The HPV Pandemic

HPV Vaccination

Hampton, VA.---The one-story brick building housed three doctors and two registered nurses. For students at Hampton University, it was the main place they went for medical assistance. A safe place where private questions could be answered. It was Hampton University’s Health center where every first Friday of every month they could find out if they had contracted a sexually-transmitted disease.

This particular Friday, a cold winter wind rocked the tree branches in the parking lot. The heavy steel door opened to a sea of blue chairs against white walls. The TV played low as cold air filled the room; an unsettling tone of fear wandered through the small space.

A few women walked in and out of grey double doors at the end of a long corridor. Some held their heads slightly down while others, wearing blank faces, held them just low enough to see the white floor tiles as they walked.

The center opened in 2016, after gonorrhea and HIV rates increased throughout the Hampton Roads area. That year, 10,000 people tested positive for gonorrhea and over 600 people were living with HIV. The Hampton Health Center tests for HIV, gonorrhea, chlamydia and syphilis.

They do not test for HPV.

Human Papillomavirus aka HPV, is one of the most common forms of sexual infections in adults in the ages of 19-24, college students. Each year the U.S has a total of 14 million cases. Of those, 44,000 cases advance to cervical cancer.

(Human Papillomavirus Vaccine HPV)

Human Papillomavirus was first discovered in 1911 by a Johns Hopkins University graduate, Dr. Peytn Rous.

Rous started his research on a chicken with a lump in its breast, which he diagnosed as sarcoma, or tumor cells connected to tissue. He tested to see if the sarcoma could be caused by a virus.

Rous removed the bacteria and tumor cells from the chicken diagnosed with a sarcoma and injected the serum into another chicken. It began to develop tumors at an aggressive rate. Rous concluded that the tumor agent was a virus.

More than 70 years later, in 1983 Dr. Harald Zur Hausen picked up on Dr. Rous’s research in his search for viruses in human genitial warts. He determined that a virus indeed caused the cancer, naming it, HPV-11.

Next, he turned his attention to cervical cancer, testing HPV-11 in twenty-four cases of cervical cancer. It tested positive in three out of twenty-four cases. He continued his testing on HPV-16, confirming half were positive for cervical cancer.

Twelve years later, in 1995, The International Biological Study Of Cervical Cancer confirmed HPV in 90 percent of cervical cancer samples. They used samples of Cervical Cancer from 22 countries confirming 93 percent of the samples positive with HPV. In 2006 the U.S. Food and Drug Administration(FDA) approved Gardisal as an HPV vaccination in women only ages 9 to 26.

By 2007, the number of cervical cancer cases had risen to 11,150 and caused over 3,000 deaths, according to the American Cancer Society.

The infection enters the body by genital, anal, oral or skin-to-skin contact. In addition to cancer, it can cause genital warts, hand warts and rashes all over the body. For women these rashes normally form behind the legs.

HPV can show no symptoms as it begins to develop into an invasive cancer. It can take up to 20 years to fully develop in a woman with a well-functioning immune system, according to the World Health Organization. In a woman, with a weakened immune system, it can take up to five to ten years to become one of the most feared cancers, Cervical Cancer.

The infection has been linked to six different cancers in the cervical, throat, penis, vagina, vulva and anus. The HPV vaccination is the first proven deterrent against these cancers, though once contracted, the infection can be tested through a Pap smear for women. For men there is no approved screening.

Ninety percent of cervical cancer and 70 percent of mouth and throat cancers have been linked to the HPV virus, carried by at least 79 million Americans.

Despite these numbers, some colleges and universities- including Hamton-do not require the HPV vaccination for medical clearance during the admission process.

Shanece Martin, a 2018 Hampton University Alumni, is on her second dosage of the HPV series. She has been doing this on her own since the university did not require it.

“I did not get vaccinated when I was young because I was not sexually active and my mom was not comfortable with me getting the vaccination. Of course as I’ve gotten older, I realized the vaccination was a good idea,” Martin said.

Hampton University requires five vaccinations for medical clearance including; Meningococcal Meningitis Tetravalent, Hepatitis B, Polio, TDap Booster(Tetanus-Diphtheria) and MMR(measles-mumps-rubella).

2007, Virginia was the first state in the country to require sixth-grade girls to get vaccinated to attend public schools. A total of four U.S jurisdictions have followed suit including Puerto Rico, Rhode Island, District of Columbia and Virginia. Still, there is resistance to the requirement.

While these states require all sixth-grade girls to be vaccinated to attend public school, the requirement does not extend to colleges.

HPV ranks as No. 3 in the top four vaccinations that students should get before college, according to the Consumer Reports article.

Despite this, just 49 percent of adolescents were up to date on the HPV vaccine in 2017, while 66 percent of 13 to 17 year olds had received their first dose to start their vaccine series, according to the Center for Disease Control and Prevention

“There are 4 categorical reasons in which parents delay or refuse vaccinations: religious reasons, personal or philosophical beliefs, safety concerns, and the desire for more information,” said Hampton University’s health education specialist, Meghan Hill.

In 2012, Virginia Del. Kathy Bryon, proposed a bill to try to revoke the state’s HPV vaccination law. Parents had expressed concerns that the vaccination encourages children to have sex and they did not want the state making the decision for them. The house passed the bill, but it was blocked by the senate.

A Father Debates

Mr. S, the father of three, sat at his office in Hampton, VA, his curly, dark brown hair cut short. His white and blue button up shirt rested over his round belly. On the cabinet behind him were pictures of his family, his wife, son and two daughters. His daughters are 24 and 25 and his son is 19.

Mr. S and his family live in Newport News, VA. All attended school there. His two daughters were already in college when the law passed, in 2009, requiring HPV vaccinations, while his son was in the third grade.

The law did not include boys, since the main focus was on preventing cervical cancer.

Once men started to get Oropharyngeal(throat) Cancer, things started to change. The (Center for Disease Control and Prevention)CDC recommended that men too start their HPV series at age 11.

There is no screening for men. The only prevention is the HPV vaccine. Over 7,000 men die from throat cancer a year, according to American Cancer Society. Oropharynx cancer has a survival rate of 54 percent if the cancer is treated before the cancer spreads beyond the larynx. If the cancer is diagnosed after it has progressed the survival rate is 45 percent.

Oropharyngeal cancers traditionally have been caused by tobacco and alcohol, but recent studies show that about 70% of cancers of the oropharynx may be linked to HPV, according to the Center For Disease Control and Prevention(CDC).

Still some parents- including Mr. S- remained unconvinced.

“I didn't feel that my son needed to be vaccinated, I only wanted him to get certain shots. Specifically the main shots like MMR and Tetanus, the basic shots,” he said in a stern voice.

Mr. S did not believe his son, who attends Norfolk State University, would ever come in contact with the virus. Ms. S’ son attends Norfolk State University.

The odds are against him.

Most college campuses have an active party life where thousands of students engage in sexual activity. A virus as common as HPV can latch to any host,even by skin-to-skin contact.

“I was aware of the possibility of contracting STD’s/STI’s in college, but I wasn’t afraid. I was just careful as I could be,”said Mr. S said of his own college experience in the 80’s.

“ When you’re young, it’s a little harder to be afraid. You feel smart and in most cases that is a recipe for disaster.”

Mr. S’s son has not received the HPV vaccination. The vaccination was not required for admission into his University.

The Burden

Cervical Cancer is the fourth most common cancer in women in the United States. Killing 313,000 women each year. Women diagnosed with cervical cancer have a five-year survival rate at 66 percent. They also may not be able to have children and may need to have the cervix removed.

Women between 20-24 contract the HPV infection at a higher rate than any other age group. The HPV vaccination is 90 percent effective.

The cervix is a small narrow organ forming the lower end of a woman's uterus. When abnormal changes develop in the lining of the cervix, the cancer could start to form.

A pap smear, a routine screening during annual pelvic exams, is the only test that can help detect abnormal cells in the cervix. The CDC recommends to start screenings at 21, but one in four fail to do so.

The pap smear and HPV vaccine are the only preventions against cervical cancer, according to the American Cancer Society. The Hampton University health center provides access to these two HPV preventions.

Wrap Up

The American College Health Association(NCHA) is an organization that serves students health and wellness. They advocate for advancing the health of college students, education and search. The organization represents 1,100 higher education institutions. The NCHA releases a document as health guidelines are updated for college vaccinations.

The last document was released in 2018. It included the HPV vaccine as a listed recommendation for college admission. Their guidelines follow the CDC. The association also provides colleges with sample immunization record forms for students.

In 2016, over 34,000 HPV cases were reported in the U.S., according to the CDC. Following in 2018, there were a total of 5.5 million new HPV cases. As cervical and orphanarx cancer cases continue to increase, colleges are still excluding HPV vaccinations for admission requirements.

The Hampton Health Center has not adjusted vaccination requirements under these circumstances.

The health center is touted as a safe haven for students to get medical assistance. Yet, Hampton’s medical requirements do not include the HPV vaccination. The infection lurks on campus posing a threat to student health.