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Vaccinating Boys for STDs?

By Elizabeth Greenwell


 

TV ads promoting Merck’s human papillomavirus (HPV) vaccine have faded from prominence in recent months – it’s been a while since we’ve heard the mantra “I want to be one less ... one less.”
But the silence does not reflect the progress made in the fight against the nation’s most prevalent sexually transmitted disease.
In the last few months, the Food and Drug Administration approved the use of Merck’s Gardasil in males ages 9 through 26, and granted competitor GlaxoSmithKline approval for Cervarix, their version of the HPV vaccine, but only for use in girls and women ages 10 through 25 years.
The drug has proved to be highly effective in the prevention of HPV-related cervical disease for girls and young women. But why vaccinate boys?
There are some compelling reasons:
• Vaccinated males could no longer infect their female partners.
• The risk of anal and penile cancer would drop among the homosexual male community.
• The vaccine reduces genital warts and precancerous lesions by 90 percent.
Up until now, adolescent girls and young women have been the priority for vaccination against a virus spread by intimate contact, but whether the drug crosses the gender line is still up in the air. For example, will it be added to the list of required vaccinations for preadolescent girls, or will boys be added?
Cost could be one inhibitor. According to a recent article in the British Medical Journal, vaccinating boys and girls would not be cost-effective when compared to vaccinating girls only. Yet, the Hepatitis B vaccination is mandatory for both boys and girls although the incidence of Hepatitis B infection is much higher in males than females.
That virus can also be spread through sexual contact. There is no doubt that the vaccine is highly effective in the prevention of HPV-related cervical disease for girls and young women.
But instead of a universal recommendation to vaccinate every schoolage girl, perhaps we should start thinking about vaccinating our boys as well. Considering that HPV affects 6.2 million people each year, a gender equitable approach may be the best strategy and provide longer-term direct and indirect health benefits for both males and females.
Elizabeth Greenwell, Sc.D., received her doctorate from Harvard School of Public Health in maternal and child health. She is a postdoctoral fellow at the University of Colorado Denver. Her research interests include the impact of pregnancy and perinatal risk factors on adverse neonatal outcome and early childhood health and development.