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A recent federal report finds that not nearly enough children are being vaccinated against the human papillomavirus, or HPV. The virus causes some STDs and a number of genital cancers.

As NPR's Patti Neighmond reports, there are several reasons why children may not be getting the safe and highly effective vaccine.

PATTI NEIGHMOND, BYLINE: HPV is the most common sexually transmitted infection. Nearly all sexually active men and women will get at least one type of the virus at some point in their lives. There are more than 40 different types of HPV; a few cause serious problems like genital warts and certain cancers, including cervical, anal and penile cancer. Most people never know they're infected, and it usually goes away by itself without causing health problems.

Shannon Stokely is an epidemiologist with the Centers for Disease Control and Prevention.

SHANNON STOKELY: The thing is, we don't know who is going to develop cancer. We don't know who will clear the infection. And that's why it's critical that we vaccinate our adolescents with this vaccine so that they're protected long before they're ever exposed to this virus.

NEIGHMOND: It's recommended the first of three doses is given to children when they're 11 or 12, a second dose about a month later, and a third within six months.

STOKELY: This vaccine has high efficacy. We know it protects against four types of HPV. Two of the types cause about 70 percent of the cervical cancer in this country. And then the other two types cause about 90 percent of the genital warts.

NEIGHMOND: In fact, a recent study found HPV prevalence was reduced by more than half among teenage girls who were vaccinated. Even so, federal officials say only one-third of girls, and not even 10 percent of boys, have been vaccinated.

STOKELY: This is a vaccine that protects against cancer. What could be better than that?

NEIGHMOND: Stokely says it's not clear why the majority of teens haven't gotten vaccinated. Some parents say they're reluctant until more is known about the long-term safety of the vaccine. Studies to date have shown no significant problems. Then there's the issue of time. Younger kids have regular well-child visits. But typically, teenagers don't see a doctor regularly. And when they do, Stokely says, doctors may feel uncomfortable talking about a vaccine that protects against sexually transmitted disease, with parents of kids as young as 11.

STOKELY: They may feel that it needs this long conversation to talk about sex with the parents, and they may not be comfortable with that.

NEIGHMOND: In Seattle, Washington, Dr. Jeff Duchin is an infectious disease specialist who oversees the immunization program for the public health department. He says physicians need to be more vigilant in recommending the HPV vaccine.

JEFF DUCHIN: Our research locally showed that parents did not have a lot of knowledge about how widespread HPV was, how readily it's transmitted, how common it is, how easy it is to acquire, and also about the severity of illness that it can cause.

NEIGHMOND: And Duchin says people often mistakenly think the vaccine is for kids who are sexually active.

DUCHIN: Because once you become sexually active, you acquire HPV infection quite readily. And the entire strategy is based on protecting kids before they get infected, just like it is with all our other vaccine-preventable diseases.

NEIGHMOND: In Washington and other states, health officials like Duchin are working to figure out how to get the vaccine - all three doses of it - to kids as conveniently as possible. One option may be school-based health clinics or pharmacies, similar to the flu vaccine.

Patti Neighmond, NPR News.

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