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Panel: Boys should get vaccine for HPV, too

A government panel wants young boys as well as girls to get the controversial HPV vaccine, in part to prevent them from spreading the sexually transmitted virus to girls.
Gardasil, a Human Papillomavirus vaccine, is displayed at the Girls to Women Health and Wellness clinic in Dallas
Gardasil, a Human Papillomavirus vaccine, is recommended for 11-12-year-old boys.Jessica Rinaldi / Reuters
/ Source: news services

A government panel wants young boys as well as girls to get the controversial HPV vaccine, in part to prevent them from spreading the sexually transmitted virus to girls.

The HPV vaccine has been recommended for young girls to protect them against cervical cancer and genital warts for the last five years. But the vaccine has been slow to catch on — only about a third of adolescent girls have gotten all three shots.

Experts say the HPV vaccine could protect boys against genital warts and some kinds of cancers. But they also say vaccinating 11- and 12-year old boys could help prevent them from spreading the human papilloma virus to girls.

The Advisory Committee on Immunization Practices made the recommendation Tuesday in a unanimous vote. Federal health officials usually adopt what the panel says and asks doctors and patients to follow the recommendations.

The vaccine has been licensed for use in boys for two years but Tuesday's vote was the first to strongly recommend routine vaccination. Officials acknowledged the disappointing rate in girls encouraged them to take a new, hard look.

But if the expensive HPV vaccine has been a tough sell to the parents of girls, it may be even tougher for boys.

Last year, just 49 percent of adolescent girls had gotten at least the first of the recommended three HPV shots. Only a third had gotten all three doses.

"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 only works if the shots are given before a girl is exposed to the virus, which occurs during sexual activity.

'Worthwhile vaccine'
CDC experts advised the panel there is no evidence the vaccine can cause "mental retardation," a concern raised by Republican congresswoman Michele Bachmann in a Republican presidential candidate debate. The U.S. medical community repudiated Bachmann's claim, which she made as a swipe at a rival, Texas Governor Rick Perry, who issued an executive order in 2007 mandating girls get the HPV vaccine as part of a school immunization program.

Perry's order was later overturned.

"I think it's a worthwhile vaccine," said Dr. Jay Siwek, a professor of family medicine at Georgetown University Medical Center, who was not part of the panel.

Siwek said the only downside of the vaccine is cost, which is $360 for a course of three shots.

In his own practice, Siwek tells parents the vaccine protects against cancers that occur in boys -- mostly mouth and throat -- and it helps protect girls from cancer as well.

"If they have concerns about vaccinating children against a potential sexually transmitted disease in the future, I'd say that we routinely vaccinate kids against diseases that primarily occur in adults," he said.

"I'd also say that most people eventually get HPV infection and that once you get the infection, the vaccine won't help."

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.

HPV shot dilemma: Should gay boys be targeted?

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 vaccine-preventable 15,000 cervical cancers occur annually.

Some feel it's unlikely that most families will agree to get their sons vaccinated primarily to protect girls. The threat of genital warts hasn't been persuasive yet, either: Some data suggest that less than 1.5 percent of adolescent males have gotten the vaccine.

Its use against anal cancer may not be much of a selling point, said Dr. Ranit Mishori, a family practice doctor in Washington, D.C., and an assistant professor at the Georgetown University School of Medicine.

Opinion: HPV vaccine attack could harm ‘innocent’ girls
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 Mishori, who supports the committee's recommendation.

There are two vaccines against HPV, but Tuesday's vote applies only to Merck & Co.'s Gardasil, which costs $130 a dose. The other vaccine wasn't tested for males.

An estimated 50 percent to 80 percent of men and women are infected with HPV in their lifestimes, although most clear the infection without developing symptoms or illness, according to the CDC.