The human papillomavirus (HPV) vaccine is a contentious debate.   A large pharmaceutical company with budget to spend can't usually find a friend in science but even with vague benefit it's difficult to argue against protecting children or opening debate about the value of all vaccines by being critical of one.

It takes more than politics and marketing to convince physicians, though.    The Advisory Committee on Immunization Practices recommends the human papillomavirus vaccination even for 11- and 12-year-old girls who face little risk and will likely have to pay to take it again later, but results of a recent survey showed that more than half of Texas physicians do not follow these recommendations.   The results were published in Cancer Epidemiology, Biomarkers&Prevention, a journal of the American Association for Cancer Research. 

The quadrivalent human papillomavirus (HPV) vaccine has been mired in controversy since it was approved in 2006. Texas placed itself at the center of that controversy early on with a mandate for universal vaccination from the governor's office, followed by a swift rebuke of that mandate from the legislature.

Jessica Kahn, M.D., M.P.H., associate professor of pediatrics at Cincinnati Children's Hospital Medical Center, said she was approached by the Texas Medical Association to assist them in conducting this survey as part of their efforts to assess educational needs related to HPV vaccination among Texas physicians. Kahn and colleagues surveyed 1,122 physicians. 

Of the respondents, 48.5 percent said they always recommend the HPV vaccine to girls, 68.4 percent said they were likely to recommend the vaccine to boys and 41.7 percent agreed with mandated vaccination. 

When the researchers assessed the predictors of vaccine recommendation, they found that those in an academic vs. non-academic practice were more than twice as likely to recommend the vaccine. Those who considered professional organizations or professional conferences an important source of information were almost twice as likely to recommend the vaccine than those who did not consider these sources valuable. 

Although the study population was limited to Texas, Kahn said she believes that the views expressed by these physicians could be representative of physicians across the country. Nationally, vaccine rates for 11- to 12-year-old girls are between 6 percent and 25 percent. 

"Physicians train all across the country using more or less the same curriculum, so as a group they tend to be fairly homogenous in their beliefs," said Kahn.