While public health officials have been recommending since 2006 that preteen girls be vaccinated against the sexually transmitted human papillomavirus, the percentage of teen girls in Illinois who received the prescribed dosage plunged last year, according to recently released federal estimates.
What's more, the state in 2012 ranked 48th among all states, ahead of only Arkansas and Mississippi, in the percentage of teen girls who have received the three HPV vaccine doses, according to those estimates.
That concerns health officials, who say low vaccination rates put the health of the next generation at risk.
"We really need to start recognizing and promoting the value of this lifesaving vaccine," said Julie Morita, medical director of the Chicago Department of Public Health's immunization program.
HPV is the most common sexually transmitted infection and in some cases can cause cervical, vaginal, penile or other cancers, according to the U.S. Centers for Disease Control and Prevention.
The CDC and other health experts say doctors should be more proactive in promoting HPV vaccinations, which are also recommended for boys, during the same office visits at which youngsters get immunized against tetanus, meningitis and other diseases.
"If a patient's there with their daughter because their throat hurts, it's hard to talk about, 'Oh by the way, you should get this vaccine,'" said Kai Tao, vice president of clinical operations who oversees 17 health centers for Planned Parenthood of Illinois. "But that's exactly what we should be doing."
Some parents are putting off HPV shots for their tween children, or deciding against them altogether, because it's difficult for them to see their children as sexually active and the primary way to contract HPV is through sexual intercourse.
But the vaccine is insurance for the future, doctors say. "You don't want to wait until you try and figure out when a young person is going to have sex," said Gregory Zimet, an Indiana University School of Medicine professor. "That's true with every vaccine, get them vaccinated before they're exposed."
While the vaccine doesn't eliminate the need for regular exams for sexually active people, it does protect them from some of the most common types of HPV that lead to disease and cancer, doctors said.
The CDC's recently released data show that only an estimated 21.1 percent of girls ages 13 to 17 in Illinois got the recommended three doses in 2012, compared with an estimated 34 percent in 2011.
The arrow pointed the other way in Chicago, however, where an estimated 37.8 percent of teen girls had three shots in 2012, up from 24.7 percent in 2011.
The national number sank slightly, to 33.4 percent last year from an estimated 34.8 percent in 2011.
Illinois law requires public heath departments to provide girls entering sixth grade and their parents with written information about the link between HPV and cervical cancer, and about the availability of the HPV vaccine. Since that law was passed in 2007, the vaccine has been recommended for boys as well.
Last year about 21 percent of boys ages 13 to 17 nationwide got at least one dose of the vaccine, according to the CDC. In Illinois, that figure was 24.3 percent.
Legislators in states including Illinois have proposed unsuccessful legislation that would make the HPV vaccine one of the mandatory shots for school attendance, according to the National Conference of State Legislatures.
Most insurance companies cover costs for the vaccine, and a federal program provides the vaccine for free for children who are uninsured or on Medicaid, Chicago's Morita said.
While access may not be a barrier, not all parents agree about when, or even if, the vaccine should be given to their children.
Conversations about the vaccine can be uncomfortable for some families, said Dr. Debra Schwartzers, a pediatrician who works for the DuPage Medical Group in Lombard and regularly brings up the vaccine to parents with teens.
Parents sometimes feel like approving the vaccine for their children is like giving "my child a license to have sex," Schwartzers said.
