Federal panel does not recommend Gardasil in boys... now what?
A CDC advisory panel has said the HPV-vaccine Gardasil should not be used routinely in men and boys. The panel's advice, which the CDC usually follows, comes on the heels of the vaccine winning approval for boys by the Food and Drug Administration.
The panel said it's OK to give the vaccine to males who want it, but stopped short of adding it to the list of routine recommended vaccines for boys.
Supporters of the vaccine's use in boys had hoped recommending the vaccine to them would lead to greater protection for girls and women from the sexually transmitted virus (HPV) that can cause cervical cancer. But members of the panel questioned whether this was cost effective. The vaccine isn't cheap -- a series of three injections runs upwards of $300.
Others hoped that the approval would signal gender parity in the war against sexually transmitted diseases. After all, it takes two doesn't it? If girls can contract HPV from sex, shouldn't their partners help protect them from the virus?
The vaccine would also protect boys from genital warts. While genital warts may not be as severe as cervical cancer, the costs associated with its treatment could be reason enough to vaccinate boys, some experts say.
"It’s embarrassing, but it does not cause cancer," Dr. Maura Gillison, an oncologist at Ohio State University told me recently. "But it does cause a heck of a lot of money for the American health care system. For that, there is no question."
Gillison, who made the connection between HPV and head and neck cancers in men, thinks perhaps with more study, the vaccine could be shown to protect against these painful, disfiguring and difficult to treat cancers.
For now, though, the CDC news begs an interesting question: will teenage boys end up getting the vaccine anyway? Will parents think it's necessary and worth it? And how will they navigate yet another uncomfortable conversation of adolescence?
As far as girls are concerned, pediatricians tell me the conversation is tough and many parents are reluctant to have their daughters vaccinated. About one in four girls gets the vaccine, which is expensive and remains controversial because of some side effects.
"Girls' parents are really hesitant about it," Dr. Terry Nguyen, a pediatrician told me recently, adding that about half of her teenage girl patients get the vaccine. "For boys, I think it’s probably going to be different. For girls, it's a conversation about cancer and their futures. For boys, it's genital warts. It’s not as concrete for them."
Comments
I intend to recommend to my cousins with young daughters that they get them vaccinated before they go off to college. By the time the vaccine was approved, I was a few months "too old" to start the shots. Subsequently tested positive, increased in severity, and had to go through a minor surgical procedure. All the stress associated with that (as an adult!) makes me believe it is worth it for my loved ones to get the vac while they are eligible so that it can protect them years down the road.
Posted by: been there | October 23, 2009 9:11 AM
Not sure why so many parents think that vaccinating their child against HPV obligates them to discuss sex. Why can't it be treated as simply a shot to prevent a future infection. Parents can discuss other issues in their time frame- the vaccine is not meant to pressure parents to have "the talk."
Posted by: Laura J. | October 24, 2009 2:40 AM
Do you only need the one vaccine or do you need to keep getting them done after a number of years
Posted by: Gemma | October 25, 2009 7:45 PM
According to the FDA, boys don't need to get vaccinated for HPV for the same reasons that they don't need to do dishes or laundry - the girls will do it for them. Never mind all of the girls whose parents are anti-vaccine kooks, or fundamentalists who think their precious will never be at risk for an STD - nevermind that over 90% of women at some point in their life will contract HPV and even if they're abstinent 'till marriage their husband probably will have at least one strain of the virus. One can also imagine that vaccinating (some) women may perhaps protect them, and their partners, but will do nothing to help prevent the spread of HPV among gay men, who get HPV-related cancers at a rate similar to the rate women get cervical cancer. Bascially, HPV is a society-wide problem and to reduce its transmission everyone should be vaccinated. But once again blame greed, as Gardasil's obscene $400+ price tag will probably put it out of reach for much of the population and cause many insurance companies to not cover it.
Posted by: Robert | October 29, 2009 11:05 PM