Position Paper on HPV Immunization

APHON’s core purpose of supporting nurses and their practice with the goal of optimizing

outcomes for children, adolescents, and young adults with cancer and blood disorders mandates

substantial attention to human papillomavirus (HPV) immunization. Pediatric

hematology/oncology nurses dedicate their practice to maximizing health throughout the cancer

trajectory (ie, from initial cancer diagnosis through survivorship) for patients with oncologic

diseases and the continuum of care for patients with blood disorders. Pediatric

hematology/oncology patients may be at increased risk for not receiving crucial adolescent

vaccines compared with the healthy population because their care often is delivered in

subspecialty clinics, where the focus is on disease management, rather than in primary care,

where the focus is on health promotion (Hofstetter, Lappetito, Stockwell, & Rosenthal, 2017).

Cancer prevention strategies are an essential component of education provided by pediatric

hematology/oncology nurses, and immunization against HPV is a necessary preventative


HPV is an attributable cause of a significant number of cancers, including cervical,

vaginal, vulvar, anal, penile, and oropharyngeal cancers and high-grade dysplasia (Forman et al.,

2012; Torre et al., 2015). Globally, more than 600,000 cases of cancer are attributable to HPV

each year (de Martel, Plummer, Vignat, & Franceschi, 2017). Infection with HPV leads to

significant morbidity, mortality, and healthcare costs (Chesson et al., 2012; Crow, 2012; Reagan-

Steiner et al., 2016). HPV vaccines have been developed to target the most common types of

dysplasia and cancers attributable to HPV, have been proven safe and effective, and are

recommended through vaccination policy for males and females during pre- and early

adolescence — prior to sexual contact — to maximize effectiveness (Arbyn, Xu, Simoens, &

Martin-Hirsch, 2018; Castle & Maza, 2015; Drolet et al., 2015; Zhai & Tumban, 2016).

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