SALT LAKE CITY — There was controversy from the moment Gardasil hit the market in 2006.

Ten years later, doctors and nurses are still trying to fight lingering misinformation that has persisted since the botched roll-out of the human papilloma virus (HPV) vaccine, Dr. Brandon Reynolds, an OB/GYN at the University of Utah, said.

"Unfortunately there's a lot of misinformation and wrong information that's out there," said Reynolds. "And because of that children are going to suffer later on."

Now health officials are renewing efforts to urge people to get vaccinated and to clear up misinformation.

The Utah Department of Health released a series of videos this week featuring local physicians answering the most common questions about HPV and the vaccine.

"Isn't this just for girls?" is one of them. "I've heard this is the shot when you have sex — I'm not sure why I need this shot?" is another.

HPV vaccination by the numbers

In Utah, take-up of the cancer-preventing vaccine lags behind that of the rest of the nation.

About 25 percent of girls and 14 percent of boys ages 13 to 15 in Utah have finished the three-shot series, according to the U.S. Centers for Disease Control and Prevention.

That puts Utah at 46th out of 50 states when it comes to getting the vaccine.

But coverage is also a problem across the U.S., said Shannon Rice, a health promotion specialist with the Utah Department of Health.

Nationwide, about one-third of girls and 21 percent of boys have gotten the full vaccine. That falls far short of the goals set by the U.S. Department of Health and Human Services: to have 80 percent of adolescent girls and boys vaccinated against HPV by 2020.

Educational and cultural roadblocks

The vaccine, now recommended for boys and girls at age 11 or 12, is given in three shots. It protects against cancers caused by HPV, which infects 14 million people a year.

Reynolds, who is one of the doctors featured on the videos, said the vaccine was rolled out so quickly that parents didn't have a chance to get used to it. Early attempts to make it a mandatory vaccine for schoolchildren also made them balk.

"The most common question that people come to me with is why do I want to vaccinate my child against a sexually transmitted disease?'" Reynolds said. "I've worked in other cities and that's not always the most common approach, but here, definitely in Utah, that's the approach."

Cultural values and social norms affect attitudes toward the vaccine, said Huntsman Cancer Institute investigator Deanna Kepka.

"Among white communities, middle-class white America, we're not seeing the uptake," she said.

Kepka published a study Thursday showing that HPV vaccine coverage is highest among low-income and Hispanic communities. But if Hispanic girls live in majority white communities, they are less likely to get vaccinated. About 68 percent of Hispanic girls got at least one shot if they lived in mostly Hispanic or mixed-race communities. But only 49 percent of them got the shot if they lived in mostly white communities.

The data runs counter to the assumption that access to health care is more difficult in high poverty communities.

"The data are really telling us that we need to do more to look at cultural values and population level norms that are influencing vaccination," Kepka said.

Need for changing attitudes

Concern about the vaccine persists even among health officials in Utah.

All but one of the local health departments in Utah offer the vaccine. The Southwest Utah Public Health Department, which serves Washington, Beaver, Kane, Garfield and Iron counties, is the exception.

The department does not offer the vaccine because it is too costly to store and not enough people want it, according to spokesman David Heaton.

But he said the department also remains concerned that there is not enough evidence of the vaccine's effectiveness at preventing cancer. Heaton added that the department's medical director, Dr. David Blodgett, remains "neutral" on the vaccine — neither discouraging nor recommending it.

Blodgett declined, through Heaton, to comment or answer questions on the issue.

Reynolds challenged Blodgett, saying, "Five or six years ago he might have had a leg to stand on, but the reality is there are doctors who lag behind the mainstream medical care and don't adopt things as readily." He said major medical organizations, including the CDC and the American Academy of Pediatrics recommend the vaccine for girls and boys.

There are signs attitudes toward the vaccine may be changing.

In Utah, for example, the HPV vaccination rate — at least for those teens getting the first shot in the series — hit an all-time high in 2014. With about 59 percent of adolescent girls getting at least the first dose, Utah is close to meeting the national average. The video series will help reinforce the need to complete the series.

Kepka said momentum is growing. She helped start the Intermountain West HPV Vaccination Coalition a year ago. With more than 130 members spanning Utah, Nevada and Idaho, the coalition is trying to get parents, providers, health departments and community groups to engage in a public awareness campaign about the vaccine.

"It's been recommended for girls since 2006," Kepka said. "We're going on 10 years now. It just has not been prioritized at the same level of enthusiasm as other adolescent immunizations. And we need everyone on board making this a priority."

Daphne Chen is a reporter for the Deseret News and KSL.com. Contact her at dchen@deseretnews.com.

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