians are having with parents and teens. “We need to find out what is being said and, perhaps more important, what is not being said.”

CDC and other organizations are leading campaigns to increase HPV vaccination rates. According to Simard, the campaigns underscore the vaccine’s anticancer function. As for the scientifically unfounded safety concerns, “we need to continue to communicate the scientific rationale for HPV vaccines to the public and underscore that all of the data support the conclusions that the vaccines are safe and efficacious,” said Simard. “We are confident in that, but we do need additional ways to combat people’s misperceptions about the HPV vaccine.”

© Oxford University Press 2013. DOI:10.1093/jnci/djt260

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

September, 2013|Oral Cancer News|

Vaccination Not Found To Increase Risk Of Guillain-Barre Syndrome

Source: Medical News Today
Article Date: 26 Jun 2013 – 0:00 PDT

 

Patients are not at increased risk of Guillain-Barre syndrome in the six-week period after vaccination with any vaccine, including influenza, according to a Kaiser Permanente study published in Clinical Infectious Diseases.

The retrospective study by researchers at the Kaiser Permanente Vaccine Study Center spanned 13 years and was controlled for seasonality.

“If there is a risk of Guillain-Barré syndrome following any vaccine, including influenza vaccines, it is extremely low,” said Roger Baxter, MD, co-director of the Kaiser Permanente Vaccine Study Center.

During the 13-year period (1994-2006), 415 confirmed cases of Guillain-Barré syndrome were observed. Within this group, the researchers found only 25 patients had received any vaccine in the six weeks prior to the onset of the disease. The study also found that 277 patients had a respiratory or gastrointestinal illness in the 90 days preceding the onset.

Guillain-Barré syndrome is an acute disease thought to be an autoimmune disorder resulting in destruction of a nerve’s myelin sheath and peripheral nerves. In many cases, the syndrome is temporally associated with an infectious disease; most published case series report that approximately two-thirds of all cases are preceded within three months by a gastrointestinal or respiratory infection. Guillain-Barré syndrome had been linked to the influenza vaccine in a 1976 study, but not clearly since. There have been reports of an association with other vaccines, which have not been confirmed.

Previous studies of Guillain-Barré syndrome as a possible adverse event related to vaccines have been subject to confounding by differences between vaccinated and unvaccinated individuals which may be unmeasured, said Dr. Baxter, who led the team that conducted this new research.

The Vaccine Study Center researchers further explained that variables that change over time – like infectious diseases or rates of vaccination – can lead to confusion in observational studies, which look at already collected data rather than randomizing people to treatment versus placebo. For this reason, they said, it is necessary to use special epidemiologic and statistical methods to overcome these variables.

The case-centered study design used to conduct this research focuses on the outcome, then looks back to determine vaccination status. This method can control for many of the variables that change over time and, consequently, lead to a more accurate assessment of Guillain-Barré syndrome risk or recurrence following vaccination.

 

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

 

July, 2013|Oral Cancer News|

Reasons for Not Vaccinating Adolescents: National Immunization Survey of Teens, 2008–2010

Source: Pediatrics
Authors: Paul M. Darden, MD, David M. Thompson, PhD, James R. Roberts, MD, MPH, Jessica J. Hale, MSa, Charlene Pope, PhD, MPH, RN, Monique Naifeh, MD, MPHa, and Robert M. Jacobson, MD
Published Online: March 18, 2013
 

 

Abstract

OBJECTIVE: To determine the reasons adolescents are not vaccinated for specific vaccines and how these reasons have changed over time.

METHODS: We analyzed the 2008–2010 National Immunization Survey of Teens examining reasons parents do not have their teens immunized. Parents whose teens were not up to date (Not-UTD) for Tdap/Td and MCV4 were asked the main reason they were not vaccinated. Parents of female teens Not-UTD for human papillomavirus vaccine (HPV) were asked their intent to give HPV, and those unlikely to get HPV were asked the main reason why not.

RESULTS: The most frequent reasons for not vaccinating were the same for Tdap/Td and MCV4, including “Not recommended” and “Not needed or not necessary.” For HPV, the most frequent reasons included those for the other vaccines as well as 4 others, including “Not sexually active” and “Safety concerns/Side effects.” “Safety concerns/Side effects” increased from 4.5% in 2008 to 7.7% in 2009 to 16.4% in 2010 and, in 2010, approaching the most common reason “Not Needed or Not Necessary” at 17.4% (95% CI: 15.7–19.1). Although parents report that health care professionals increasingly recommend all vaccines, including HPV, the intent to not vaccinate for HPV increased from 39.8% in 2008 to 43.9% in 2010 (OR for trend 1.08, 95% CI: 1.04–1.13).

CONCLUSIONS: Despite doctors increasingly recommending adolescent vaccines, parents increasingly intend not to vaccinate female teens with HPV. The concern about safety of HPV grew with each year. Addressing specific and growing parental concerns about HPV will require different considerations than those for the other vaccines.

 

*This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

 

June, 2013|Oral Cancer News|

Throat Cancer and HPV – the researcher

6 February, 2013 12:26PM AEDT
By Carol Duncan (ABC Local)
Source: abc.net.au

 

Assoc Prof Karen Canfell is a researcher with the Lowy Cancer Research Centre at the University of NSW. HPV is her area of expertise. What does she want us to know about HPV and the vaccination program?

CAROL DUNCAN: Karen, your area of expertise is human papilloma virus and I understand there’s not just one but 100 or more?

ASSOC PROF KAREN CANFELL: That’s right, there’s a large number of types HPV that have been implicated in cancer but it’s really two of those types that are responsible for the vast majority of cancers, HPV 16 & 18 and those types are the ones that are included in the vaccine that is now available to us.

CAROL DUNCAN: I guess this is the point of this series this week is that we now have another cancer which is, in essence, preventable.

ASSOC PROF KAREN CANFELL: Yes, I think what we’re seeing with HPV is an incredible success story in cancer prevention. This started with the vaccination of girls and women in Australia. Because HPV has a very important role in cervical cancer and, in fact HPV is responsible for virtually all cervical cancers, the types we just mentioned (types 16 & 18) are responsible for about 70% of those cancers.

Five years ago, in 2007, we had the implementation of the National HPV Vaccination Program in girls and women in Australia and that’s really had incredible effects already. For example we’ve already seen a drop in the number of young girls infected with HPV, we’ve also seen a reduction in the numbers of high-grade abnormalities of the cervix which are the precursor to cervical cancer, and we’ve seen a reduction in anogenital warts which are also caused by different types of HPV which are also included in the vaccine.

So in terms of what’s happened in females, it’s just a remarkable story and we’ve really seen it play out in Australia before anywhere else in the world because Australia was one of the first countries to adopt the vaccine.

CAROL DUNCAN: And now it takes another step as of this year (2013) with the extension of the cervical cancer vaccine to boys.

ASSOC PROF KAREN CANFELL: That’s right. Again, Australia is one of the first countries to make this decision.

Last year, the Pharmaceutical Benefits Advisory Committee recommended that young boys are included in the National HPV Vaccination Program and that will roll out from this year. What that means is that it is going to provide incremental benefits to both girls and boys and I think what we have to remember here is that HPV is transmitted between males and females so vaccination of females was already going to have some beneficial effects for males ultimately because it would cut off the circulation of the virus in the population, but by including young boys in the program we have even greater coverage and we also have protection of the gay community, so I think this really does provide and important incremental step to protecting males even further against HPV infection and the cancers that can be caused by it.

CAROL DUNCAN: The cancers that HPV can cause in men are equally as horrific as cervical cancer.

ASSOC PROF KAREN CANFELL: That’s right, there is a whole range of cancers that HPV can cause in men and also in women in sites other than the cervix.

These include anogenital cancers but also cancers of the head and neck. These are an important set of cancers. I think the complication is that not all of these cancers are caused by HPV but still a significant fraction are and probably that fraction is increasing in the case of head and neck cancers.

CAROL DUNCAN: Dr Jonathan Clark mentioned that, and that so far researchers don’t know why the rate is increasing.

ASSOC PROF KAREN CANFELL: We can’t say definitively but it certainly seems that in Australia and the US that that is happening. A US study has recently shown that cancers of the head and neck maybe now about 70% of them could be attibutable to HPV, so that is a high proportion of those cases.

The other message we need to say here is that vaccination is a really wonderful thing and it’s going to have important long-term effects for men and women in Australia and in most countries which have implemented vaccination programs.

But for women in particular, it’s really important not to forget about cervical screening because that’s what is also protecting older, unvaccinated women against cervical cancer and really the two preventative mechanisms need to work together for the forseeable future.

The main message here is that the vaccination program in females has been incredibly effective. It’s about 73% coverage in young girls in Australia, so there still is one in four girls in Australia not being vaccinated so I think for parents of both young boys and young girls at school it’s really important to see this as a long-term wonderful gift that you can give to your children in terms of cancer prevention.

CAROL DUNCAN: I have watched six hours of throat cancer surgery, I can assure you you don’t want your children to go through that.

ASSOC PROF KAREN CANFELL: Yes I can imagine.

 

 * This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

 

February, 2013|Oral Cancer News|