Position Paper on HPV Immunization

Despite established efficacy and safety, uptake of the HPV vaccine lags behind that of

other recommended adolescent vaccines (Reagan-Steiner et al., 2016), and vaccination rates are

significantly less in cancer survivors than in the general population (Klosky et al., 2017).

Underimmunization is a problem that has particular relevance for the pediatric, adolescent, and

young adult (PAYA) oncology patient population because this population has the potential to be

at increased risk for secondary cancers, including those associated with HPV (Inskip & Curtis,

2007; Nasioudis, Ramer, Sisti, & Fambrini, 2015; Ojha et al., 2013; Reulen et al., 2011;

Temming et al., 2015). In many cases, the cause of second cancers may be apparent (eg,

radiation), but for others, the etiology of a second cancer may not be specifically linked with

prior cancer therapy or known genetic causes. Therefore, for cancer prevention, all potential risk

factors, including HPV, should be considered, highlighting the need for preventative

immunization against HPV.

Nursing Practice

 As suggested by the American Nurses Association (ANA) Code of Ethics, Provision 4,

“the nurse takes actions consistent with the obligation to promote health and to provide

optimal care” (American Nurses Association, 2015a). A PHON endorses the ANA’s

position of immunizing individuals against vaccine-preventable diseases, since

immunization aligns with “the nurse’ s obligation to use interventions to optimize health

and well- being” (American Nurses Association, 2015a, 2015b).

 The pediatric hematology/oncology nurse is responsible for assessing the patient ’s and

family ’s knowledge of the importance of HPV immunization to ensure they receive

comprehensive education and recommendations for immunization.

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