HPV vaccine needs wider use

Last week, the state Legislature’s Public Health Committee hosted a hearing on HB 7199 (“An Act Concerning Immunizations Against The Meningococcal Virus and Human Papillomavirus”). Hundreds of Connecticut residents shared their written and spoken testimonies in support of this bill.

Why is this legislation important? As an internist and pediatrician at Yale New Haven Hospital in New Haven and at Saint Mary’s Hospital in Waterbury, I feel strongly that this legislation could save lives and suffering in Connecticut. Specifically, this legislation would make the HPV vaccine an opt-out vaccine in Connecticut, meaning that schools would require the vaccine, but also give parents the agency to opt out of its administration.

Human Papillomavirus is a virus well-established in the scientific literature to cause cervical, vulvar, vaginal, penile, anal and head/neck cancers. The development of the HPV vaccine has been revolutionary for medicine. The HPV vaccine is the first and only vaccination of its kind to protect women and men from developing cancers associated with HPV.

In my practice, I take care of patients of all ages, from children to adults. I have taken care of countless patients with HPV-associated cancer. I also routinely counsel families on vaccines and administer vaccines to both children and adults. This puts me in a unique position to advocate for how I envision that this bill could positively affect our community.

When I was a newly minted physician on the inpatient oncology service at Smilow Cancer Center, I took care of a patient, who for privacy purposes, I’ll call Jane. Jane was in her early 30s and a young mother, with three young children and a doting husband. Jane had metastatic vulvovaginal cancer. If it was not enough that this young, vibrant mother had a lethal cancer, the cancer itself was disfiguring. Jane confided to me that she felt like a monster. Furthermore, the tissue was prone to infections.

And it was unimaginably painful for Jane. Despite continuous infusions of strong narcotics, we could not easily control Jane’s pain. I would often find Jane spending time with her three young children in the afternoon, the room full of their bright smiles and laughter. However, despite Jane’s strength and best efforts to fully engage with her children, I frequently saw her gritting her teeth and holding back tears. The reality of her suffering and premature demise was too much for her to bear. Jane, a loving and young mother, was slowly being torn away from her children’s lives.

This could have been avoided with a simple vaccine administration.

As physicians, we have excellent scientific evidence that the HPV vaccine prevents both HPV infections and cancers caused by HPV. The CDC estimates that there are 33,000 cases of cancer attributable to HPV each year. Many of these are in Connecticut.

When I counsel families on the HPV vaccine, I often think of Jane. I advocate for all children to be vaccinated. However, I have found that whereas families quickly accept that their child should and must receive other vaccines (which are required for school), the discussion about vaccination for HPV tends to be more challenging. When parents learn that schools do not require it, the importance of this vaccine feels discredited.

Despite my best efforts, I have not been able to vaccinate as many children as I would like. CDC data show that I am not alone in this — statewide in Connecticut we vaccinate children with the HPV vaccine approximately 20 percent less than other vaccines, such as the measles/mumps/rubella vaccine, which are required for schools.

Connecticut has the opportunity to be a leader in the nation in preventing HPV-associated cancer through opt-out vaccine legislation. We can make a powerful impact on our community in Connecticut with HB 7199. Please consider writing your local senator and representative to help Connecticut enact this change.