Human papillomavirus vaccination uptake among childhood cancer survivors in Western New York

Abstract

Introduction The risk of human papillomavirus (HPV)‐associated cancers is significantly higher among survivors of a childhood cancer compared to the general population. Despite this, their HPV vaccine uptake rates are lower. We examined factors related to HPV vaccine uptake among childhood cancer survivors from Western New York over 13 years following the introduction of HPV vaccines. Methods Retrospective review of patients diagnosed with invasive or noninvasive cancerous conditions at age 9 or younger treated at Roswell Park Oishei Children's Cancer and Blood Disorder Program. We matched vaccine date information for patients aged 9–26 years between 2006 and 2020 from the New York State Immunization Information System. Demographic and cancer‐related information was abstracted from electronic medical records. Cumulative vaccine uptake was assessed by Kaplan–Meier and Cox proportional hazards regression models. Results A total of 284 patients were included in the analyses. Most were non‐Hispanic/White (80.3%) and resided in a metropolitan area (81.7%). Approximately half had leukemia or lymphoma (54.9%), and most received chemotherapy. Females were more likely to initiate the HPV vaccine and did so sooner (median = 5.5 years) than males (median = 5.7 years; log‐rank p = .301). Patients who were older at vaccine eligibility and males who received blood product transfusions were significantly less likely to initiate the HPV vaccine. Conclusion While rates of HPV vaccine initiation have been increasing with time among childhood cancer survivors, they remain low overall, with differences seen by treatment and diagnosis. Our findings support the need for further research to optimize HPV vaccine delivery in cancer care.

Human Papillomavirus Vaccination in Pediatric, Adolescent, and Young Adult Cancer Survivors—Opportunity to Address Gaps in Cancer Prevention and Survivorship

“…Vaccination is imperative for preventing HPV-related disease because, aside from cervical and anal cancer screening tests (e.g., Papanicolaou (Pap) test, HPV DNA tests), there is a lack of screening tools for other types of HPV-related cancers [ 7 ]. However, HPV vaccination rates in the U.S. remain suboptimal, attributed to missed opportunities for vaccination (i.e., health visits during which at least one vaccine, other than the HPV vaccine, is received) [ 21 , 22 , 23 ]. The Centers for Disease Control and Prevention (CDC) estimated that if the HPV vaccine was administered to all adolescent girls born in the year 2000 during health visits when they received another vaccine, HPV vaccine initiation by age 13 years could have reached 91.3% [ 24 ].…”

“…The current HPV vaccines available to the general population have been shown to be safe and effective for cancer survivors [ 27 ], and the CDC and Children’s Oncology Group (COG) recommend vaccinating patients within 6 months after cancer treatment [ 25 ]. Despite this, HPV vaccination rates among young cancer survivors remain low; compared to the general population, HPV vaccination rates are as much as 20% lower for PYAC survivors and are well below the 80% Healthy People 2030 target [ 23 , 30 , 31 , 32 , 33 ]. A recent review of five cancer centers reported that only 24% of cancer survivors have initiated HPV vaccination, with just 13.5% completing the vaccine series [ 31 ].…”

“…A recent review of five cancer centers reported that only 24% of cancer survivors have initiated HPV vaccination, with just 13.5% completing the vaccine series [ 31 ]. In addition, a recent study at our cancer center showed that less than half of pediatric cancer survivors received at least one dose after five years, and less than a quarter completed all required doses in the vaccine series [ 23 ].…”

“…Whereas pediatric oncology providers endorse the HPV vaccination of young cancer survivors, many lack the resources or opportunities to intervene [ 41 ]. The responsibility of the HPV vaccination of PYAC survivors, therefore, falls to primary care providers (PCPs), but remains suboptimal, as reflected by the low vaccination rates [ 23 , 31 , 32 , 33 ]. This article provides a brief overview of the challenges and opportunities associated with increasing HPV vaccine coverage among PYAC survivors.…”

Pediatric hematology and oncology physician and nurse practitioner views of the HPV vaccine and barriers to administration

“… 12 A western New York retrospective review of 312 patients diagnosed with cancer at under 10 y old found that only 43.5% (27/62) males and 55.1% (43/78) of females had completed the three-dose vaccine series. 13 …”