Older age groups could benefit from HPV vaccine

I would like to thank Dr. Linus Chang for his thorough presentation and call to awareness of the HPV vaccine benefits. (“HPV vaccine provides safe protection,” The Norwalk Hour, Jan. 10)

In addition to protecting the generation of females now 24 and younger and the males 19 and younger, we must not overlook the benefit to the older population age groups. The FDA approved the HPV vaccine for catch up in the age 11-to-26 range after the supply of vaccine for the 11-to-12 age range was adequate for administration. In just 2018 the FDA approved the vaccine for the 27-to-45 at-risk population to have the option of receiving the vaccine series. This is the group that is neither in the 11-to-12 recommended vaccination range nor the catch-up range.

The age group 27-to-45 is the most stable in terms of divorce rates and thus at lowest risk of new infection with HPV. (The highest divorce groups are age 21-to-24 and lowest age 40+) The divorce rate of the 50+ age range from 1990 to 2015 has increased by more than 100 percent. Thus, we must define the at-risk population.

As mentioned by Dr. Chang, almost everyone has been exposed to a strain of the HPV. However, the 50+ age group was not vaccinated and also just at the era where condoms for STD protection were encouraged. This population, however, does not need protection from pregnancy and thus the importance of condoms should not be lessened but since this fear of pregnancy is gone, they are not used.

As it stands, insurance companies cover fully the vaccine cost in the 11-to-26 age range for it is categorized as preventive care. The availability of the coverage and the level of coverage is at the insurance companies’ discretion in this much needed age group 27-to-45 and possibly the 50+ divorcee population.

Yes, the vaccine is 98 percent effective for prevention of the nine strains of HPV in the 11-to-26 age range and only 88 percent in the 27-to-45 age range (for at least four years as to date studied), yet would any percentage of protection from cervical, anal, vulvar and oral cancer be of benefit if the 45+ age group could elect to be vaccinated?

Physicians must educate their patients as to the availability of the vaccine when applicable by a thorough social/sexual history taking. In addition, physicians should pressure insurance coverage for this vaccine as it prevents future morbidity and cost to the population.