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What exactly are the new guidelines for vaccinating boys against HPV infection-and why is this development good news for both men and women?



We’ve invited Dr Meg Fisher, Chair of the Department of Pediatrics and Medical Director of the Children’s Hospital of Monmouth Medical Center in Long Branch, New Jersey, to discuss those new guidelines. Dr Fisher is a former member of the RedBook Committee on Infectious Diseases.  
 

New Guidelines for Vaccinating Boys Against HPV Infection

What exactly are the new guidelines for vaccinating boys against HPV infection-and why is this development good news for both men and women? 

Podcast: New Guidelines for Vaccinating Boys Against HPV Infection

Presidential candidate Michelle Bachmann recently made the unsubstantiated comment on national TV that the HPV vaccine has “very serious consequences” and that it can cause mental retardation. Do such statements have an impact on the lay public? How would you address the issue with your patients?

Here to address that clinical implications of this issue is pediatric nurse practitioner, Patsy Stinchfield, RN, MS, CPNP, who is Director of Infectious Diseases at Children’s Hospitals and Clinics of Minnesota.

Ms Stinchfield has provided the following list of web sites that she recommends as excellent sources of information about vaccines.



http://www.chop.edu/service/vaccine-education-center/home.html

http://www.texaschildrens.org/carecenters/vaccine/Default.aspx

Presidential candidate Michelle Bachmann recently made the unsubstantiated comment on national TV that the HPV vaccine has “very serious consequences” and that it can cause mental retardation.

HPV Vaccine: The Myths . . . and the Facts

HPV series initiation and completion was lower among adolescents seen at public vs private care settings and so was clinician guidance on vaccination in a new study. 

HPV Vaccination Rates, Clinician Recommendations Lag at Public Health Care Facilities  

According to a new CDC report, 38.6% of children aged 9-17 years received ≥1 doses of the HPV vaccine in 2022. 

CDC: One-Third of Children in US Received an HPV Vaccine Dose

Your daily dose of the clinical news you may have missed.

Daily Dose: Parental Stigma Toward HPV Vaccine Barrier to Adolescent Uptake

Parent's stigmatizing beliefs about the HPV vaccine may keep them from communicating openly with teens' clinicians, creating barriers to getting shots in arms.  

Parents Negative Beliefs about HPV Vaccination Create Barriers to Adolescent Uptake, a New Study Suggests 

Investigators from CDC warned, however, that HPV vaccinations missed due to the COVID-19 pandemic could stymie this progress. 

Impact of HPV Vaccination in US is Rising, and Herd Immunity is Getting Stronger, According to New Research

For frontline "immunizers," the upcoming flu season represents a "tall order," according to Immunization Action Coalition president and chief executive officer Kelly Moore, MD, MPH. 

In a recent interview with Patient Care Online Moore pointed out that "most clinicians haven't spent this much time focusing on vaccination in their career." And now, even as a 4th and dangerous surge of COVID-19 infection drives severe disease and hospitalizations, clinicians who deliver primary care will need to integrate influenza vaccines into their COVID-19 activities as well as look for gaps in routine adult and childhood vaccinations, she added.

"We can just about guarantee that any adult that walks into your clinic is missing some routine immunization [that] they need today."

Among other topics Moore discussed, she warned that unlike last year, influenza 

 this year and that without the strict infection mitigation measures enforced last year, the most effective  tool available is flu vaccination. The COVID-19 vaccine, Moore stressed, now can be coadministered with other routine immunizations which could, possibly, make this flu season's tall order easier to fill. 

is the president and chief executive officer of the Immunization Action Coalition where she previously served as deputy director. She also is adjunct associate professor of health policy at Vanderbilt University School of Medicine. 

The following has been edited for clarity. 

 So you have many years’ experience with influenza and its spread and containment, including leading the pandemic influenza preparedness Planning in Tennessee and also that state's vaccine distribution during the 2009 H1N1 pandemic. I'm interested in your thoughts on the influenza/respiratory virus season we're now approaching given this situation: the low case rates of last year; the potential for lower immunity against some flu strains in some Americans; the poor national appetite that's getting a little bit worse for resumed mitigation measures as we go into the season plus the overlap with the surge in the Delta variant of COVID-19. Do you feel there's a potential for the twindemic this year that we didn't see last year?

 That’s a question that everybody is wondering about. But one of the things that I learned close to 20 years ago, when I first started following influenza closely, is people cannot predict what influenza is going to do. And if someone tells you, they can predict what's going to happen, they're trying to sell you something. Because what we've learned—even the best experts hesitate to say what a flu season is going to look like. But the conditions that you've laid out, the fact that we had very little influenza last year means that we do have a lot of susceptible people out there. And the more important thing is that we saw how well the mask-wearing, the staying-at-home, the social distancing work to prevent influenza. And we don't intend to keep doing that this season. So since we're not going to be doing that, we have to go back and rely heavily on our traditional best strategies for protecting our health. And that's vaccination. So one of the things about preparedness is that you don't know what the crisis will be. So you have to be prepared every time. You can’t fight the last war. You know, last season was a wonderful remission from influenza that usually takes 10s of 1000s of American lives. So we got a break from that. We cannot expect a similar outcome this season for lots of reasons. And so it's incredibly important that we go ahead and move full force in encouraging our patients to be vaccinated this year, just like they would have before COVID.

And one of the things that is going to be really helpful for us is that we can now coadminister COVID vaccines and influenza vaccines together. So it's going to be really important to start teaching our patients right now, that influenza is going to come back and we need to be prepared for whatever influenza decides to throw at us, even if we can't predict exactly what the season’s going to look like.

 A good deal of guidance that we've been hearing on vaccine hesitancy and the resistance focuses on using science and providing facts to counter misinformation and the myth du jour, and on drawing people's fears out and using empathy? How effective is that in areas where health literacy is lower, and vaccine acceptance has really fallen off. What are our what are our options?

 One of the things we've been working on is health communication and trying to reach the unvaccinated and persuade them in different ways. And we've been studying that carefully. One of the conclusions that we've seen is that just data doesn't really help most people; just giving them more information doesn't tend to motivate them to make a decision to vaccinate. When you look at a patient's decision to vaccinate, it's really a matter of trust. And that can happen where whether they're highly literate in health issues or not so literate in health issues. If they trust their healthcare professional, their physician, their nurse practitioner, their pharmacist, a strong recommendation from a well-informed health professional actually is proven to be the most influential in that patient's decision to get vaccinated. So while the information is really valuable for us who are providing the health care, what we need is to maintain that trusting relationship. And if you are someone who has a relationship with a distrustful patient who's not sure about getting vaccinated, your strong recommendation is really the best thing that's going to make the difference in their decision to vaccinate. And if they have a concern, address that concern, and then restate your strong conviction that vaccination is the best way to protect their health. Sometimes people forget to come back to their original recommendation. And it's important to always return to that. And even if they don't make that decision today, keep bringing it up the next time. And if they really trust you, they will often change their mind and make a decision even if they don't understand all the science.

 What is your sense of how or if the vaccination climate will shift given the FDA’s approval of the Pfizer mRNA vaccine?

IAC president Kelly Moore, MD, MPH, has a long history of fighting flu and promoting vaccination. She talks about the influenza/COVID season to come and using the best tools we have.  



Immunization Action Coalition President and Flu Expert Dr Kelly Moore Explains Primary Care's "Tall Order" 

HPV

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