As if a sexually transmitted infection (STI) wasn’t bad enough, the human papillomavirus virus (HPV) is an STI that can cause cancer.

Fortunately, there is a vaccine against HPV recommended by the Centers for Disease Control and Prevention for all boys and girls aged 11 to 12. However, new research shows that while the number of children vaccinated is increasing, it is still far behind target.

Like HIV (Human Immunodeficiency Virus) and HSV (Herpes Virus), HPV is transmitted sexually. HPV infection can cause warts on the genitals and elsewhere, but is especially dangerous to the ability to cause cancer. The virus penetrates deep into the skin, through a cut or an accidental opening. There it finds its way into a cell and causes that cell to replicate very quickly.

Although HPV can cause cancer in those with penis, it is most commonly linked to cervical cancer in women.

Most medical advice is to vaccinate children with three doses at the age of 11 or 12 years before they are sexually active. This prevents HPV from taking hold. However, there are no national regulations and, unlike some vaccines, an HPV vaccine is not routinely required for public school attendance.

The nationwide study was conducted by researchers from Harvard University’s TH Chan School of Public Health and published in Pediatrics in October. Over 7 million children followed from 2003 to 2017; slightly less than half were girls. Over the 14 years of the study, the HPV vaccination rate increased, although more girls were vaccinated more often than boys.

But it wasn’t all good news. The researchers found large geographical differences.

In many states in the Midwest, East Coast, and West Coast, an average of more than half of all girls received two doses of the HPV vaccine. However, in most southern states, the vaccination rate for girls and boys was below 50%.

The researchers only looked at children with commercial insurance, which is just over half of all American children. Children on Medicaid were still receiving HPV vaccines, but at lower rates than children on commercial insurance.

It found that children who lived in urban areas were more likely to receive the HPV vaccine, as were children who lived in places with better pediatrician-to-child ratios.

Separately, the authors found that American children are unlikely to hit the 2020 target of 80% vaccination rates among 15-year-olds.

Affected parents should speak to their pediatrician about vaccinating their child. Although the vaccine is recommended at a younger age, it is still effective in older children. Not all types of HPV cause cancer, so people who are already sexually active should also receive the vaccine. Three doses of prevention is worth a pound of cure.

Sabrina Emms is a science journalist. She began as an intern on a health and science podcast on Philadelphia public radio. Before that, she worked as a researcher studying the way bones are formed. When she is not in the laboratory and at her computer, she is in the moonlight as an assistant to a pig veterinarian and bagel baker.

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