Wednesday 29 February 2012

Pediatricians Renew Call for HPV Vaccine for Boys

The American Academy of Pediatrics on Monday renewed its call that all boys ages 11 and 12 receive the three-dose vaccine for the human papillomavirus (HPV).

The HPV vaccine has been available and recommended for girls and young women since 2006, because it's highly effective at preventing cervical cancer. Since then, other cancers thought to be caused by HPV have increased, including anal cancer and some head and neck cancers.

"Initially, when HPV vaccines were being evaluated, there was an assumption that they would be for preventing cervical cancer and genital warts. Subsequent to that, some things have occurred that show us that providing the vaccine to both genders would be beneficial," Dr. Michael Brady, chairman of the academy's Committee on Infectious Diseases, told HealthDay.

"Currently, our approach isn't effective from a public health perspective since males are also participants in the transmission of HPV. If we include both girls and boys, we could have a potential impact on HPV transmission," added Brady, also physician-in-chief at Nationwide Children's Hospital in Columbus, Ohio.

The new guidelines, published online Feb. 27 in the journal Pediatrics, mirror a recommendation released last October by the U.S. Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices.

The HPV virus can cause cervical, anal and some head and neck cancers, as well as genital warts, according to the CDC. The virus is transmitted though genital or oral sex, and many people who have the virus don't know they have it. To be effective, the vaccine for the virus must be given before someone is ever infected. That's why health experts recommend giving it in the preteen years of 11 or 12.

"I understand most parents aren't interested in hearing about their children being sexually active, but this is a cancer vaccine that's given for a number of different reasons that has to be given prior to the onset of sexual activity," Brady said, adding that another reason to give the vaccine at a younger age is that studies have shown the immune system responds more strongly to the vaccine at this age. "Children between 9 and 12 get the best response to this vaccine," he explained.

He cautioned that the vaccine doesn't protect against all sexually transmitted diseases. Whether vaccinated against HPV or not, practicing safe sex is still crucial for preventing potentially life-threatening infections.

"Plus, if you give HPV vaccine only to females, you won't have any impact for men who have sex with men. By expanding the vaccine to both genders, we would reduce the overall transmission of HPV. And, we would make sure all of the complications of HPV would be prevented in both genders," said Brady.

Brady noted that this vaccine is quite safe, with the most significant side effect being transient soreness in the vaccinated arm. "This vaccine has very minimal risk," he said. However, he said any time you give children in this age group a vaccination or take their blood, they are more likely to faint than people in other age groups. For this reason, your child will be asked to sit for 15 minutes or so after getting the vaccine to make sure that doesn't happen.

One vaccine expert agreed with the new recommendation.

"What the AAP is doing is being consistent with the [CDC] recommendations. There will be a benefit to women from immunizing men, as well as the prevention of warts in males, and possibly cancer associated with HPV," said Dr. Kenneth Bromberg, director of the Vaccine Research Center at the Brooklyn Hospital Center in New York City.

Both experts said that by providing the vaccine to girls and boys, the vaccine might become less controversial. And, because the CDC recommends it, both said that insurance coverage likely wouldn't be an issue. The three-shot regimen costs approximately $360.

SOURCES:
Michael T. Brady, M.D., chairman, American Academy of Pediatrics' Committee on Infectious Diseases, and physician-in-chief, Nationwide Children's Hospital, Columbus, Ohio; Kenneth Bromberg, M.D., chairman, pediatrics, and director, the Vaccine Research Center, The Brooklyn Hospital Center, New York City; Feb. 27, 2012, Pediatrics, online

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