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CDC panel recommends HPV vaccine for boys

Adolescent boys should get the controversial HPV vaccine as protection against cancers and diseases that can result from being sexually active, a federal vaccination panel recommended Tuesday.

The U.S. Centers for Disease Control and Prevention's immunization experts now support the Gardasil vaccine as strongly for adolescent boys as for girls of the same age. For both, it protects against the human papillomavirus, or HPV, the most common sexually transmitted infection.

HPV is estimated to infect at least half of sexually active Americans at some point in their lives, though in most cases it clears up on its own. But the virus is associated with about 18,000 cancers in women each year, with cervical cancer being the most prevalent. About 7,000 men also get HPV-linked cancers affecting the anus, penis, mouth and neck, according to the CDC.

The 15-member panel of doctors, nurses and public health experts arrived at the decision after weighing increasing evidence of the vaccine's effectiveness in preventing rare but serious cancers in men. They also noted that immunizing boys would help to protect the girls who become their sexual partners, especially since many parents have been reluctant to vaccinate their daughters.

"The idea that we could prevent cancer with the vaccine was really motivating," said Dr. Anne Schuchat, director of the CDC's Center for Immunization and Respiratory Diseases. She noted that the panel previously advised that boys may receive the HPV vaccine, but stopped short of the strong recommendation it had issued for girls.

"It was sort of like a footnote," she added. "Now it's going to be a routinely recommended vaccine."

Tuesday's action may intensify the debate over the Gardasil vaccine, which protects against four types of HPV known to cause most cervical cancers and genital warts. It's already controversial because many parents do not feel their young children need protection against sexually transmitted diseases. And it could be an even more delicate issue for parents of boys, since many of the HPV-related cancers in men result from gay sex.

Gardasil became an issue in the Republican presidential campaign, with some candidates criticizing Gov. Rick Perry of Texas for trying to require that girls in his state be vaccinated. And Rep. Michele Bachmann of Minnesota outraged many when she falsely suggested during a Tampa debate that the HPV vaccine causes mental retardation.

As of last year, fewer than half of girls between the ages of 13 and 17 had received at least one HPV shot — and fewer than one-third had completed the recommended three doses. That low rate factored into the immunization's panel recommendation that boys get the vaccine.

"It's a delicate subject, because we have to approach sex at 11 or 12 years of age," said Dr. Philip Adler of HealthPoint Medical Group in Tampa's Westchase community. "This is something that mothers don't expect to talk about until their kids are 16 or 17."

A practicing pediatrician with more than 50 years' experience, Adler brings up the HPV vaccine carefully during children's routine seventh-grade visits. To the parents of boys, he explains the link to genital warts and penile, anal and oral cancers. Most are comfortable getting the vaccine after hearing him out, he said.

But some still don't get it because their insurance plans don't cover the HPV vaccine for boys. Nationally, the three-shot series can cost $400 to $600-plus.

"That's pretty darn expensive," said Dr. Juan Dumois, chairman of infectious diseases at All Children's Hospital in St. Petersburg, who paid to immunize his 12- and 16-year-old sons. "We thought it was important enough to go ahead and give it."

Tuesday's recommendation should prompt more insurers to cover the immunization, Dumois noted. And it should address concerns about gender inequity that came up in the initial push to give the HPV vaccine to girls, without strong recommendations for boys, he said.

"I've heard complaints of why should the girls be immunized if you are not immunizing the boys,'' he said, noting the virus is passed during sexual activity.

"Now I think the question is eliminated because the recommendation is to give it to all of them."

Information from Times wires was used in this report. Letitia Stein can be reached at lstein@sptimes.com or (813) 226-3322.

Q&A

HPV vaccine

When should the vaccine be administered?

It is most effective if given before sexual activity begins and is commonly recommended for ages 11 and 12, though it can be given as early as age 9. Young women who weren't previously immunized should get it up to age 26; young men should get it up to age 21. (Among considerations in the age recommendations were cost-effectiveness data.)

Who made Tuesday's recommendations?

The CDC's Advisory Committee on Immunization Practices has 15 voting members who are doctors, nurses and public health experts in immunization. They were selected by federal health officials to develop recommendations for the vaccination of American children and adults.

CDC panel recommends HPV vaccine for boys 10/25/11 [Last modified: Tuesday, October 25, 2011 10:48pm]

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