The CDC Updates Its HPV Vaccine Recommendations, and So Should Compounding Pharmacists
Earlier this year, the CDC’s Advisory Committee on Immunization Practices recommended the use of Gardasil 9, a vaccine that extends protection against the human papillomavirus (HPV) from 4 types to 9. It’s a good move — HPV is a group of more than 150 related viruses that are transmitted by intimate skin-to-skin contact and can lead to cervical and other cancers. HPV can take years, even decades, to develop. When it does, it’s usually at an advanced stage that is difficult to treat. If effective, this vaccine could save millions of lives, but prevailing attitudes about vaccines for a sexually transmitted disease generate more suspicion than optimism. Fortunately, educating patients about the specifics of HPV and about the process of administering vaccines are the compounding pharmacist’s forte.
What Do the Guidelines Say?
The current guidelines recommend one of three existing HPV vaccines be administered to children of 11-12 years in age. Gardasil and Gardasil 9 protect against 4 and 9 types of HPV, respectively. These vaccines also provide protection against genital warts and anal cancer. A third vaccine, Cervarix, may be administered instead but is preventive against only HPV. The vaccines are given in a 3-dose schedule.
Although the vaccine is targeted for use by pre-teens, older patients can benefit from it as well. Sexually active women up to 26 years old should consider the vaccine; sexually active men, especially those who are sexually active with other men or who have compromised immune systems, should consider the vaccine — particularly from ages of 21 to 26.
Screening tests for HPV do not exist except for women aged thirty or older and even then, the test is limited. A further complication is that patients of both genders typically outgrow their pediatricians at an early age, leaving them without a primary care physician who can advise them on such issues at their most critical, relevant stage.
What Is the Compounding Pharmacist’s Role?
How often do pharmacists administer vaccinations? The first organized pharmacological immunization training program took place in 1994 in Seattle and was attended by fifty pharmacists. Shortly thereafter, pharmacists slowly began administering the influenza vaccine. Today, the vaccine rate by pharmacists is 78%. Carolyn Bridges, the associate director of adult immunizations for the CDC, says that pharmacist administration of the flu vaccine has “really helped increase access to the pandemic vaccine. That was, I would say, kind of the turning point.”
Imagine if we could achieve the same results for other vaccines — and why not? The push for pharmacists to administer vaccines has heavily underway since the 1990s, thanks to then-Secretary of Health Services, Donna Shalala’s guidance. State adoption of that push has been slow, but all fifty states now allow pharmacists to administer vaccines. The positive result is clearly evident in flu vaccine rates.
What Can Compounding Pharmacists Do?
The first thing is for compounding pharmacists to make sure we are all allowed to administer the HPV vaccine. While we can give flu shots in all fifty states, only a third of pharmacists are allowed to administer the HPV vaccine. The differentiation is by state, which suggests there are politics at work. Digging deeper, it appears that prior approval and prescriptions are required for treatment by a pharmacist, a measure that was not implemented for flu shots. Cost of vaccine and parental approval can also function as barriers to vaccination, so those issues should be discussed with our patients.
Regardless of whether we are allowed to vaccinate against HPV, we can still advocate for it. Some options include speaking to patients who come to us needing other required medications, including:
- Incoming 7th graders and college freshmen
- Young women on birth control pills
We can also:
- Identify and partner with providers who are not providing the vaccine — gynecologists, some family practitioners, and health departments.
- Encourage health insurance carriers to provide coverage for all vaccines in compounding pharmacies.
- Use local statistics to help mandate county and state requirements.
Speaking to our patients openly despite the public stigma associated with treatment creates a relationship of trust. Given that we know our patient’s attitudes and medical conditions, their autism concerns and gluten-free needs, we are the best choice to provide them with the information they need to treat body and mind.
Pharmaceutica North America is your trusted source for quality compounding ingredients. We work hard to stay on top of the latest information so we can give you advice on the safest, most effective treatments. To speak to us about your particular pharmaceutical needs, please contact us today.