Time to vaccinate boys against HPV?

Carolyn Moynihan
21 Feb 2011
Reproduced with Permission

Five years after western governments began to fund vaccination of girls against the sexually transmitted, cancer-causing, human papillomavirus (HPV) medical professionals and drug companies are calling for subsidised vaccination for boys.

A study funded by Gardasil manufacturer Merck & Co (as well as some private sources) and published in the New England Journal of Medicine earlier this month has found that vaccination against HPV can prevent 90 per cent of genital warts in males when offered before exposure to the four strains of the disease covered by the vaccine. In the general population of young males effectiveness was 66 per cent.

Those figures are based on a three-year follow-up of 4,065 men aged 16 to 26 years, at 71 sites in 18 countries. Of those men, 85 per cent reported having exclusively female sexual partners and the remainder self-identified as having sex with men. (Evidently there were no virgins among those 4000 young men.) Men with a history of anal or genital warts or lesions were excluded.

Genital warts are one of the leading STDs in men, and the US Centres for Disease Control and Prevention (CDC) estimate that half of all sexually active Americans will get HPV at some point in their lives. Think of that: 50 per cent.

And, to speak of morality, there is no guarantee, given the prevalence of the disease, that keeping sex for marriage will protect a person from it. That is why Australian nurse and parent Denise Pintado encourages use of the HPV vaccine as much as any other vaccine. Working at a Sydney laboratory of Sonic Healthcare, the largest diagnostics company in Australia, has strengthened her convictions on the subject. She told Family Edge:

"As a parent I feel very strongly about vaccination. Prevention and protection of my children is paramount. The possibility of eventual eradication of the disease in the wider community would be a bonus but unlikely due to the number of mutations. HPV is at pandemic proportions around the world and it causes cancer. The vaccination protects against just a few versions of the disease but they are the most significant cancer causing variants."

Australia was one of the participants in the Merck study and local drug company CSL along with doctors is also promoting the HPV vaccine as prevention against anal cancer, the incidence of which has risen from 120 new cases in 1982 to 270 in 2005.

Although anal cancer would be largely confined to a small sub-population, preventing cancer was what "sold" the vaccine to governments as a public health measure for girls, so it looks as though the same argument is being used here. The vaccine is also said to be effective against mouth and throat cancers, which a report in the London Telegraph today says are "rocketing" in Britain. This appears to have more to do with the increasing use of oral sex than with smoking and drinking.

To mention morality again: what a sad and ugly idea of sex young people are growing up with.

As it happens, uptake of the vaccine has been disappointing in some places. Among teenage girls in the United States it remains at only 30 to 40 per cent.

That seems to make it even more important that boys should be vaccinated, to reduce at least one source of infection. Says Denise Pintado:

"Because HPV is sexually transmitted that is even more reason to protect my children. Not because of anything to do with promiscuity but because it is a virus and these can lie latent for many years before activating or reactivating. I know of many very good people who have ended up with cancer due to these viruses through no fault of their own. Currently only girls are vaccinated. Boys should be as well to protect our girls."