HPV ON PAP SMEAR: Image of normal squamous cells [left] and HPV-infected cells [right].
Image: Wikimedia Commons
A vaccine originally intended to prevent cervical cancer in girls should be given to boys as well, an advisory panel for the Centers for Disease Control and Prevention (CDC) said today (Oct. 25).
The panel voted to recommend the human papillomavirus (HPV) vaccine be given to boys ages 11 to 12. The vaccine is already recommended for girls of this age.
The rationale behind the recommendation is that the vaccine prevents genital warts and anal cancers in males, both of which can be caused by HPV. The vaccine may also prevent head and neck cancer, which has been on the rise in recent years.
In addition, vaccinating boys may help reduce cervical cancer in women. If males do not acquire the infection, they cannot pass it to females.
The new recommendation "will be a hugely important step in cancer prevention in this country, both for girls and for boys; women as well as men," said Dr. William Schaffner, chairman of the department of preventive medicine at Vanderbilt University, in an interview before the vote. Because rates of HPV vaccination in girls have been low, it's important to vaccinate boys as part of the public health strategy to prevent cervical cancer, Schaffner said.
Although the vaccine has been licensed by the Food and Drug Administration for boys ages 9 to 26, only about 1 percent of males in this age group have received it, said Dr. Paul Offit, chief of the director of the Vaccine Education Center at the Children's Hospital of Philadelphia. After this new recommendation, that percentage should increase dramatically, Offit said.
Boys and men ages 13 to 21 who have not been vaccinated, or haven't received all their shots should also be vaccinated, the committee said.
Benefit for boys and girls
Two of the most common strains of HPV (HPV 16 and 18) cause about 21,000 cancers per year in the United States. One-third of these cancers are in males, according to the CDC.
There are now studies showing the vaccine is effective at preventing genital warts and anal cancers caused by HPV. The recommendation is for the Gardasil vaccine, made by Merck & Co. Inc, which protects against four strains of HPV. The other available HPV vaccine, called Cervarix and made by GlaxoSmithKline, is not licensed for use in males.
And although the vaccine has not been proven to prevent head and neck cancers, which can also be caused by HPV, the recent rise in cases of these cancers likely factored into the panel's reasoning for the recommendation, Schaffner said. Between 1988 and 2004, there was a 28 percent increase in oropharyngeal cancer, a type of head and neck cancer, said Dr. Lauri Markowitz, a member of the CDC committee on HPV vaccines.
In addition, it wasn't previously clear whether vaccinating boys as a means to prevent cervical cancer in girls would be worth the cost. If every girl was vaccinated, the benefit of vaccinating boys would be minimal, and come at a high price, researchers reasoned.
However, new research shows only about 32 percent of U.S. girls receive all three shots of the HPV vaccine (three shots are thought to be optimal for HPV prevention). This low rate of vaccination rate in girls means "it becomes much more sensible to vaccinate the boys also," Schaffner said.
Schaffner also pointed out that the new recommendation will protect men who have sex with men – a group that may not be protected from even a high rate of vaccinations among girls and women.
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29 Comments
Add CommentThis vaccination is a big scam by massive drug companies. The recommendation that men be included was inevitable since it doubles the market for this scam drug even though there is very little evidence it would do anything to help your average heterosexual male.
Reply | Report Abuse | Link to this@Velstras, do you have any proof of this scam or are you just another pathalogical liar/troll? Do you really think your unsubstanciated B.S. comment will mean more than an actual scientific article on the subject? The CDC is making the recommendations, how do they benefit from the sale of the drug? Why does every psychotic with paranoid delusions feel the need to post on sciam?
Reply | Report Abuse | Link to this@pokerplyer, "there is also a valid argument against the practice" but you never said what that was. You indicated why you didn't think there was justification for it, "prevent the spread of diseases between students who were brought together into confined spaces by the government...In the case of HPV there really is not a similar case..." That isn't an argument against, it just is not an argument for. But even then it doesn't make sense as school is one of the first places that young people begin exploring sex. Of course not at school as such but with people they meet at school.
Reply | Report Abuse | Link to thisI agree it will be resisted but not by people with reasonable arguments but rather by religious fanatics and anti-inoculation lunatics. The advantage to having this done in the schools is that it reduces the ability of these fanatics to commit child abuse by denying their children access to responsible medical care. It is sad that the state must force parents to provide adequate care to their children but the American population is largely irrational, prone to superstition and reactionary thinking. Someone needs to save these kids from their parents' ignorance.
If you believe the government doesn't lie to us and that officials in government organizations don't take money to promote big pharma then I feel sorry for you. This is an obvious attempt to enrich executives and fuel corporate profits at the expense of the American consumer.
Reply | Report Abuse | Link to this@Velstras, again, what is your proof! Your paranoid delusions are not proof. Prior bad acts are not proof of current bad acts. We live in a society of laws and the law requires proof before it finds someone guilty. Only tyrants make summary judgements. You are worse than those you accuse.
Reply | Report Abuse | Link to this@robert schmidt. There is plenty of evidence that drug companies report studies that support their products and don't publish ones that are detrimental to their sales. They have review articles published by authors who haven't written them, but just sign their name to what the drug company has written. There are journals that have been set up to publish work that couldn't pass peer review in an established journal. Many of these stories have been in Scientific American. You should always take into account the self-interest of the parties involved. Given that I still think there is enough evidence in favour of giving the vaccine to both girls and boys. I think a lot of the initial push for this was from GlaxoSmithKline which wanted to get their vaccine out before someone else developed one. This was from the discussion here in Ontario at the time they started offering it. This has caused the expense to be higher than necessary, than if the field had been more competitive.
Reply | Report Abuse | Link to thisI heard on Fox News during the republican debate, about a month ago, that the vaccinations cause mental retardation in girls that got the shots, and they even proved it by pointing at Sarah Palin and her campaign with John McCain. I believe every word the republicans say because they are the science experts. Now, they want to make the boys mental retarded too? When is this madness ever going to stop???
Reply | Report Abuse | Link to this@William Fairholm, "There is plenty of evidence that drug companies report studies that support their products and don't publish ones that are detrimental to their sales" that is not what Velstras claimed. He said, "This vaccination is a big scam by massive drug companies" and I was asking him to prove it. He didn't. That makes him a liar. I'm tired of listening to fanatics rant about conspiracy theories and corrupt science. If someone makes accusations without evidence then all they are demonstrating is their own low moral character.
Reply | Report Abuse | Link to thisWell, check this out:
Reply | Report Abuse | Link to thisPrevalence of financial conflicts of interest among
panel members producing clinical practice guidelines
in Canada and United States: cross sectional study
http://www.bmj.com/content/343/bmj.d5621.full.pdf
Thanks Amy but again that does nothing to support Velstras claim. He didn't say we should be careful because there may be a conflict of interest. He said, "This vaccination is a big scam by massive drug companies." That is an accusation. Where is the evidence?
Reply | Report Abuse | Link to thisI don't know what kind of evidence you're asking for, but this seems pretty awful to me:
Reply | Report Abuse | Link to thishttp://www.nytimes.com/2008/08/20/health/policy/20vaccine.html
"Even critics of the marketing efforts recognize the benefits of the vaccines." yes Amy seems pretty awful. Is the word Armageddon too strong? It would be much better for people to get HPV and cancer. The evidence I am looking for is the evidence that proves Velstras accusation that this is a scam. Companies profiting off a drug that works is not a scam. I think you need to step back and look at your own bias' here. When I want to argue a point I start with my best evidence. When someone starts with conspiracy theories I know they have nothing. It is very telling that the article you referenced has little about the medical properties of the drug and more about the marketing, which can be spun in any direction you like. It's easy to point the figure at those that profit from helping us. It just doesn't seem morally correct to charge someone for something that can save their life. So the media love to frame big pharma as the villain. It sells papers. Delusional people enjoy having someone to blame for whatever is wrong with the world. Fact is, medicine saves lives. So unless you are going to create a non-profit pharmaceutical company and give the drugs away for free (let me know how that works for you), you should be a little more certain of the crime before making accusations.
Reply | Report Abuse | Link to thisSomething that can save their life? And where is your evidence?
Reply | Report Abuse | Link to thisPerhaps you can explain me the words "modest efficacy" in this FDA document:
In the subgroup of subjects that did not have prior exposure to vaccine-relevant HPV and had normal baseline Pap tests, there appeared to be a modest efficacy of approximately 20% against CIN 2/3 or worse due to any type HPV.
http://www.fda.gov/ohrms/dockets/ac/06/briefing/2006-4222B3.pdf
Incorrect. The vaccine has been shown to prevent genital warts in men. HPV also causes oral cancer, anal cancer, and penile cancer, and the vaccine would likely prevent most cases of these cancers in men. It would also reduce the risk of transmission of the virus to women, thus reducing their risk of these diseases as well as cervical cancer.
Reply | Report Abuse | Link to thisYou are cherry picking and misrepresenting the facts which demonstrates that you have an agenda and have no interest in the facts. The stats you site where for "HPV types not contained in Gardasil". So wow, viruses not targeted by the vaccine where only controlled in 20% of cases. Sure sounds like proof of a conspiracy to me. Very telling though that you overlooked the trials with 100% efficacy. If you are so blinded by your obsession that you can't even read your own reference, then what can anyone do to convince you? Sorry Amy, I'm done with you. Conspiracy theory and confirmation bias are the best you have to offer. Someone here posted an article that said it best; scientists try to falsify their hypothesis, pseudo-scientists only look for data that supports their hypothesis and ignore the rest.
Reply | Report Abuse | Link to thisAs I can see you're not really able to read the data. Maybe reading this from Cancer Letters will help you to understand what it's all about:
Reply | Report Abuse | Link to thishttp://www.deepdyve.com/lp/elsevier/letter-to-the-editor-response-to-the-article-of-luisa-lina-villa-hpv-MxsazjHRXG
I looked at the link you posted. It describes the results of two phase III studies assessing the safety and efficacy of Gardasil. There was very high efficacy in preventing cervical intraepithelial neoplasia (CIN, the precursor to cervical cancer) caused by the high-risk HPV types at which the vaccine is directed. The first study compared 6032 women who received Gardasil with 6075 women who received placebo. There were 22 cases of grade 2 or 3 CIN due to HPV types 6,11,16, and 18 in the placebo group and none in the vaccine group, for an observed efficacy of 100%. In the second study which included 2717 subjects in the vaccine group and 2725 subjects in the placebo group, there were 37 subjects with grade 1 or worse CIN due to HPV types 6,11, 16, and 18 in the placebo group and none in the vaccine group for an observed efficacy of 100%.
Reply | Report Abuse | Link to thisSounds pretty good to me!
I realize you are trying to hijack this thread to advance your "cause", whatever that is. But you haven't posted anything that proves that Gardasil is a hoax perpetrated by corporations to steal money from the American tax payer, with complete support of the US government, which is the claim that I objected to. As with any drug there are a range of reactions from patients. There are also circumstances in which you would not administer the drug. Those clinical research trials provide some guidance in that area. But none of those issues are proof of a hoax. Your own references have shown the high efficacy of Gardasil for its target application. Again, not proof of a conspiracy. On the other hand your irrational approach to this issue, the fact that you are not deriving your information from peer reviewed science but instead from biased commentary and your obvious self imposed ignorance of the benefits of this drug do clearly demonstrate that you are nothing more than someone with an axe to grind. Sad that you would willingly deny people access to life saving medicine because of your own personal prejudices.
Reply | Report Abuse | Link to thisYou should also look at the Table 26. What really matters to women is the efficacy (against CIN 2/3 or worse) due to any HPV = only 20.5% ! And that's what this FDA document calls "modest efficacy".
Reply | Report Abuse | Link to thisIt was just reported in yesterday's New England Journal of Medicine that vaccination significantly reduces the incidence of anal intraepithelial neoplasia (the precursor to anal cancer) among men who have sex with men.
Reply | Report Abuse | Link to thisSome facts from the National Cancer Institute: HPV types 16 and 18 cause 70% of all cases of cervical cancer. In 2011 more than 12,000 women in the United States are expected to be diagnosed with cervical cancer, and more than 4,000 women will die from it. If this vaccine has 100% efficacy in preventing CIN from HPV types 16 and 18, this would be very good news for women!
Reply | Report Abuse | Link to thisAmy! You do not understand! From your own reference; "Gardasil™ that contains the major capsid protein (L1 protein) from four types of HPV: types 6, 11, 16, and 18. HPV types 16 and 18 are thought to be responsible for more than 50% of cervical cancer," So, as I said, it is only 20% effective against HPV strains not contained in the vaccine. Do you not understand that? It has modest efficacy against strains that it is not targeting. It is like saying that a breast cancer treatment is no good because it only cures 20% of colon cancers. You need to realise that your problem here is that you are ignorant of the facts not that there is a problem with the drug. Move on!
Reply | Report Abuse | Link to thisRead it carefully: 20.5% is the efficacy against CIN 2/3 or worse caused by any HPV type. You could say that's the overall vaccine impact.
Reply | Report Abuse | Link to thisWhich drug company do you work for, Robert?
Reply | Report Abuse | Link to thisSome facts from the National Cancer Institute: HPV types 16 and 18 cause 70% of all cases of cervical cancer. In 2011 more than 12,000 women in the United States are expected to be diagnosed with cervical cancer, and more than 4,000 women will die from it. If this vaccine has 100% efficacy in preventing CIN from HPV types 16 and 18, this would be very good news for women!
Reply | Report Abuse | Link to thisYes, but what counts is the overall vaccine impact: not 100% nor 70% but only 20.5%.
Reply | Report Abuse | Link to thisWhat counts is the ability of the vaccine to prevent disease. If 70% of cervical cancer is caused by HPV types 16 and 18, and the vaccine is 100% effective in preventing CIN from types 16 and 18, then the vaccine could be up to 70% effective in preventing cervical cancer, i.e., reducing incidence and mortality from cervical cancer by 70%.
Reply | Report Abuse | Link to thisEven if it was only 20.5%, that would still be potentially over 2000 fewer cases of cervical cancer per year and potentially over 800 fewer deaths from cervical cancer per year.
And these figures do not take into account possible reductions in incidence and death from oral cancer, anal cancer, and penile cancer.
The vaccine COULD have been up to 70% effective in preventing cervical cancer, but it obviously isn't. I don't mind if 20.5% efficacy against CIN 2/3 or worse satisfies you. All I'm saying is: let's stick to the facts!
Reply | Report Abuse | Link to thisThe facts are that we don't yet know how effective the vaccine will be in preventing cervical cancer, because the timeline is still too short. The vaccine was approved based on a surrogate marker for cervical cancer, i.e., CIN. In the phase III trials it was 100% effective in preventing CIN due to the high risk HPV types which cause 70% of cervical cancer. Whether that means it will prevent 70% of cervical cancer is of course still unknown. If it's only 20%, that would still be a substantial accomplishment.
Reply | Report Abuse | Link to this