When it comes to the question of children getting vaccines, parents have pretty strong opinions. But it’s not always just yea or nay: Opinions can shift depending on which vaccine you’re talking about.
In my experience, when it comes to vaccines regularly recommended or required by children people are most comfortable with TDAP vaccines and most dubious with HPV vaccines.
I mention this duo because those two were in a recent study by folks at Dartmouth-Hitchcock Medical Center and Dartmouth College concerning vaccine hesitancy both before and after the COVID pandemic supercharged the antivaxx movement. I mention that study because it gave me a little bit of hope that the irrational, self-defeating pushback against vaccines might eventually fizzle out.
TDAP, which protects against tetanus, diphtheria and whooping cough (pertussis), has been part of school vaccines for a long time. HPV, which protects against the cancer-causing human papillomavirus, is newer.
In the study in question, Dr. Stephanie Harlow, chief obstetrics and gynecology resident at Dartmouth-Hitchcock, Dr. Illana Cass, OBGYN chair and professor of obstetrics and gynecology at Geisel Medical School, and Elizabeth Anderson, a Ph.D. candidate at Geisel, looked at vaccination records for 15,696 adolescents aged 9 to 18 within the Dartmouth Health system in New Hampshire and Vermont from 2019 to 2023.
They compared data before, during and after the pandemic to see what effect could be measured on the acceptance of these two vaccines, which that had nothing to do with COVID-19. In brief, they found that there was little decline in people getting TDAP shots but there was a real drop in HPV vaccination, especially among boys in urban areas.
That sounds depressing for those of us who realize the social benefit of vaccines: Rejection of a vaccine increased due to issues over a completely unrelated vaccine.
But I prefer to look at the glass half full: All the anti-vaccine craziness around COVID couldn’t really shake belief in TDAP, a vaccine that people are more familiar with. In other words, antivax sentiment can fade.
“Any time there’s a new vaccine, people are hesitant about it when it first comes out, which is justified, I think. But once there’s good data for it, especially if it’s a disease that people are impacted by on a day to day basis … they change,” said Harlow.
The HPV vaccine is newer, first approved by the FDA in 2006. It makes sense that it would be more susceptible to a general suspicion about vaccines.
And the HPV vaccine faces another problem. Although it can prevent many types of cancer it is linked in many people’s minds to girls having sex, and we know what that does to rational decision-making.
The reason for that perception is that HPV was developed to target cervical cancer in women, a nasty and pervasive problem. It was so effective that Cass recalled thinking 20 years ago, “I really thought, naively, ‘Oh, well, I will never see another woman with cervical cancer again.'”
Alas, the idea spread that the HPV vaccine somehow encouraged young girls to be promiscuous or was unnecessary because all parents know their sweet little girl isn’t a sexual being. It drew cultural backlash that has stalled its usage. This is a real shame, Cass said, because there are lots of horrible cancers that it can prevent.
“We are now seeing that there’s an absolute meteoric rise in oral cancers, especially HPV associated. Oral cancers tend to involve men more than women and used to be dominated by cigarette smoke, but no more,” said Cass. “Now, the most biggest rise is actually HPV mediated, and suddenly, guess who’s our best friend in our crusade to endorse HPV vaccination? Dentists.”
There’s a lesson there, Cass and Harlow said. Vaccines are science-based medicine but getting the word out requires feelings-based storytelling. Facts are necessary but not sufficient when people are making decisions about their health.
HPV vaccine became tainted in many minds because medical folks only talked about cervical cancer in girls. Trying to change the image now is hard.
The adoption of antivaxx sentiment in Washington and social media makes it even more important for those who understand the topic to get the word out, early and often. That means, of course, nurses and doctors.
“If folks have questions, just go talk to your doctor. There’s so much out there in social media and even now at administrative levels in our country that is deeply confusing, and doctors are happy to talk to you about these things,” said Cass.
Ignore the guy splashing in sewage to make a point and all those online BS artists — sorry, I mean influencers — chosen by algorithm. Listen to actual humans in the region who have spent time to understand the risks and rewards of one of humanity’s greatest accomplishments.
You can read the whole study, published in Journal of Pediatric and Adolescent Gynecology, at https://www.dartmouth-health.org/about/news/article/dartmouth-health-research-suggests-increased-hesitancy-post-covid-era-toward-standard.
