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Boys should also get HPV vaccine, says medical panel
Question of the Day
ATLANTA — The controversial HPV shot given to girls should also be given to boys, in part to help prevent the spread of the virus through sex, a government medical panel said Tuesday.
The expensive vaccine, which protects females against cervical cancer, hasn’t been popular, and doctors concede it will be a tough sell to parents of 11- and 12-year-old males, too.
For males, the vaccine is licensed to prevent genital warts and anal cancer. Experts say another key benefit of routinely vaccinating boys could be preventing the spread of the humanpapillomavirus to others through sex - making up somewhat for the disappointing vaccination rate in girls.
The Advisory Committee on Immunization Practices made the recommendation Tuesday. Federal health officials usually adopt what the panel says and asks doctors and patients to follow the advice.
There are two vaccines against HPV, but the vote applies only to Merck’s Gardasil, which costs $130 a dose. The other vaccine wasn’t tested for males. The Merck vaccine has been available to boys for two years, but Tuesday’s vote was the first to strongly recommend routine vaccination.
Officials acknowledged that disappointing vaccination rates in adolescent girls - only one-third have gotten all three recommended HPV shots - encouraged the panel’s action. Other data suggest that less than 1.5 percent of adolescent males have gotten the vaccine.
“Pretty terrible,” said Dr. Anne Schuchat, a U.S. Centers for Disease Control and Prevention administrator who oversees the agency’s immunization programs.
She attributed the low rates for girls to confusion or misunderstanding by parents that they can wait until their daughter becomes sexually active. It works best if the shots are given before a girl becomes sexually active.
The vaccine is approved for use in boys and girls ages 9 to 26; but it is usually given to 11- and 12-year olds when they are scheduled to get other vaccines. The committee also recommended the vaccination for males 13 through 21 years who have not been vaccinated previously or who have not completed the three-dose series.
Tuesday’s vote follows recent studies that indicate the vaccine prevents anal cancer in males. A study that focused on gay men found it to be 75 percent effective. But while anal cancer has been increasing, it’s still a fairly rare cancer in males, with only about 7,000 cases in the U.S. each year that are tied to the strains of viruses targeted in the HPV vaccine. In contrast, about 15,000 vaccine-preventable cervical cancers occur annually.
Some say it’s unlikely that most families will agree to get their sons vaccinated primarily to protect girls and its use against anal cancer may not be much of a selling point.
Some parents may say ” ‘Why are you vaccinating my son against anal cancer? He’s not gay! He’s not ever going to be gay!’ I can see that will come up,” said Dr. Ranit Mishori, a family-practice doctor in Washington and an assistant professor at the Georgetown University School of Medicine who supports the panel recommendation.
By Andrew P. Napolitano
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