Maternal Child

Maternal Child Health ‹ Child Health Notes ‹ April 12

IHS Child Health Notes

"It doesn’t matter if the cat is black or white as long as it catches mice."

- Deng Hsaio P’ing 1904-1997

This is a page for sharing "what works" as seen in the published literature as well as what is done at sites that care for American Indian/Alaskan Native children. If you have any suggestions, comments or questions please contact Steve Holve, MD, Chief Clinical Consultant in Pediatrics at steve.holve@tchealth.org

April 2012

Articles of Interest

Quote of the month

“The world requires at least ten years to understand a new idea, however important or simple it may be.”
Sir Ronald Ross

Articles of Interest

Human Papillomavirus Vaccination Practices Among Providers in Indian Health Service,
Tribal and Indian Urban Health Facilities
Journal of Women’s Health, Volume 21, Number 4; 2012.

The human papillomavirus (HPV) vaccine is of particular importance in American Indian/Alaska Native women because of the higher rate of cervical cancer incidence compared to non-Hispanic white women. To better understand HPV vaccine knowledge among providers working with American Indian/Alaska Native populations, the authors conducted a provider survey in Indian Health Service, Tribal and Urban Indian (I/T/U) facilities in 2009 and 2010.

Providers were more likely to administer vaccine to 13–18-year-olds (96%) than to other recommended age groups (89% to 11–12-year-olds and 64% to 19–26-year-olds). Perceived barriers to HPV vaccination for 9–18-year-olds included parental safety and moral/religious concerns. Funding was the main barrier for 19–26-year-olds. Overall, providers were very knowledgeable about HPV, although nearly half of all providers and most obstetricians/gynecologists thought that a pregnancy test should precede vaccination.

This study shows that recommendations for HPV vaccination have been broadly implemented in I/T/U settings. Vaccination barriers for I/T/U providers are similar to those reported in other provider surveys. Provider education efforts should stress that pregnancy testing is not needed before vaccination.

Editorial Comment

Rates of sexually transmitted diseases and cervical cancer are higher in all IHS areas compared to the overall US rates. The HPV vaccine gives us the potential to prevent one of these sexually transmitted illnesses and cervical cancer. I/T/U sites have an advantage in that this expensive vaccine is available at no cost to our patients up to age 19 years through the Vaccine for Children’s program. Clinics should make every effort to use the RPMS immunization package to forecast when this vaccine is indicated. In addition, note that the HPV vaccine is now recommended for boys and also available through the VFC program at no cost to our clinics and patients up to 19 years of age.

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	Maternal Child Health ‹ Child Health Notes ‹ April 12 IHS Child Health Notes "It doesn’t matter if the cat is black or white as long as it catches mice." - Deng Hsaio P’ing 1904-1997 This is a page for sharing "what works" as seen in the published literature as well as what is done at sites that care for American Indian/Alaskan Native children. If you have any suggestions, comments or questions please contact Steve Holve, MD, Chief Clinical Consultant in Pediatrics at steve.holve@tchealth.org April 2012 Articles of Interest Quote of the month “The world requires at least ten years to understand a new idea, however important or simple it may be.” Sir Ronald Ross Articles of Interest Human Papillomavirus Vaccination Practices Among Providers in Indian Health Service, Tribal and Indian Urban Health Facilities Journal of Women’s Health, Volume 21, Number 4; 2012. The human papillomavirus (HPV) vaccine is of particular importance in American Indian/Alaska Native women because of the higher rate of cervical cancer incidence compared to non-Hispanic white women. To better understand HPV vaccine knowledge among providers working with American Indian/Alaska Native populations, the authors conducted a provider survey in Indian Health Service, Tribal and Urban Indian (I/T/U) facilities in 2009 and 2010. Providers were more likely to administer vaccine to 13–18-year-olds (96%) than to other recommended age groups (89% to 11–12-year-olds and 64% to 19–26-year-olds). Perceived barriers to HPV vaccination for 9–18-year-olds included parental safety and moral/religious concerns. Funding was the main barrier for 19–26-year-olds. Overall, providers were very knowledgeable about HPV, although nearly half of all providers and most obstetricians/gynecologists thought that a pregnancy test should precede vaccination. This study shows that recommendations for HPV vaccination have been broadly implemented in I/T/U settings. Vaccination barriers for I/T/U providers are similar to those reported in other provider surveys. Provider education efforts should stress that pregnancy testing is not needed before vaccination. Editorial Comment Rates of sexually transmitted diseases and cervical cancer are higher in all IHS areas compared to the overall US rates. The HPV vaccine gives us the potential to prevent one of these sexually transmitted illnesses and cervical cancer. I/T/U sites have an advantage in that this expensive vaccine is available at no cost to our patients up to age 19 years through the Vaccine for Children’s program. Clinics should make every effort to use the RPMS immunization package to forecast when this vaccine is indicated. In addition, note that the HPV vaccine is now recommended for boys and also available through the VFC program at no cost to our clinics and patients up to 19 years of age. Return to top of page