Image via Wikipedia
Boys and young men should be vaccinated against human papillomavirus (HPV), to protect against anal and throat cancers, a federal advisory committee said Tuesday.
The recommendation by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention is likely to transform the use of the HPV vaccine, since most private insurers pay for vaccines once the committee recommends them for routine use.
The committee recommended that boys ages eleven and twelve should be vaccinated. It also recommended vaccination of males ages thirteen through twenty-one who had not already had all three shots. Vaccinations may be given to boys as young as nine.
The committee recommended in 2006 that girls and young women ages eleven to twenty-six should be vaccinated. Vaccination rates in the U.S. have been disappointing.
The vaccine is controversial because the disease it prevents results from sexual activity. The controversy is likely to intensify with the new recommendation since many of the cancers in men result from homosexual sex. The HPV vaccine is a source of contention among Republican Presidential candidates after candidates criticized Governor Rick Perry for trying to require that girls in Texas be vaccinated. Representative Michele Bachmann falsely suggested the vaccine causes mental retardation.
“This is cancer, for Pete’s sake,” said Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt University School of Medicine and a nonvoting member of the committee. “A vaccine against cancer was the dream of our youth.”
HPV infection is the most common sexually transmitted disease — between 75% and 80% of females and males in the United States will be infected in their lives. Most overcome the infection with no ill effects. In some people, infections lead to cellular changes that cause warts or cancer, including cervical, vaginal and vulvar cancers in women and anal cancer and throat cancer in men and women.
HPV infections cause about 15,000 cancers in women and 7,000 cancers in men each year. While cervical cancer rates have plunged over the past four decades because of screening, anal cancer rates in men and women are increasing. Head and neck cancers are also increasing, with the share associated with HPV infection increasing rapidly.
The burden of disease in males results mostly from oral or anal sex, but vaccinating boys will also benefit female partners since cervical cancer in women results mostly from vaginal sex with infected males.
Vaccinating the nation’s eleven- and twelve-year-old boys will cost almost $140 million annually. The government generally pays for about half of all vaccinations.
The committee is concerned about the cost effectiveness of vaccines, since the vaccines are very expensive but protect against diseases that affect fewer people. Vaccinating boys is cost effective when vaccination rates in girls are low. Fewer than one-third of girls between the ages of thirteen and seventeen have received all three doses.
Only about 1% of boys have received the HPV vaccine, even though the committee has said that boys could be vaccinated against the disease if they or their parents wished.
Dr. S. Michael Marcy, a clinical professor of pediatrics at the University of Southern California, said the money needed to vaccinate boys would pay for only a few hours of the war in Afghanistan while potentially saving thousands of lives in the United States.
The vaccine loses effectiveness if it is given after the onset of sexual activity.
For HPV, the committee voted eight to five to approve a recommendation that males thirteen to twenty-one be vaccinated, with those voting against the recommendation hoping to make the upper age limit twenty-six.
Not only are the committee’s recommendations used by insurers to determine which vaccines to pay for, but the health reform legislation of 2010 requires insurers that participate in health exchanges to offer vaccines recommended by the committee.
Via NYT.
Related articles
- CDC Recommends HPV Vaccine For Boys and Young Men (lezgetreal.com)
- Vaccinating Boys for HPV: Why Scientists Say Yes (But Some Parents Will Say No) (healthland.time.com)
- Panel: Boys should get routine vaccine for HPV (msnbc.msn.com)
- Panel says boys should get HPV vaccine, too (sfgate.com)
- A New Strategy to Fight HPV: Panel Says Boys Should Be Vaccinated Too (time.com)
Pingback: Can vaccine recommendations be based solely on individual and public health? « Health and Medical News and Resources