Selected Podcast
HPV Vaccine Awareness and Education
Dr. Annabelle Veerapaneni discusses what you should know about HPV and the HPV vaccine.
Featured Speaker:
Annabelle Veerapaneni, MD
Dr. Annabelle Veerapaneni received her medical education from the Southern Illinois University School of Medicine. She then went on to complete her residency at McGaw Medical Center of Northwestern University, Evanston Northwestern Healthcare and fellowship at Georgetown University Hospital/Washington Hospital Center. Board-Certified in Medical Oncology, Hematology and Internal Medicine, Dr. Veerapaneni sees patients at Riverside Cancer Institute in Bourbonnais, IL. Transcription:
Alyssa Diaz (Host): Welcome to the Well Within Reach podcast. I'm your host, Alyssa Diaz, and today we have with us medical oncologist and hematologist Dr. Annabelle Veerapaneni. The topic today is HPV vaccine awareness and education. Before we get into the topic, I'd like to introduce Dr. Veerapaneni. So Dr. V, thank you for joining us today. Would you like to give us a brief description on your role as a medical oncologist and hematologist, and what that specialty means?
Annabelle Veerapaneni MD (Guest): Well, first off thank you very much for having me here. So as a medical oncologist, I treat individuals who are afflicted with solid tumors, malignant hematologic issues. As a hematologist, I also treat benign hematologic issues. So ladies who have iron deficiency, or even men who do. It’s a range of disease. A range of diseases, but something that I really, really enjoy doing.
Host: Something that goes right along with those things is the importance and emphasis on prevention. So today for our podcast we’re going to be talking about the importance of HPV vaccinations in today’s youth. So let’s just start with what is the HPV vaccine, and why is it so important?
Dr. Veerapaneni: So I think a lot of people might find it odd that a medical oncologist would be coming onto a podcast to promote HPV vaccination, but yes. You absolutely hit the nail on the head. I'm really all about cancer prevention because I truly believe that HPV vaccination is one of the true methods of cancer prevention. Right now everything that I do to help patients is in terms of risk reduction. So when we talk about smoking cessation, weight loss, trying to avoid known toxins in the environment or behaviors that can promote cancer growth, we’re really talking about reducing risk. When you are able to vaccinate an individual with an HPV vaccine, that truly is cancer prevention in the sense that it prevents the infection that can then lead to cancer.
So the Gardasil 9 vaccine is the only one that’s currently available in the United States. It is a vaccine that is directed against seven different strains that can cause cancers of the cervix, of the anal region, the penis, vagina, vulva. It can also cause oropharyngeal cancers, what we call head and neck cancers. So by educating individuals about the importance of HPV vaccination, so that way individuals can be protected from the infection, those individuals then will not be at risk for developing the cancers that can develop as a result of the infection later on in life.
Host: Yeah, and you made some really good points. It’s multiple cancers. We need to do our part to make sure that we’re preventing any and all that we can. I read somewhere that every year in the United States alone, 30,000 people are diagnosed with cancers caused by HPV, and that’s pretty staggering.
Dr. Veerapaneni: That’s correct. I mean if you think about it, that’s enough to fill a baseball stadium. So it’s a really staggering number. If there’s something we can do to honestly prevent that from happening, I really feel strongly that we can take those measures to enforce that.
Host: Absolutely. Could you elaborate on why preventing cancer is better than treating it? Furthermore, preventing the infections that lead to cancer is even better. Just kind of explain that mindset.
Dr. Veerapaneni: Absolutely. So in terms of the HPV vaccination, what we’re trying to do is encourage the vaccination of all of our youths, both males and females, starting at ages 11 and 12 whenever they're going to be due for their routine vaccinations for school anyway. So at the time they come in for their sixth grade physical, they’re already going to be receiving their vaccines for meningitis, for whooping cough, for tetanus. So it’s a very wonderful opportunity to tack on another vaccination that we know can prevent infection and cancer.
In the sense of prevention, we know that youth that young will have a very robust immune response and be able to fight off infection much more readily than other individuals. So HPV stands for human papilloma virus. It’s essentially a very ubiquitous virus that pretty much 95% of the adult population in the United States has been effected by. So most individuals acquire it by sexual contact, but it can literally be transmitted skin to skin. So most teenagers, most young adults, are usually infected by it, but most individuals usually clear it. So there’s a number of individuals who will develop chronic changes within their cells that then lead to cancer as a result of this HPV infection.
Some of the strains of HPV can lead to noncancerous lesions like genital warts, but some of the strains of this HPV can cause precancerous lesions which can be identified at times of a pap smear. Then the gynecologist would then follow up with routine examinations and perhaps a colposcopy, biopsies. Those procedures as a result of having these lesions, whether they're noncancerous or precancerous or even cancerous leads to a lot of morbidity. It can cause a lot of stress, both psychologically and emotionally, as well as financially for women. For men who are also effected by issues like genital warts, that can also create a lot of issues for them too.
Host: Absolutely. Getting back to the vaccination itself, what are the recommendations for girls and for boys?
Dr. Veerapaneni: So current recommendations from the Centers for Disease Control are that every 11 and 12 year old boy and girl should be vaccinated against HPV. The virus was first introduced in 2006. At the time recommendations were only for females. Then in 2011, the CDC expanded the recommendation to include boys. Then in June of 2016, the recommendation was for all 11 and 12 year old boys and girls to be vaccinated. Because what they found was that the increased number of youths being vaccinated lead to a decreased number of precancerous lesions being identified in girls, and there was a herd immunity effect where it also translated to boys not getting effected. Therefore, infecting other individuals. To be able to vaccinate the entire population would really be a wonderful thing, but unfortunately out of all the developed countries in the world, the United States really lags behind doing this. So we’re lucky if maybe 60% of our U.S. population is vaccinated appropriately.
Host: Wow. That’s pretty staggering. I'm glad that you mentioned that for girls and for boys because I think there’s a lot of misconception out there, at least there used to be, about only assuming that girls needed to be vaccinated for this.
Dr. Veerapaneni: That’s correct. In fact, I still run into it. Nurses that I speak to will say, “Oh, I never thought about having my sons vaccinated.” So it’s really important that everyone understands that recommendations for vaccination include both boys and girls, and because it’s because of the way that it can be transmitted from male to female, male to male, from female to female.
Host: Okay. Now because of its relative nature, the discussion of the HPV prevention and awareness can be difficult to face. What are some good things to keep in mind when discussing this topic with your healthcare provider or even with your children?
Dr. Veerapaneni: So when I talked to other parents and they have questions about the relative nature and, I guess, the insinuations that can be made about making recommendation for vaccinating against something that can be sexually transmitted. What I usually counsel patients and parents about is that we’re talking about prevention against infection because ultimately that’s what it’s about. The conversation that’s been had doesn’t have to include whatever your own cultural beliefs are regarding sexual contact. I think ultimately if we frame the conversation to emphasize prevention against infection then I think parents are a lot more willing to accept that information because they don’t necessarily feel like their own personal beliefs and values are being impinged upon.
My husband and I believe so strongly in HPV vaccination and prevention that we’ve already vaccinated our 12 year old. So she completed the series this past spring. When her younger sister is of age, she’ll begin the vaccination series when she turns 11. So it can be kind of an uncomfortable situation if you allow for it to be, but I think whenever you focus on the scientific information, the data that supports the knowledge. That yes, we are seeing decreased rates of precancerous lesions dropping by anywhere from 40 to 70%. In other areas of the world that are doing a much better job of vaccination than we are, places like Scotland and Australia, I think the United States has a lot of catching up to do.
Host: Yeah. So as parents, maybe perhaps a family conversation is today we’re going to get your vaccinations. They include this, this, and this. Oh, and there’s an HPV vaccination as well. Oftentimes children don’t question further than that. They just know they're getting a shot and are gonna need a band aid at the end of it. So really just making sure that we’re being diligent as parents and protecting our children and having those conversations when we feel it’s appropriate.
Dr. Veerapaneni: Absolutely. I think it really helps for providers to understand that there are a wealth of resources out there right now to help have that conversation with parents whenever they come into the primary care office and they have questions about the vaccine. What should I anticipate, why should I go ahead and do it? So one common approach is to look at the HPV vaccine in the same way and to receive it on the same day as the other vaccines. So that way, as you mentioned, those individuals getting vaccinated for the other diseases can get vaccinated against this one. I think as long as there’s a uniform message starting from the front desk staff that is uniform all throughout the office staff, everyone rooming the patients to the physicians and the nurses, then I think parents feel much more comfortable allowing their child to go ahead and receive an extra vaccination.
Host: Yeah. That makes perfect sense. Are there other resources for individuals who are looking for more information on this topic that you recommend?
Dr. Veerapaneni: So the Centers for Disease Control has a wonderful website with regards to information about HPV vaccination. I also encourage patients to go to the World Health Organization for information. The American Academy of Pediatrics as well as the American Academy of Family Physicians are all wonderful resources in terms of why individuals should get vaccinated against HPV. I know that vaccine safety is also a very big issue for parents and understandably so. The CDC and the FDA have two different reporting systems that are in place to help parents understand that the vaccine is being monitored very carefully in post-marketing surveillance studies to ensure the safety and efficacy of the vaccine. The World Health Organization itself also has this committee—it’s the Global Advisory Committee on Vaccine Safety—that also investigates reports about potential concerns about reactions being caused by the vaccine. But to date, there have not been any relationships identified.
Host: So all of the resources there it’s going to help you get a clear understanding of these vaccines, the safety understanding precautions, et cetera. All of the resources are there for the taking. Dr. Veerapaneni, in closing, what is your take away message?
Dr. Veerapaneni: So the take away message I would encourage parents to receive is that the vaccine is safe. It’s very effective. It’s truly one of the biggest things we can do to prevent cancer.
Host: Thank you very much for joining us today. If you seek more information, visit the resources that Dr. Veerapaneni has shared as well as riversidehealthcare.org. This is Alyssa Diaz signing off with the Riverside Well Within Reach podcast.
Alyssa Diaz (Host): Welcome to the Well Within Reach podcast. I'm your host, Alyssa Diaz, and today we have with us medical oncologist and hematologist Dr. Annabelle Veerapaneni. The topic today is HPV vaccine awareness and education. Before we get into the topic, I'd like to introduce Dr. Veerapaneni. So Dr. V, thank you for joining us today. Would you like to give us a brief description on your role as a medical oncologist and hematologist, and what that specialty means?
Annabelle Veerapaneni MD (Guest): Well, first off thank you very much for having me here. So as a medical oncologist, I treat individuals who are afflicted with solid tumors, malignant hematologic issues. As a hematologist, I also treat benign hematologic issues. So ladies who have iron deficiency, or even men who do. It’s a range of disease. A range of diseases, but something that I really, really enjoy doing.
Host: Something that goes right along with those things is the importance and emphasis on prevention. So today for our podcast we’re going to be talking about the importance of HPV vaccinations in today’s youth. So let’s just start with what is the HPV vaccine, and why is it so important?
Dr. Veerapaneni: So I think a lot of people might find it odd that a medical oncologist would be coming onto a podcast to promote HPV vaccination, but yes. You absolutely hit the nail on the head. I'm really all about cancer prevention because I truly believe that HPV vaccination is one of the true methods of cancer prevention. Right now everything that I do to help patients is in terms of risk reduction. So when we talk about smoking cessation, weight loss, trying to avoid known toxins in the environment or behaviors that can promote cancer growth, we’re really talking about reducing risk. When you are able to vaccinate an individual with an HPV vaccine, that truly is cancer prevention in the sense that it prevents the infection that can then lead to cancer.
So the Gardasil 9 vaccine is the only one that’s currently available in the United States. It is a vaccine that is directed against seven different strains that can cause cancers of the cervix, of the anal region, the penis, vagina, vulva. It can also cause oropharyngeal cancers, what we call head and neck cancers. So by educating individuals about the importance of HPV vaccination, so that way individuals can be protected from the infection, those individuals then will not be at risk for developing the cancers that can develop as a result of the infection later on in life.
Host: Yeah, and you made some really good points. It’s multiple cancers. We need to do our part to make sure that we’re preventing any and all that we can. I read somewhere that every year in the United States alone, 30,000 people are diagnosed with cancers caused by HPV, and that’s pretty staggering.
Dr. Veerapaneni: That’s correct. I mean if you think about it, that’s enough to fill a baseball stadium. So it’s a really staggering number. If there’s something we can do to honestly prevent that from happening, I really feel strongly that we can take those measures to enforce that.
Host: Absolutely. Could you elaborate on why preventing cancer is better than treating it? Furthermore, preventing the infections that lead to cancer is even better. Just kind of explain that mindset.
Dr. Veerapaneni: Absolutely. So in terms of the HPV vaccination, what we’re trying to do is encourage the vaccination of all of our youths, both males and females, starting at ages 11 and 12 whenever they're going to be due for their routine vaccinations for school anyway. So at the time they come in for their sixth grade physical, they’re already going to be receiving their vaccines for meningitis, for whooping cough, for tetanus. So it’s a very wonderful opportunity to tack on another vaccination that we know can prevent infection and cancer.
In the sense of prevention, we know that youth that young will have a very robust immune response and be able to fight off infection much more readily than other individuals. So HPV stands for human papilloma virus. It’s essentially a very ubiquitous virus that pretty much 95% of the adult population in the United States has been effected by. So most individuals acquire it by sexual contact, but it can literally be transmitted skin to skin. So most teenagers, most young adults, are usually infected by it, but most individuals usually clear it. So there’s a number of individuals who will develop chronic changes within their cells that then lead to cancer as a result of this HPV infection.
Some of the strains of HPV can lead to noncancerous lesions like genital warts, but some of the strains of this HPV can cause precancerous lesions which can be identified at times of a pap smear. Then the gynecologist would then follow up with routine examinations and perhaps a colposcopy, biopsies. Those procedures as a result of having these lesions, whether they're noncancerous or precancerous or even cancerous leads to a lot of morbidity. It can cause a lot of stress, both psychologically and emotionally, as well as financially for women. For men who are also effected by issues like genital warts, that can also create a lot of issues for them too.
Host: Absolutely. Getting back to the vaccination itself, what are the recommendations for girls and for boys?
Dr. Veerapaneni: So current recommendations from the Centers for Disease Control are that every 11 and 12 year old boy and girl should be vaccinated against HPV. The virus was first introduced in 2006. At the time recommendations were only for females. Then in 2011, the CDC expanded the recommendation to include boys. Then in June of 2016, the recommendation was for all 11 and 12 year old boys and girls to be vaccinated. Because what they found was that the increased number of youths being vaccinated lead to a decreased number of precancerous lesions being identified in girls, and there was a herd immunity effect where it also translated to boys not getting effected. Therefore, infecting other individuals. To be able to vaccinate the entire population would really be a wonderful thing, but unfortunately out of all the developed countries in the world, the United States really lags behind doing this. So we’re lucky if maybe 60% of our U.S. population is vaccinated appropriately.
Host: Wow. That’s pretty staggering. I'm glad that you mentioned that for girls and for boys because I think there’s a lot of misconception out there, at least there used to be, about only assuming that girls needed to be vaccinated for this.
Dr. Veerapaneni: That’s correct. In fact, I still run into it. Nurses that I speak to will say, “Oh, I never thought about having my sons vaccinated.” So it’s really important that everyone understands that recommendations for vaccination include both boys and girls, and because it’s because of the way that it can be transmitted from male to female, male to male, from female to female.
Host: Okay. Now because of its relative nature, the discussion of the HPV prevention and awareness can be difficult to face. What are some good things to keep in mind when discussing this topic with your healthcare provider or even with your children?
Dr. Veerapaneni: So when I talked to other parents and they have questions about the relative nature and, I guess, the insinuations that can be made about making recommendation for vaccinating against something that can be sexually transmitted. What I usually counsel patients and parents about is that we’re talking about prevention against infection because ultimately that’s what it’s about. The conversation that’s been had doesn’t have to include whatever your own cultural beliefs are regarding sexual contact. I think ultimately if we frame the conversation to emphasize prevention against infection then I think parents are a lot more willing to accept that information because they don’t necessarily feel like their own personal beliefs and values are being impinged upon.
My husband and I believe so strongly in HPV vaccination and prevention that we’ve already vaccinated our 12 year old. So she completed the series this past spring. When her younger sister is of age, she’ll begin the vaccination series when she turns 11. So it can be kind of an uncomfortable situation if you allow for it to be, but I think whenever you focus on the scientific information, the data that supports the knowledge. That yes, we are seeing decreased rates of precancerous lesions dropping by anywhere from 40 to 70%. In other areas of the world that are doing a much better job of vaccination than we are, places like Scotland and Australia, I think the United States has a lot of catching up to do.
Host: Yeah. So as parents, maybe perhaps a family conversation is today we’re going to get your vaccinations. They include this, this, and this. Oh, and there’s an HPV vaccination as well. Oftentimes children don’t question further than that. They just know they're getting a shot and are gonna need a band aid at the end of it. So really just making sure that we’re being diligent as parents and protecting our children and having those conversations when we feel it’s appropriate.
Dr. Veerapaneni: Absolutely. I think it really helps for providers to understand that there are a wealth of resources out there right now to help have that conversation with parents whenever they come into the primary care office and they have questions about the vaccine. What should I anticipate, why should I go ahead and do it? So one common approach is to look at the HPV vaccine in the same way and to receive it on the same day as the other vaccines. So that way, as you mentioned, those individuals getting vaccinated for the other diseases can get vaccinated against this one. I think as long as there’s a uniform message starting from the front desk staff that is uniform all throughout the office staff, everyone rooming the patients to the physicians and the nurses, then I think parents feel much more comfortable allowing their child to go ahead and receive an extra vaccination.
Host: Yeah. That makes perfect sense. Are there other resources for individuals who are looking for more information on this topic that you recommend?
Dr. Veerapaneni: So the Centers for Disease Control has a wonderful website with regards to information about HPV vaccination. I also encourage patients to go to the World Health Organization for information. The American Academy of Pediatrics as well as the American Academy of Family Physicians are all wonderful resources in terms of why individuals should get vaccinated against HPV. I know that vaccine safety is also a very big issue for parents and understandably so. The CDC and the FDA have two different reporting systems that are in place to help parents understand that the vaccine is being monitored very carefully in post-marketing surveillance studies to ensure the safety and efficacy of the vaccine. The World Health Organization itself also has this committee—it’s the Global Advisory Committee on Vaccine Safety—that also investigates reports about potential concerns about reactions being caused by the vaccine. But to date, there have not been any relationships identified.
Host: So all of the resources there it’s going to help you get a clear understanding of these vaccines, the safety understanding precautions, et cetera. All of the resources are there for the taking. Dr. Veerapaneni, in closing, what is your take away message?
Dr. Veerapaneni: So the take away message I would encourage parents to receive is that the vaccine is safe. It’s very effective. It’s truly one of the biggest things we can do to prevent cancer.
Host: Thank you very much for joining us today. If you seek more information, visit the resources that Dr. Veerapaneni has shared as well as riversidehealthcare.org. This is Alyssa Diaz signing off with the Riverside Well Within Reach podcast.