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CDC Panel Votes to Extend HPV Vaccine to Young Boys
All males starting at age 11 should receive the HPV vaccine Gardasil to
protect themselves against sexually transmitted forms of human
papillomavirus, the cause of most cervical and anal cancers as well as most
mouth and throat cancers, a Centers for Disease Control and Prevention
advisory committee voted today.
Thirteen members of the committee voted in favor of extending the HPV
vaccine recommendation to young boys, and one member abstained. The
recommendation now goes to the director of the CDC and the secretary of the
U.S. Department of Health and Human Services for final approval.
The CDC already recommends routinely immunizing girls with a three-dose
vaccine beginning at age 11 or 12, before they become sexually active,
although they can be vaccinated as young as age 9. The agency previously
issued a so-called permissive recommendation giving boys and young men from
ages 9 through 26 the option of receiving the vaccine.
The prospect of requiring that preteen boys and girls get vaccinated against
a sexually transmitted infection has drawn the sharpest outcry from some
parents, who fear that vaccinating preteens might encourage promiscuous
behavior. Vaccination policies also have become an issue in the 2012
presidential campaign, with several GOP candidates objecting to mandates for
HPV vaccination.
Many infectious disease specialists welcome universal vaccination as a key
tool in reducing the toll of preventable diseases.
"Vaccination is perhaps the greatest invention of medicine," said Dr. John
Sinnott, director of the Division of Infectious Disease at the University of
South Florida. "It is a tragedy that this vaccine has become politicized."
But Dr. Lawrence Stanberry, chief pediatrician at New York Presbyterian
Morgan Stanley Children's Hospital, said parents support universal
recommendations more recommendations targeting groups at higher risk.
"Recommending universal immunization for girls and making the recommendation
for boys permissive sends parents mixed messages," Stanberry said. He
offered a fairness argument for recommending vaccinations for both sexes. "
Girls acquire the infection from boys and it seems appropriate, even fair,
for boys to share responsibility for maximizing community [herd] immunity,"
he said.
Nearly a dozen experts contacted by ABC News cited "herd protection" from
HPV-associated diseases in both women and men as a main reason they
supported universal immunization.
William Muraskin, an urban studies professor at Queens College in New York,
said it's hard to determine which men and women will benefit directly from
vaccination. "The HPV vaccine if given before males become sexually active
will also protect those who will become homosexual or bisexual," Muraskin
said. Routine vaccination of all young men protects "an important subgroup
that otherwise will be at significant risk but cannot be identified until it
is too late."
The panel is expected to issue a policy statement on the importance of
vaccinating men who have sex with men, because of the risk they could
develop anal cancer from HPV.
Two HPV Vaccines On The Market Protect Against Multiple Strains
There are two HPV vaccines currently available, both of which protect
against the two principal cancer-causing types of HPV, HPV 16 and HPV 18. By
CDC estimates, the two strains cause 15,000 malignancies in women and 7,000
in men every year. The two strains account for an estimated 70 percent of
cervical cancers, about 70 percent of vaginal cancers and most vulvar
cancers. HPV 16 by itself causes 85 percent of anal cancers.
In addition to protecting against HPV 16 and HPV 18, Merck's Gardasil
protects against two other disease-causing strains, HPV 6 and HPV 11,
responsible for 90 percent of genital warts as well as cervical cell changes
. GlaxoSmithKline's Cervarix protects against HPV 16 and HPV 18, but also
has been found to confer some protection against three other cancer-causing
strains, HPV 31, HPV 33 and HPV 45.
Dr. Diane Harper, director of the Gynecologic Cancer Prevention Research
Group at the University of Missouri-Kansas City called it "misguided to
think that all boys will gain any health benefit from HPV vaccination."
She contended that "mass vaccination for the prevention of the other HPV-
associated cancers puts large numbers of people at risk for harms from
vaccination compared to both the personal and public health risk of anal,
penile, and oropharyngeal cancers."
In a background memo leading up to the vote, the CDC estimated that
routinely vaccinating 11- and 12-year-old boys would likely be cost-
effective. If 1 million 12-year-old boys were vaccinated, over the course of
a lifetime, they would prevent 2,381 cases of mouth and throat cancer; 633
cases of anal cancer and 169 cases of penile cancer, assuming the vaccine
was 75 percent effective against those conditions.
All males starting at age 11 should receive the HPV vaccine Gardasil to
protect themselves against sexually transmitted forms of human
papillomavirus, the cause of most cervical and anal cancers as well as most
mouth and throat cancers, a Centers for Disease Control and Prevention
advisory committee voted today.
Thirteen members of the committee voted in favor of extending the HPV
vaccine recommendation to young boys, and one member abstained. The
recommendation now goes to the director of the CDC and the secretary of the
U.S. Department of Health and Human Services for final approval.
The CDC already recommends routinely immunizing girls with a three-dose
vaccine beginning at age 11 or 12, before they become sexually active,
although they can be vaccinated as young as age 9. The agency previously
issued a so-called permissive recommendation giving boys and young men from
ages 9 through 26 the option of receiving the vaccine.
The prospect of requiring that preteen boys and girls get vaccinated against
a sexually transmitted infection has drawn the sharpest outcry from some
parents, who fear that vaccinating preteens might encourage promiscuous
behavior. Vaccination policies also have become an issue in the 2012
presidential campaign, with several GOP candidates objecting to mandates for
HPV vaccination.
Many infectious disease specialists welcome universal vaccination as a key
tool in reducing the toll of preventable diseases.
"Vaccination is perhaps the greatest invention of medicine," said Dr. John
Sinnott, director of the Division of Infectious Disease at the University of
South Florida. "It is a tragedy that this vaccine has become politicized."
But Dr. Lawrence Stanberry, chief pediatrician at New York Presbyterian
Morgan Stanley Children's Hospital, said parents support universal
recommendations more recommendations targeting groups at higher risk.
"Recommending universal immunization for girls and making the recommendation
for boys permissive sends parents mixed messages," Stanberry said. He
offered a fairness argument for recommending vaccinations for both sexes. "
Girls acquire the infection from boys and it seems appropriate, even fair,
for boys to share responsibility for maximizing community [herd] immunity,"
he said.
Nearly a dozen experts contacted by ABC News cited "herd protection" from
HPV-associated diseases in both women and men as a main reason they
supported universal immunization.
William Muraskin, an urban studies professor at Queens College in New York,
said it's hard to determine which men and women will benefit directly from
vaccination. "The HPV vaccine if given before males become sexually active
will also protect those who will become homosexual or bisexual," Muraskin
said. Routine vaccination of all young men protects "an important subgroup
that otherwise will be at significant risk but cannot be identified until it
is too late."
The panel is expected to issue a policy statement on the importance of
vaccinating men who have sex with men, because of the risk they could
develop anal cancer from HPV.
Two HPV Vaccines On The Market Protect Against Multiple Strains
There are two HPV vaccines currently available, both of which protect
against the two principal cancer-causing types of HPV, HPV 16 and HPV 18. By
CDC estimates, the two strains cause 15,000 malignancies in women and 7,000
in men every year. The two strains account for an estimated 70 percent of
cervical cancers, about 70 percent of vaginal cancers and most vulvar
cancers. HPV 16 by itself causes 85 percent of anal cancers.
In addition to protecting against HPV 16 and HPV 18, Merck's Gardasil
protects against two other disease-causing strains, HPV 6 and HPV 11,
responsible for 90 percent of genital warts as well as cervical cell changes
. GlaxoSmithKline's Cervarix protects against HPV 16 and HPV 18, but also
has been found to confer some protection against three other cancer-causing
strains, HPV 31, HPV 33 and HPV 45.
Dr. Diane Harper, director of the Gynecologic Cancer Prevention Research
Group at the University of Missouri-Kansas City called it "misguided to
think that all boys will gain any health benefit from HPV vaccination."
She contended that "mass vaccination for the prevention of the other HPV-
associated cancers puts large numbers of people at risk for harms from
vaccination compared to both the personal and public health risk of anal,
penile, and oropharyngeal cancers."
In a background memo leading up to the vote, the CDC estimated that
routinely vaccinating 11- and 12-year-old boys would likely be cost-
effective. If 1 million 12-year-old boys were vaccinated, over the course of
a lifetime, they would prevent 2,381 cases of mouth and throat cancer; 633
cases of anal cancer and 169 cases of penile cancer, assuming the vaccine
was 75 percent effective against those conditions.
