August 16, 2011 in Features

Gardasil urged for boys

New strategy against HPV is to vaccinate both genders
Deia De Brito McClatchy
 

What’s the best way to protect teenage girls from sexually transmitted diseases? Some doctors say the answer is to vaccinate boys.

More than 65 million Americans – that’s one in five – carry a sexually transmitted disease. The most common one – the human papillomavirus, or HPV – affects more than half of sexually active Americans at some point, according to the federal government.

Since 2007, health officials have recommended that adolescent girls get vaccinated against HPV because it can lead to cervical cancer later in life.

Now, they’re also suggesting the vaccine for boys to prevent genital warts and anal cancer, rare symptoms of HPV. But for some doctors, vaccinating boys is also a favored new strategy in preventing the spread of the virus to girls.

Dr. Sameena Evers, a physician at Dilworth Pediatrics, encourages boys to get vaccinated against HPV “so that girls don’t get it.” This kind of practice is called “herd immunity,” or vaccinating one segment of the population to protect another.

“It’s no surprise that women are getting it from the men in the world,” Evers said.

Officials say that along with Pap smears, vaccinating girls is the most effective way to prevent cervical cancer.

They say it’s as important for girls as vaccinating against illnesses like tetanus, meningitis and the flu. The series of three shots cost about $400 or more but are covered by Medicaid and most private insurance programs.

Since the approval of the vaccine for boys in 2009, health officials have debated whether vaccinating boys for girls’ sake is an effective way to control cervical cancer. In part, there are questions about how long the vaccine stays active in boys’ bodies.

The federal government recommends the vaccine for boys, too, but it’s considered less urgent. It’s optional for doctors to tell boys and their parents about it.

But many doctors are recommending it to both boys and girls with the same urgency. Every year, cervical cancer leads to about 4,000 deaths in the United States. (By comparison, breast cancer kills 10 times as many women.)

The correlation between cervical cancer and some types of HPV is clear: the primary cause of the cancer in women is HPV. One out of 10,000 women who contract HPV end up with cervical cancer.

Most infections clear up on their own within a couple of years and don’t develop into cervical cancer. Nonetheless, some 35 million doses of Gardasil have been distributed in the U.S.

Some attribute the gender difference to heavy advertising for Gardasil by Merck, the manufacturer, that targeted middle and high school-age girls and their parents. The pharmaceutical company hasn’t done that for boys.

Health experts say patients are learning about Gardasil mostly from their doctors.

Nationally, while teens and young adults represent only a quarter of the sexually active population, they account for half of the new STD cases every year.

Not all doctors are on board with use of the Gardasil vaccine for either gender. Some have criticized the speed with which the drug was approved. They say Pap smears are a highly effective tool for detecting cervical cancer and that the vaccine is just another layer of cost.


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