HPV vaccine leads to more than 80% drop in infections: What parents need to know

Source: Good Morning, America
Date: April 2nd, 2021
Author: Katie Kindelan

 

A new study has shown the effectiveness of the HPV vaccine, and found a dramatic decline in human papillomavirus infections in both vaccinated and unvaccinated teen girls and young women in the United States.

“This study shows that the vaccine works very well against a common virus, HPV,” Dr. Hannah Rosenblum, lead author of the study and medical epidemiologist at the Centers for Disease Control and Prevention (CDC), told “Good Morning America.”

“HPV can cause serious health problems later in life, including some cancers in both women and men,” she said. “HPV vaccination is cancer prevention — by vaccinating children at age 11 or 12, we can protect them from developing cancers later in life.”

HPV is the most common sexually transmitted infection in the United States and can cause health problems like genital warts in addition to cancer, which are most commonly cervical cancer in women and throat cancer in men, according to the CDC.

The HPV vaccine was first authorized in the U.S. for females in 2006, and for males in 2011. There has since been a more than 80% decline in HPV infections nationally, according to the CDC study.

The newly-released data from the CDC shows an 88% decrease in HPV infections among 14 to 19-year-old females and an 81% decrease among 20 to 24-year-old females.

There has also been a drop in unvaccinated females, according to Rosenblum, who warned that does not mean people should let their guard down.

“We also see an effect among unvaccinated females in these age groups due to less spread of the virus, however, unvaccinated persons are not immune and are still at risk of getting HPV,” she said. “They should talk to their doctor about getting vaccinated if they are 26-years-old or younger.”

HPV viruses are found in 80 million people in the United States, according to the CDC. There are hundreds of subtypes of HPV, and 1 in 4 people in the U.S. are infected with HPV at some point in their lives.

The CDC recommends two doses of the HPV vaccine, taken six to 12 months apart, for all girls and boys ages 11 to 12, but says the vaccine can be given to children as young as 9.

Teens and older who are not vaccinated are encouraged to do so by the age of 26. People ages 15 and older need three doses of the vaccine, according to the CDC.

The timing of the vaccine has to do with the state of children’s immune systems and also trying to vaccinate pre-teens before they are sexually active, Dr. Laura Riley, chair of obstetrics and gynecology at Weill Cornell Medicine and New York-Presbyterian in New York City, told “GMA.”

“Your immune system [at ages 11 and 12] is such that you have a robust response to this vaccine, and it lasts for a really long time,” she said. “But if you haven’t had it, still continue talking to your doctor about getting it up to age 26.”

Riley said she hopes the CDC’s new data — which stands out for being a 10-year study — combined with the safety of the HPV vaccine eases any remaining concerns parents may have about getting their children vaccinated against HPV.

“When [the HPV vaccine] first rolled out, the message wasn’t quite clear, so instead of people recognizing that you were going to prevent your kid from getting cancer, people were focused on the fact that HPV is a sexually transmitted disease,” she said. “The education has to continue so that parents can understand the real benefit of this vaccine.”

“The real benefit is to prevent your child from getting cervical cancer,” Riley said. “The fact that you can prevent [cervical cancer] with a vaccine that has been used for years and has shown to be safe, why wouldn’t you do it?”

Long-lasting infection with certain types of HPV is the main cause of cervical cancer, which has the best survival rates if detected early according to the CDC. Doctors routinely screen for cervical cancer with the Pap test and HPV DNA testing depending on age and risk factors.

“We need to make sure that the teenagers and pre-teens are getting the benefit of the HPV vaccine, because it really is an anti-cancer vaccine,” said Riley. “[Cervical cancer] is a really devastating disease.”

Globally, a woman loses her life to cervical cancer every two minutes, according to a 2019 article published in the medical journal The Lancet.

In the U.S., doctors on the frontlines like Riley said more must continue to be done to educate parents about the HPV vaccine and make sure that all children across the country have access to the vaccine. As of 2018, nearly 40% of adults ages 18 to 26 reported receiving one or more doses of the HPV vaccine, according to the CDC.

“We need to make sure that we work on access to this vaccine and make sure that all girls of all races and ethnicities have the access,” said Riley. “And we need to be sure that the message is clear so that everyone gets the two doses of the vaccine, because that’s what is associated with the best protection.”

2021-05-11T10:31:22-07:00May, 2021|Oral Cancer News|

Cancer vaccine shows early promise across tumor types

Source: www.webmd.com
Author: Walter Alexander

A personalized cancer vaccine proved possible to manufacture and was well tolerated in an early phase I clinical trial, researchers said. The vaccine, known as PGV-001, was given to 13 patients with solid tumors or multiple myeloma who had a high risk of recurrence after surgery or stem cell transplant.

At last follow-up, four patients were still alive without evidence of disease and had not received subsequent therapy, four were alive and receiving therapy, three had died, and two could not be contacted for follow-up.

Thomas Marron, MD, of Mount Sinai in New York presented these results at the American Association for Cancer Research Annual Meeting recently.

“While cancer immunotherapy has revolutionized the treatment of cancer, we know that the majority of patients fail to achieve significant clinical response,” Marron said during his presentation. Personalized vaccines may help prime an improved immune response, he said.

With this in mind, Marron and colleagues developed PGV-001, a vaccine consisting of customized peptides – a kind of amino acid — given to patients along with initial treatment.

Feasibility and safety
Vaccines were given to 13 patients. Six had head and neck cancer, three had multiple myeloma – a cancer of the white blood cells — two had lung cancer, one had breast cancer, and one had bladder cancer.

Eleven patients received all 10 intended doses, and two patients received at least eight doses.

“The vaccine was well tolerated, with only half of patients experiencing mild, grade 1 adverse events,” Marron said.

Four patients developed reactions at the injection site and one person Transient injection site reactions occurred in four patients, and one patient developed a low-grade fever.

After an exam after an average of 880 days, four patients had no evidence of cancer and had not received more therapy. This includes one patient with stage III lung cancer, one with stage IV positive breast cancer, one with stage II bladder cancer, and one with multiple myeloma.

Four patients were alive and receiving other kinds of therapy. Three patients have died, two of whom saw their cancers return.

“Our results demonstrate that the OpenVax pipeline is a viable approach to generate a safe, personalized cancer vaccine, which could potentially be used to treat a range of tumor types,” Bhardwaj said.

HPV vaccine leads to more than 80% drop in infections: What parents need to know

Source: Good Morning, America
Date: April 2nd, 2021
Author: Kathleen Kindalen

 

A new study has shown the effectiveness of the HPV vaccine, and found a dramatic decline in human papillomavirus infections in both vaccinated and unvaccinated teen girls and young women in the United States.

“This study shows that the vaccine works very well against a common virus, HPV,” Dr. Hannah Rosenblum, lead author of the study and medical epidemiologist at the Centers for Disease Control and Prevention (CDC), told “Good Morning America.”

“HPV can cause serious health problems later in life, including some cancers in both women and men,” she said. “HPV vaccination is cancer prevention — by vaccinating children at age 11 or 12, we can protect them from developing cancers later in life.”

HPV is the most common sexually transmitted infection in the United States and can cause health problems like genital warts in addition to cancer, which are most commonly cervical cancer in women and throat cancer in men, according to the CDC.

The HPV vaccine was first authorized in the U.S. for females in 2006, and for males in 2011. There has since been a more than 80% decline in HPV infections nationally, according to the CDC study.

The newly-released data from the CDC shows an 88% decrease in HPV infections among 14 to 19-year-old females and an 81% decrease among 20 to 24-year-old females.

There has also been a drop in unvaccinated females, according to Rosenblum, who warned that does not mean people should let their guard down.

“We also see an effect among unvaccinated females in these age groups due to less spread of the virus, however, unvaccinated persons are not immune and are still at risk of getting HPV,” she said. “They should talk to their doctor about getting vaccinated if they are 26-years-old or younger.”

HPV viruses are found in 80 million people in the United States, according to the CDC. There are hundreds of subtypes of HPV, and 1 in 4 people in the U.S. are infected with HPV at some point in their lives.

The CDC recommends two doses of the HPV vaccine, taken six to 12 months apart, for all girls and boys ages 11 to 12, but says the vaccine can be given to children as young as 9.

Teens and older who are not vaccinated are encouraged to do so by the age of 26. People ages 15 and older need three doses of the vaccine, according to the CDC.

The timing of the vaccine has to do with the state of children’s immune systems and also trying to vaccinate pre-teens before they are sexually active, Dr. Laura Riley, chair of obstetrics and gynecology at Weill Cornell Medicine and New York-Presbyterian in New York City, told “GMA.”

“Your immune system [at ages 11 and 12] is such that you have a robust response to this vaccine, and it lasts for a really long time,” she said. “But if you haven’t had it, still continue talking to your doctor about getting it up to age 26.”

Riley said she hopes the CDC’s new data — which stands out for being a 10-year study — combined with the safety of the HPV vaccine eases any remaining concerns parents may have about getting their children vaccinated against HPV.

“When [the HPV vaccine] first rolled out, the message wasn’t quite clear, so instead of people recognizing that you were going to prevent your kid from getting cancer, people were focused on the fact that HPV is a sexually transmitted disease,” she said. “The education has to continue so that parents can understand the real benefit of this vaccine.”

“The real benefit is to prevent your child from getting cervical cancer,” Riley said. “The fact that you can prevent [cervical cancer] with a vaccine that has been used for years and has shown to be safe, why wouldn’t you do it?”

Long-lasting infection with certain types of HPV is the main cause of cervical cancer, which has the best survival rates if detected early according to the CDC. Doctors routinely screen for cervical cancer with the Pap test and HPV DNA testing depending on age and risk factors.

“We need to make sure that the teenagers and pre-teens are getting the benefit of the HPV vaccine, because it really is an anti-cancer vaccine,” said Riley. “[Cervical cancer] is a really devastating disease.”

Globally, a woman loses her life to cervical cancer every two minutes, according to a 2019 article published in the medical journal The Lancet.

In the U.S., doctors on the frontlines like Riley said more must continue to be done to educate parents about the HPV vaccine and make sure that all children across the country have access to the vaccine. As of 2018, nearly 40% of adults ages 18 to 26 reported receiving one or more doses of the HPV vaccine, according to the CDC.

“We need to make sure that we work on access to this vaccine and make sure that all girls of all races and ethnicities have the access,” said Riley. “And we need to be sure that the message is clear so that everyone gets the two doses of the vaccine, because that’s what is associated with the best protection.”

Which COVID-19 vaccine is best for cancer patients?

Source: www.mdanderson.org/
Author: Cynthia DeMarco

With three COVID-19 vaccines now authorized for emergency use by the Food and Drug Administration (FDA), you might be wondering which vaccine is best for current and former cancer patients. After reviewing all available data, MD Anderson medical experts agree that all three vaccines are safe and recommended for cancer patients.

So, should you take Johnson & Johnson’s Janssen COVID-19 vaccine (J&J), which requires only one dose, if that’s what’s available? Or should you wait for one of the Pfizer or Moderna vaccines, which both require two doses, spaced 21 and 28 days apart, respectively?

According to our experts, the answer is clear: “Don’t pass up an opportunity to get the vaccine, no matter which one it is,” says Anita Ying, M.D., vice president of Ambulatory Medical Operations. “The best COVID-19 vaccine to get is the first one available to you.”

Timing matters for cancer patients getting a COVID-19 vaccine
Ying’s advice is particularly true for cancer patients, since some may be immunocompromised, making them both more vulnerable to severe infections and more likely to need hospitalization should they contract COVID-19.

“The sooner you can start building resistance to the novel coronavirus, the sooner you’ll have at least some protection against it,” notes infectious diseases specialist David Tweardy, M.D. “And that benefits everyone.”

For patients in active treatment, a COVID-19 vaccine will likely be more effective when coordinated with their treatment schedules. Those who have recently had surgery should wait two weeks before receiving one. And those enrolled in clinical trials, or who are receiving chemotherapy, CAR T cell therapy, immunotherapy or stem cell transplants should consult their care teams for additional guidance on timing.

Other timing considerations apply for those who’ve received a different vaccine recently, who’ve received monoclonal antibody therapy or convalescent plasma to treat a COVID-19 infection.

Everyone else can receive a COVID-19 vaccine as soon as one becomes available to them.

Benefits of all three vaccines outweigh risks of COVID-19
No matter which COVID-19 vaccine you get, you can rest assured that it is both safe and effective in protecting against severe infections. Vaccines must be at least 50% effective at preventing symptomatic infection in order to be authorized by the Food and Drug Administration.

“The Pfizer and Moderna vaccines are 95% and 94% effective, respectively, at preventing symptomatic infection,” says Tweardy. “The Johnson & Johnson vaccine is 67% effective overall.”

At first glance, that may make the J&J vaccine look slightly less desirable. But both the J&J and the Pfizer vaccines were 100% effective at preventing hospitalizations and death due to COVID-19, and the Moderna vaccine was 89% effective. The J&J vaccine also had the second-highest rates of efficacy at preventing severe infections: 77% after 14 days and 85% after 28 days.

“The overall numbers are different,” notes Tweardy. “There’s no getting around that. But when you consider the fact that different strains of the virus were circulating at the time the Johnson & Johnson one was being tested, it’s really not a fair comparison. What we’re looking for is a vaccine that prevents death and allows patients to survive the infection, and that’s exactly what the Johnson & Johnson one does, just as effectively as the other two.”

One dose or two: choosing the COVID-19 vaccine that’s right for you
Though their methods of accomplishing it differ slightly, all of the current COVID-19 vaccines work by inducing people’s bodies to produce a spike protein dotting the novel coronavirus’ surface. Recipients’ immune systems then recognize the protein as an invader and start generating antibodies against it.

This immune response is what makes vaccine recipients much less likely to develop a COVID-19 infection, should they ever be exposed to it. And that’s why it’s best to be vaccinated as quickly as possible.

Still, there may be some situations in which it makes more sense to opt for the Johnson & Johnson vaccine. For one thing, the J&J vaccine requires only one dose to be effective, while the Pfizer and the Moderna vaccines require two, spaced several weeks apart. That means you could achieve the maximum protection afforded by the J&J vaccine in a much shorter time period.

“The goal is to start building up resistance as quickly as possible,” says Tweardy. “So, the sooner you can launch that process, the better. But if you’re really afraid of needles or unable to commit to receiving a second dose at the recommended time, Johnson & Johnson might be a better option for you, if it’s available.”

When a vaccine opportunity knocks, don’t hesitate
One of the most important things to keep in mind is that supplies of the COVID-19 vaccine are still limited across the country. So, if an opportunity arises to get a COVID-19 vaccine, think very hard before letting it pass you by — especially if the only reason you’d be doing so because it’s not the vaccine you’d prefer most.

“It might be several weeks or months before you get another opportunity,” adds Ying. “And it may or may not be the one you want. So, in my opinion, it’s not worth missing the chance to be vaccinated.”

More parents balking at giving kids cancer-fighting HPV vaccine

Source: www.usnews.com
Author: Steven Reinberg

From 2012 to 2018, more doctors recommended their patients get vaccinated with the HPV vaccine — from 27% to 49%. But at the same time, the number of parents who were reluctant to have their kids vaccinated increased from 50% to 64%, researchers found.

“Overall, more U.S. teens are getting the HPV vaccine, and the nation is making progress towards reaching the HPV vaccination goals; however, if parental reluctance continues to grow, the current rate of our progress might plateau or possibly decline,” said lead study author Kalyani Sonawane. She’s an assistant professor in the department of management, policy and community health at the University of Texas Health Science Center in Houston.

“In the long term, the lost opportunity to protect our teens from HPV might contribute to cases of HPV-associated cervical, oropharyngeal, penile, anal, vaginal and vulvar cancers in the future,” Sonawane said.

Parents’ reluctance to have their kids vaccinated rose more for girls, from 54% to 68%, compared with 44% to 59% for boys, the researchers noted. The report was published online Feb. 9 in the journal Pediatrics.

To increase the number of boys and girls who get vaccinated, doctors need to strongly recommend it, Sonawane said.

“Further improvements in provider recommendations can be made, given that it is the most important factor for improving HPV vaccine uptake,” she said. “Providers should be prepared to tackle hesitancy by conveying the importance of HPV vaccination to parents and debunking vaccine misinformation. Increasing vaccine confidence in parents will be key to attaining HPV vaccination goals in the U.S.”

The reluctance is largely due to safety concerns, Sonawane said. In a study, she and her colleagues found that the most common reason parents cite for their reluctant to HPV vaccine is concerns regarding adverse effects.

“The public message about the HPV vaccine should highlight that the vaccine protects against cancers. It is important to emphasize to parents that the vaccine offers protection for up to six cancers, because data indicates that many people are not aware of this fact,” Sonawane said.

In another study, Sonawane found that less than one-third of Americans know that HPV causes anal, penile and oral cancers.

Sonawane added that the anti-vaxxer movement is likely contributing to the growing reluctance of parents to have their children vaccinated, and she is concerned that the “negative coverage of the COVID vaccine will trickle down to HPV vaccine and affect perceptions regarding vaccines.”

HPV is a sexually transmitted infection that is the cause of most cervical, vagina and vulva cancers, penis cancer and cancer in the back of the throat. It can take years for these cancers to develop, but children can be protected by getting the HPV vaccine at ages 11 to 12, according to the U.S. Centers for Disease Control and Prevention.

One pediatrician unconnected to the study noted the importance of the marketing for the vaccine.

“When this vaccine first hit the market, they didn’t focus the messaging around it being a cancer preventer vaccine. They focused on the sexually transmitted infections,” said Dr. David Fagan, vice chairman of pediatric administration-ambulatory at Cohen Children’s Medical Center in New Hyde Park, N.Y.

Fagan believes, however, the message should be that the vaccine prevents cancer. “Wouldn’t you, as a parent, want to do everything you could for your child to prevent the possibility of your child getting a cancer — this vaccine does that,” he said.

He also thinks that the quality of the recommendation is key to convincing parents to vaccinate their children.

The American Academy of Pediatrics is doing a lot to educate pediatricians in motivational interviewing techniques, Fagan said.

The tetanus booster, the meningitis vaccine and the HPV vaccine are those recommended for adolescence.

Evidence shows, if you offer the HPV in first or second place as opposed to third place, parents are more likely to opt for it, Fagan said.

“If you do tetanus, meningitis, HPV, they are less likely to accept HPV, but if you put HPV first or even second, there’s evidence that there’s better uptake. So messaging is really, really important,” he said.

The vaccine is safe, Fagan said. A study has shown that no serious side effects have been seen since the vaccine was released.

“You know these things on social media about the safety of the vaccine, obviously that’s crazy stuff,” he said.

“I tell parents if this vaccine was unsafe, it would have been pulled from the market,” Fagan said. “Additionally, you would be reading about multimillion dollar legal settlements in the press, and that has not happened. So the take-home message is this vaccine is safe and effective in preventing cancers caused by HPV.”

More information
For more on the HPV vaccine, go to the U.S. Centers for Disease Control and Prevention.

Sources:
Kalyani Sonawane, Ph.D., assistant professor, department of management, policy and community health, University of Texas Health Science Center at Houston; David Fagan, MD, vice chairman, Pediatric Administration-Ambulatory, Cohen Children’s Medical Center, New Hyde Park, N.Y.; Pediatrics, Feb. 9, 2021, online

2021-02-10T10:56:54-07:00February, 2021|Oral Cancer News|

How enlisting dentists can speed up Covid-19 vaccinations

Source: Knowable Magazine
Date: February 3rd, 2021
Author: Mary E. Northridge

OPINION: Dental care providers have the skills, the facilities and the trust of patients who might otherwise miss out

 

Even as the Biden administration has upped its Covid-19 vaccine goal to 1.5 million per day, early reports say vaccination rates are lagging in hard-hit Black and Latino communities. On both fronts, America’s dentists can help.

Dental professionals — dentists, dental hygienists and dental assistants — have been responding to the pandemic from the outset, even as many practices were shut down by the emergency. At the health center where I work in Brooklyn, dental providers first donated their personal protective equipment (PPE) to the affiliated hospital. Then many of them were redeployed to perform arterial blood gas measurements and even transport deceased patients to makeshift morgues.

Today, the urgent need is to get millions of shots in arms. States should immediately authorize dental providers to administer Covid-19 vaccines. That would not only expand the trained immunization workforce, it would open up additional sites to dispense the vaccine and bolster vaccine acceptance among patients who do not routinely go to the doctor.

This is not without precedent. In 2019, Oregon became the first state to allow dentists to offer any vaccine to patients. Other states, including Illinois and Minnesota, allow dentists to administer influenza vaccines. Since late 2020, Arkansas, Massachusetts and California have permitted dentists to administer Covid-19 vaccines.

During this devastating public health emergency, this idea needs to be extended to all states.

There are more than 110,000 dentists – excluding specialists — and over 200,000 hygienists in the United States, and they already have the skills needed. Dentists routinely administer intra- and extra-oral injections to provide anesthesia, so any additional training would be minimal. In California, for instance, dentists will do four hours of online training before joining the vaccination effort.

California currently plans to utilize dentists just as extra manpower at vaccine clinics. But dental offices, too, will be valuable in vaccinating hard-to-reach populations.

Dental offices and clinics are a safe location. Despite early concerns that they might be particularly vulnerable to aerosol-borne transmission of the novel coronavirus, evidence is mounting that transmission at dental sites is rare. As in medical settings, precautions such as using PPE and increasing ventilation are effective. Nearly all dental practices and clinics have reopened to provide care. And that has been essential during the pandemic: Treating damaged teeth, tooth decay, gum disease and oral sores before they become acute prevents patients from going to emergency departments because of dental pain.

Interrupting community spread, however, is the chief imperative to prevent Covid-19 cases from overwhelming hospitals today. And that means adding vaccines to dental services.

Inoculating patients who are already in chairs for dental visits could improve vaccine acceptance. At the health center where I work, a simple workflow change for preventive tooth sealant placement nearly doubled the number of eligible children treated, from 37 percent to nearly 78 percent. Rather than schedule a separate appointment, sealants were applied during the kids’ initial or recall visits. Fewer visits meant greater acceptance of the treatment and higher rates of completion. The same could be true for vaccines.

Community dental clinics also serve hard-to-reach patients — minorities, immigrants, impoverished people — those who may be hesitant to seek out the vaccine because of historical injustices, fear of deportation or lack of health insurance. But dental providers have often earned trust through longstanding service in these communities. Ongoing quality improvement studies at our health center, for instance, document no racial/ethnic bias in treatment by dental providers. When patients are treated with respect regardless of their ability to pay for services, they may be more willing to accept a vaccine that will protect them, their families and their communities.

Many states have suspended regulations and expanded the scope of dental practices to combat the pandemic. To help ensure health equity and successfully immunize the whole US population, all states ought to enlist dental providers to administer Covid-19 vaccines as well.

This article is part of “Reset: The Science of Crisis & Recovery,” an ongoing Knowable Magazine series exploring how the world is navigating the coronavirus pandemic, its consequences and the way forward. “Reset” is supported by a grant from the Alfred P. Sloan Foundation. 

 

2021-02-08T12:25:34-07:00February, 2021|Oral Cancer News|

UArizona clinical trail expanding after early results with personalized cancer vaccine

Source: www.kold.com
Author: Karly Tinsley

Despite the pandemic, groundbreaking research has not stopped at the University of Arizona. Researchers with the UArizona Health Sciences are working to help treat cancer by using personalized vaccines. It works in combination with the immuno-therapy drug Pembrolizumab.

According to the UArizona, Julie E. Bauman, MD, MPH, deputy director of the University of Arizona Cancer Center and a professor of medicine and chief of the Division of Hematology and Oncology at the UArizona College of Medicine – Tucson, presented preliminary data on the first 10 patients with head and neck cancer, seven of which were treated at Banner – University Medicine, the clinical partner for the UArizona Cancer Center. Five of the 10 patients experienced a clinical response to the personalized cancer vaccine, and two patients had a complete response after the treatment (no detectable disease present).

Molly Cassidy is one of the 10 who went through the trial.

“I was a young healthy woman, so it was a big shock to get diagnosed,” said Cassidy.

She was first diagnosed with oral cancer after complaining of an ear ache. Dentists initially found a tumor in her tongue that was later identified as cancer. She then went through treatment for the tumor, but her cancer came back aggressively.

“I had tumors throughout my neck, in my lungs, I was really really ill,” said Cassidy.

At this time she was seeing Dr. Bauman, who said they both understood her chances of survival were slim at that point.

“I was writing my will,” said Cassidy.

“She asked me to prepare her. It was not viewed as curable and she began to do end of life work,” said Dr. Bauman.

That’s when Dr. Bauman offered her the option of joining her clinical trial. It’s a treatment tailored specifically to the patient. Their cancer cells are used to develop a personalized vaccine that teaches their immune system how to recognize and destroy their cancer.

According to UArizona, to identify the patient-specific mutations of the cancer, mutated DNA from the patient’s tumor is simultaneously sequenced with healthy DNA from the patient’s blood. Computers compare the two DNA samples to identify the unique cancer mutations.

The results are used to develop a set of genetic instructions that are loaded onto a single molecule of messenger RNA (mRNA) and made into a vaccine. These instructions teach immune cells such as T-cells – white blood cells that help protect against infection – how to identify and attack the mutated cancer cells.

“It’s a medicine that is individualized, personalized, and is not one size fits all,” said Dr. Bauman.

Cassidy began the series of 9 shots of her specific vaccine and for the first time things were improving.

“We were cautiously hopeful,” said Dr. Bauman.

It makes her one of two patients in the trial who’ve responded completely, with cancer no longer detectable on a CT scan.

“To see that reversed was striking, stunning, extremely unusual,” said Dr. Bauman.

The trial is now being expanded to more patients due to the early results, as Dr. Bauman is now working with 40 patients with head and neck cancer. Giving those like Cassidy a second chance to picture life after a cancer diagnosis.

“To have such a great response has given me so much of my life back,” said Cassidy.

Her treatment is for two years in the trial, and so far Cassidy remains in complete response.

Dr. Bauman said a personalized vaccine also strives to be less toxic on the body, by not awakening cells that typically attack the organs with regular immunotherapy.

2020-11-21T10:33:28-07:00November, 2020|Oral Cancer News|

Most parents of unvaccinated teens have no intention of getting HPV vaccine for their kids, study finds

Source: www.newstribune.com
Author: Kasra Zarei, The Philadelphia Inquirer

The human papillomavirus (HPV) vaccine has been proven to prevent certain types of oral and genital cancers and other health problems. However, in a study published this week in Lancet Public Health, researchers found that more than half of the parents of adolescents who have not received the HPV vaccine had no intention to initiate the vaccine series for their children.

Using data from a nationally representative survey of U.S. adolescents, the study authors estimated national-level and state-level parental intent to initiate and complete the HPV vaccine series for their kids. In states including Idaho, Montana, Nebraska, North Dakota, Oklahoma, and Utah, more than 65 percent of parents of unvaccinated adolescents had no intention to initiate the HPV vaccine series.

According to the most recent data by the Centers for Disease Control and Prevention, Wyoming and Mississippi have the lowest HPV vaccine rates at roughly 50 percent. The new study found of parents of unvaccinated adolescents in these states, almost 62 percent and 57 percent, respectively, did not intend to initiate the HPV vaccine for them.

Lack of parental intent to complete the vaccine series was lowest in the District of Columbia, at nearly 11 percent, and Rhode Island, at 20 percent. HPV vaccination is mandated in both regions.

In Philadelphia, HPV vaccine coverage is among the highest in the country — roughly 71 percent in 2018, according to CDC data. Still, in Pennsylvania, between 60-65 percent of the parents of unvaccinated adolescents do not intend to have their kids start the vaccine.

“I was surprised that the intent to vaccinate (for HPV) is this low,” said Cynthia DeMuth, a primary-care pediatrician in Harrisburg and the Pennsylvania chapter immunization representative for the American Academy of Pediatrics, who was not involved with the study.

The HPV vaccine guidelines recommend adolescents who start the vaccine series before their 15th birthday receive two doses, or three doses if they start after their 15th birthday.

But even among kids who receive the first dose, many parents don’t intend to have their child complete the series, the study found. Nationally, almost a quarter of the parents of adolescents who received the first dose of the vaccine had no intention to complete the series. In states like Arkansas, Florida, Georgia, Hawaii, Idaho, Utah, and West Virginia, that percentage was even higher at more than 30 percent.

Research suggests parents’ main driver is perceived safety of the vaccine, which may be due to past reports of adverse effects since the vaccine’s approval in 2006.

“It’s a safe and effective vaccine, and there haven’t been any serious adverse events related to the vaccine,” DeMuth said.

Studies have since proven rates of cancers that are prevented by the HPV vaccine have greatly decreased. Experts estimate widespread HPV vaccination has the potential to reduce new cervical cancer cases around the world by as much as 90 percent.

Lack of knowledge about the vaccine and lack of recommendations from health-care providers are also reasons expressed by parents with no intent to vaccinate their kids.

“Adults between the ages of 18 to 45 don’t even know what HPV is, and there is a vaccine to protect it,” said Kalyani Sonawane, professor in the department of management, policy, and community health at the University of Texas Health Science Center and lead author of the study.

There are also perceptions the vaccine is not needed for younger teens who may not be sexually active, as HPV is mainly sexually transmitted.

When declining the HPV vaccine, “sometimes parents say their child is too young and isn’t sexually active, and they’ll think about it for next year,” DeMuth said. “But the vaccine works better at young ages — the antibody levels are higher at a younger age with two shots compared to three shots at older ages.”

These trends worry experts who say it could cause a rise in HPV-related cancer rates.

“Particularly among girls, the coverage rate has not improved. If parents are not intending to vaccinate their kids, in the future, we could expect to see an increase in HPV-associated cancers,” Sonawane said.

Sonawane said while people may not think about HPV like measles, for which low vaccine coverage can lead to outbreaks, HPV is still an infectious disease and can remain in the body for years. HPV-related cancers are already on the rise by almost 3 percent. Experts caution if vaccine coverage doesn’t improve, increases in HPV-related cancers are only going to get worse.

Health care professionals and pediatricians can play an immediate role in addressing these potential health concerns.

“A strong recommendation from the provider is one of the most significant things providers can do,” DeMuth said. “The longer it’s been out, the more confident I am it’s safe, and the better I feel about giving a strong recommendation for the vaccine.”

FDA approves Gardasil 9, the HPV vaccine, to prevent head-and-neck cancer

Source: www.statnews.com
Author: Matthew Herper

For the past decade, evidence has suggested that Gardasil, the HPV vaccine, could stem an epidemic of throat cancer. But it has also never received approval from the Food and Drug Administration for that use — and it was unclear if it ever would.

Charles Rex Arbogast/AP

On Friday, the agency granted that approval, clearing the latest version of the vaccine, Gardasil 9, to prevent a cancer that affects 13,500 Americans annually. The decision was announced by Gardasil’s maker, Merck.

The decision doesn’t change recommendations about who should get the vaccine, which is already recommended for females and males ages 9 through 45 to prevent cervical, vulvar, vaginal, and anal cancer as well as genital warts. But cancers of the head and neck — mainly those of the tonsils and throat — have been left off the list.

It’s a striking omission, because head and neck cancer, mostly cancer of the throat, is the most common malignancy caused by HPV, the human papilloma virus, in the U.S. According to the Centers for Disease Control and Prevention, there are 35,000 cases of HPV-related cancer in the U.S. annually. On top of the 13,500 cases in the throat, 10,900 are cases of cervical cancer.

“That’s excellent news,” said Stewart Lyman, a pharmaceutical consultant whose doctors discovered a tumor in his throat in 2016. It was removed surgically, and was caused by HPV. “To have this extended to head and neck cancer is really very helpful for helping to inform the public that this serious disease, which has significant morbidity and mortality associated with it, can be prevented with the vaccine,” Lyman said.

Marshall Posner, the director of head and neck medical oncology at the Tisch Cancer Institute, said the approval is “a good thing for the FDA to do” and that he would be “thrilled” if head and neck cancer cases could be reduced through vaccination in coming decades. He said he has “every expectation” that an HPV vaccine would reduce cancer rates.

The original version of the Gardasil vaccine was approved in 2006 for girls and women between the ages of 9 and 26 based on data from clinical trials showing that the vaccine, by preventing HPV infection, could also prevent precancerous cervical lesions. But such lesions don’t exist in head and neck cancer, and it was not clear how to prove the vaccine’s efficacy.

Maura Gillison, now a professor at M.D. Anderson Cancer Center, first connected a subset of head-and-neck cancers to HPV in 1999. But then she and other epidemiologists noticed something: The number of head and neck cancers was rising rapidly, and HPV seemed to be a culprit. What’s more, these sexually transmitted cases seemed different — and somewhat easier to treat. The most common victims were middle-aged men who had contracted the virus decades before.

The FDA is granting what’s known as an accelerated approval, meaning that the decision is contingent on the production of more data and is based on what’s known as a “surrogate endpoint” — an indication that a medicine works that is not foolproof. In this case, the FDA is approving the drug based on data on preventing anogenital infection. In February, Merck began a study of 6,000 men that will test whether patients who receive the vaccine are less likely to get persistent HPV infections in their throats.

Adding another disease to the approval does impact what Merck can say to doctors and patients about HPV and head and neck cancer. “It’s something that was missing in the label,” said Alain Luxembourg, director, clinical research, Merck Research Laboratories. “It is something missing in the conversation between patients and doctors.”

Otis Brawley, an oncology and epidemiology professor at Johns Hopkins University, said that while he is usually opposed to surrogate endpoints, in this case he is comfortable with the decision. “There’s already enough reasons to vaccinate for HPV in men,” he said, adding that doing so broadly might make it possible to eradicate the virus, and the cancers it causes.

For Gillison, who spotted the emergence of HPV throat cancer, it came too late. She pushed Merck to do a study, and said that the one that started in February is coming “10 years plus after when it would have really mattered.” She also thinks that the real reason for the decision is the weight of epidemiologic evidence that she and others produced.

“The fact of the matter is that this approval probably has little whatsoever to do with the anal data per se,” Gillison wrote via text message. “It is because the FDA is made more comfortable with inference because of all the data that has been generated regarding the relationship between oral HPV infection and HPV vaccination outside of vaccine trials in the last 10 years.”

What parents need to know about the HPV vaccine

Source: www.news-medical.net
Author: University of Chicago Medical Center, reviewed by Kate Anderton, B.Sc. (Editor)

The vaccine that prevents infection from human papillomavirus (HPV) is nothing short of a medical marvel. “It’s one of the most effective vaccines we have against any disease or infection. And it prevents cancer,” said Andrea Loberg, MD, clinical associate of obstetrics and gynecology.

Pre-teens and teens who are vaccinated against HPV can be spared some of the deadliest, most disfiguring and hard-to-treat cancers-;those of the cervix, vagina, vulva, penis, anus, mouth and throat. Over 90% of cancers caused by HPV can be prevented-;29,000 cases of cancer per year-;with the HPV vaccine.

Concerns about sexual promiscuity
To some parents, however, the HPV vaccine may be an uncomfortable reminder that their child will be moving into adulthood and may choose to express his or her sexuality. HPV is transmitted by oral, vaginal and anal sex and other intimate skin-to-skin contact, and it is extremely prevalent; about 80% of people will be exposed to the virus in their lifetime.

Condoms reduce but don’t eliminate the risk of HPV infections because the virus lives in both oral and genital tissues. Condoms do not cover the entire genital area of either gender. Nor are same-sex female partners protected from contracting the virus, which often causes no symptoms until precancerous lesions or cancer show up years later. “It’s hard for parents to think about our kids becoming sexually active, but we also want them to have fulfilling lives,” said Truehart, whose own two teenagers have received the HPV vaccine. “We want to make sure they are protected before they start having sex.”

The recommended age for receiving the HPV vaccine is 11 or 12, when children are also scheduled to receive the Tdap vaccine (tetanus, diphtheria and pertussis) and the meningitis vaccine. But the two-dose vaccine-;the second dose is given six to 12 months after the first-;can be given to children as young as nine. Teens older than 15 and men and women need three doses of the vaccine to develop an immunity against HPV.

“Pre-teens have a more robust response to the vaccine and generate enough antibodies to protect against HPV after two immunizations, whereas older kids and adults need three doses to get the same immune response,” said Truehart. Another reason not to delay getting the HPV vaccine: an older teen may not want to wait six months or more to be fully immunized against HPV once he or she is on the verge of becoming sexually active. “It’s important for kids to be immunized before they are exposed to HPV,” Truehart said.

Not just for girls
When the U.S. Food and Drug Administration approved the HPV vaccine in 2006, it was recommended for girls and women to protect against cervical cancer. Three years later, the vaccine was approved for boys and men, based on evidence that males are also susceptible to HPV-related cancers. “Cancers caused by HPV affect women and men in equal numbers,” said Loberg. “Each year, there are approximately 10,800 cases of cervical cancer diagnosed in women, and 9,600 cases of head and neck cancer diagnosed in men.” And while there is a screening test for cervical cancer to catch and treat it early, there are no such screening tests for any of the other HPV-related cancers. And because most HPV infections are asymptomatic, people may be unwittingly transmitting the infection to their sexual partners.

HPV also causes genital warts which, although not harmful in most people, can be embarrassing and unsightly. In some cases, however, genital warts can be extremely painful and may even require surgery to remove them. For people with autoimmune disorders or who take medications that compromise their immune system, genital warts can be very difficult to manage, said Loberg. Out of more than 150 strains of HPV, the vaccine targets the most prevalent and harmful ones: two strains that cause genital warts and seven strains that cause various types of cancer.

No serious side effects
Despite HPV being the most common sexually transmitted infection, HPV-related cancers are relatively uncommon because in about 90% of people exposed to HPV, their immune systems clear the virus from their bodies before it causes cancer or precancer. “But we don’t know which individuals will develop a persistent infection, so why take that gamble when cancer can be the consequence?” said Loberg.

When parents ask whether the HPV vaccine is safe, Loberg’s ready answer is that “it’s incredibly safe.” More than 270 million doses of the HPV vaccine have been distributed worldwide since 2006, and there have been no serious side effects. One study that examined data from more than 56 million doses of HPV vaccine administered in the U.S. found that some girls became dizzy or fainted 15 minutes after receiving the vaccine. “That is the only side effect that we see,” other than mild side effects typical of other vaccines, such as fever, headache, and pain and redness at the injection site, said Loberg.

Pediatricians and primary care providers should be recommending the HPV vaccine for children, but if not, parents should bring it up.

“There is absolutely no downside to getting the HPV vaccine, and the upside is preventing your child from getting a deadly or disfiguring cancer,” she said.

Go to Top