UTMB to offer HPV vaccination against cervical cancer

University of Texas Medical Branch at Galveston's Dr. Abbey Berenson has been awarded a $1.2 million grant to start a program that will provide a vaccination against cervical cancer to many hundreds of low-income women who receive health care services at UTMB.

Berenson, a physician who specializes in pediatric and adolescent gynecology, received the grant from the Cancer Prevention Research Institute of Texas.

According to the National Cancer Institute, cervical cancer affects nearly half a million women worldwide each year and kills more than 250,000. Hispanic women have almost twice the risk of cervical cancer as white women. In 2006, the FDA approved an HPV vaccine that when properly administered, is extremely effective, 96 to 100 percent, against four virulent strains of the HPV virus - the main cause of cervical cancer and genital warts.

The complete vaccine series consists of three shots and is recommended for girls between 11 and12, before sexual activity has commenced. But even for women who already have become sexually active, the vaccination is still recommended for those up to 26. The recommended course of the vaccine, after the initial shot, is a second shot four to eight weeks later and a final shot four months after the second. However completion rates of this vaccine have been very low in many parts of Texas, including Galveston County.

A survey of low-income pregnant women from Galveston County who were seen at UTMB, indicated that their HPV vaccination rates are far lower than those reported among the general population by the Centers for Disease Control. Seventy percent of the low-income pregnant women UTMB serves are Hispanic and thus at high risk for cervical cancer.

Reasons for the low inoculation rate among this population, according to Berenson, include a lack of awareness about the vaccine, limited access to vaccination sites and high cost. Berenson's CPRIT grant project will improve vaccination rates by addressing all three barriers. Galveston County women who receive prenatal care at UTMB clinics will receive information about the HPV vaccine during their pregnancy and again after they deliver. Injections will be available on the postpartum ward, which will improve access. All costs will be covered by federal or state programs, including CPRIT. Berenson said she anticipates that this innovative system change will allow UTMB to provide the vaccination series in 900 postpartum women over two years.

Berenson is director of UTMB's Center for Interdisciplinary Research in Women's Health and holds the Ruth Hartgraves Chair in Obstetrics and Gynecology. Her research on the HPV vaccine, published recently in the journal Cancer, showed that many women who begin the HPV vaccine do not return for the second or third dose. This is a significant problem because fewer than three doses may not provide complete protection against cervical cancer.

To address the completion rate problem, she has developed a partnership with additional clinics that see the mothers and their babies for postpartum visits and infant vaccinations.

"These partnerships will allow us to coordinate the timing of their subsequent doses with their postpartum visits and their children's visits to their pediatricians," said Berenson. "We anticipate that this prevention project will show that administering the HPV vaccination postpartum decreases barriers and that follow-up injections should be given at postpartum or infant visits. We feel certain this plan can provide a model for reducing the number of women who experience cervical cancer and its devastating consequences."