– Gail Petersen Hock, MS, RN, PHCNS-bc
The Arizona Partnership for Immunization (TAPI), Program Manager- Community Partnerships

School nurses have been at the forefront of protecting their populations from disease since the time of Lina Rogers and the Henry Street Settlement.  It took just one short month, in 1902, for the New York City Board of Health to realize the value Lina Rogers and her illness prevention protocols brought to overcrowded schools.  Recognizing nursing’s value in preventing communicable disease, and reducing absenteeism, the New York City Board of Health hired a dozen more school nurses and promoted Ms. Rogers to the position of Superintendent of School Nurses as their leader.1

Arizona school nurses, and the health assistants they supervise, continue to be on the frontline of preventing communicable diseases ensuring review of immunization records and referral to health care providers for the vaccines children need now and for their futures. Through rigorous adherence to vaccine requirements for school entrance, our sixth grade and tenth grade students’ 2012-2013 coverage levels for tetanus, diphtheria and pertussis (Tdap) and one dose of meningococcal conjugate (MV/MCV) vaccine exceed the Healthy People 2020 objective of 80% coverage.2 Arizona coverage of Tdap and MV/MCV exceeded Healthy People 2020 with levels of greater than 90% for sixth and tenth grades! 3

The Advisory Council on Immunization Practice (ACIP) recommended Human Papillomavirus (HPV) vaccine for girls in 2007 and for boys in 2011.4  Although HPV vaccine is safe and routinely recommended at the same age, 11-12 years, as Tdap and the first dose of MV/MCV 5 only 53% of Arizona’s teen girls have received one or more doses of HPV vaccine.6 Nearly all people are exposed to HPV in their lifetimes and transmission is possible with any type of intimate contact.  In the United States HPV causes nearly 17,000 cancers in women and 9,000 cancers in men annually.7   Health care providers know that HPV infections may lead to cervical cancer and can assume that HPV causes cancers of the base of the tongue, the tonsils, soft palate and throat. 8 The incidence of HPV positive oral cancers has increased by 225%.  If this upward trend continues the number of HPV related cancers of the mouth and throat is expected to exceed the yearly number of cervical cancers by 2020.9

TAPI understands the competing priorities each school health office faces and that HPV is not a required immunization for school entrance.  The voices of school health personnel are powerful; parents, teachers and school administrators trust you.  HPV vaccine is safe and prevents cancer in our children’s futures. Please join the Centers for Disease Control and Prevention (CDC), the Arizona Department of Health Services and TAPI in educating parents that; 1) HPV vaccine is safe and recommended at ages 11-12 (for both boys and girls) and is given at the same time as Tdap and MC/MCV, 2) HPV vaccine can prevent cancer in their child’s future and 3) we give all vaccines before a child may be exposed to the disease to protect them (including that annual flu vaccine!).

TAPI thanks all Arizona School Health Office personnel for the work you do to keep Arizona’s young people healthy now and prepared for a healthy, productive adulthood.  For more evidence based information on vaccines visit TAPI’s website https://www.whyimmunize.org.  Click on here for HPV vaccine related resources.  Please remember, as the CDC says, “You Are the Key” to preventing cancer in your students’ futures by educating parents about HPV vaccine. School nurses, and the health office personnel they supervise, play a valuable role in protecting children before they go to college, become adults and are out on their own.  We appreciate your efforts in sharing evidence based health information with parents, teachers, and school administrators on the importance of HPV vaccination and cancer prevention for Arizona’s children.