Vaccines are a revelation – countless lives saved and countless more improved due to not contracting a disease. The rapid development, production, and dissemination of our newest vaccine, to SARS-COV-2, is an even more remarkable addition to this legacy. Even more, our collective ability to pivot gives us leverage to push back when anyone in our health care spaces says change is impossible – we are all very much capable of so much growth, improvement, and change.
The vaccine to human papilloma virus (HPV), which causes most cancers of the cervix, has been available since 2006. This is an amazing advance in the primary prevention (before the bad even happens) of cervical cancer. But today only about 49% of 13-17 year olds have been vaccinated. The HPV vaccine has been subject to pushback from various community groups since being introduced, in some cases by larger and more vocal groups than for other vaccines. Cervical cancer is unique in having this form of primary prevention – really the best we have. Imagine if we had a vaccine to prevent skin, ovarian, or prostate cancer. I would be first in line.
Bree is lucky in having a workgroup dedicated to reducing deaths and illness from cervical cancer that has been meeting since January. These improvement mechanisms build off of last year’s Reproductive and Sexual Health and Cervical Cancer Screening Recommendations. Both offer lessons in overcoming individual and system-level barriers to helping people achieve disease-free lives. Talking about cultural humility was especially meaningful for me as we work towards person-provider interactions that are trauma-informed and acknowledge the full breadth of human fallibility and potential.
We have outlined the complete pathway whereby a population avoids cervical cancer and finds and treats cases that exist. The HPV vaccine is where we start, building off the advance of pap tests that have dramatically decreased cervical cancer mortality in the last forty years. Stigma around pelvic exams and around sexually transmitted diseases is a large factor as we build a system capable of stopping disease prior to exposure and catching any incidence when disease occurs. Hard things are hard and uncomfortable topics are uncomfortable, but cancer is cancer and we can and should take all the steps needed to avoid cancer when possible and stop cancer when found.
Ginny Weir, MPH
Interim CEO, Foundation for Health Care Quality
Director, Bree Collaborative