Study: Clinics Don't Offer HPV Vaccine

A follow-up report from Public Advocate Betsy Gotbaum's office released last Wednesday, Dec. 17 found that the city-run clinics that diagnose and treat sexually transmitted diseases still do not offer vaccinations against the human papilomavirus (HPV).

Regarded as the most common STD in the United States, HPV is reportedly responsible for 70 percent of the country's cervical cancer cases.

In March 2007, Gotbaum's office released a report assessing the availability of the HPV vaccine at city health clinics. The 2007 report indicated that none of the city's STD clinics, nor its five immunization centers, offer the vaccine, and that the HPV vaccine was available at 35 of the 67 city-run child and teen health clinics.

The follow-up report found that the cost for the uninsured still varies widely, but that the availability of the HPV vaccine at Health and Hospitals Corporation (HHC) child and teen health clinics and Department of Health and Mental Hygiene (DOH) immunization walk-in clinics has increased.

"Every young woman should have affordable access to the lifesaving HPV vaccine to reduce the risk of developing cervical cancer," Gotbaum said in a statement. "I'm pleased that some city clinics have increased access to this vaccine, but more must be done to keep young women safe from a common, but preventable disease."

The follow-up report assesses changes since March 2007 and updates information from the earlier report. The findings include:

• None of the ten city-run STD clinics offer the vaccine.

• Eighty percent (4 of 5) of DOH immunization walk-in clinics now offer the HPV vaccine for free, up from 0 of 5 in 2007.

• Approximately 90 percent (57 of 64) of the HHC child and teen health clinics now offer the HPV vaccine, up from 57 percent of all clinics in 2007.

• For the uninsured, out-of-pocket costs for the HPV vaccine vary widely among HHC child and teen health clinics; at one clinic the cost is $600.

• HPV immunization services are not available at all DOH immunization clinics and are not available every business day.

• Many HHC child and teen health clinics are difficult to reach by telephone; over a third of clinics needed to be called multiple times in order to reach a staff member.

In June 2008, investigators called the 10 Health Department STD clinics, five DOH immunization walk-in clinics, and 64 Health and Hospitals Corporation (HHC) child and teen health clinics on weekdays between 9:30 a.m. and 4 p.m. Investigators inquired as to the availability and cost of the HPV vaccine for an uninsured 12-yearold girl at each clinic.

To address the problems she identified in her report, the public advocate made these recommendations:

• Offer the HPV vaccine at STD walk-in clinics and at all HHC child and teen health clinics.

• The immunization clinic at the Queens Corona Health Center should expand services to include children.

• The DOH should expand immunization services in Staten Island.

• Train all applicable HHC clinic staff so that they are knowledgeable about the circumstances in which a child is eligible for state health insurance and/or to receive the HPV vaccine for free or at little cost through the Vaccines For Children (VFC) program.

• Ensure that staff is available to answer calls during clinic hours.

• Ensure that immunization services at DOH immunization clinics are available every business day.