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CHICAGO — Many pediatricians and family doctors are not strongly recommending the cancer-preventing HPV vaccine to preteens and their parents, contributing to low vaccination rates, a survey of nearly 600 doctors suggests.

The vaccine protects against the human papillomavirus, which is spread through sex and can cause several kinds of cancer, including cervical cancer. The government wants girls and boys to get it at age 11 or 12 because it works best if kids get it before they become sexually active.

While nearly all doctors surveyed discuss the vaccine with at least some patients that young, more than one-third don't strongly recommend it for those ages. They were most likely to recommend vaccination and to give the shots to older kids and girls.

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The most common reasons doctors cited for delaying HPV discussions and vaccinations included a belief that patients hadn't had sex and that parents would object.

Noting that about one-third of all youth have had sex by age 16, the researchers said some doctors need a clearer understanding of reasons to vaccinate preteens.

The authors, led by University of Colorado researcher Dr. Allison Kempe, surveyed 582 pediatricians and family physicians by mail or online about two years ago.

The HPV vaccine has been available for girls since 2006 and for boys since 2011.

Associated Press