The American Academy of Pediatrics is
recommending that all boys between the ages of 11 and 12 receive the
three-dose vaccine for the human papillomavirus (HPV).
That's the most significant change in the latest immunization schedules, released Wednesday by the pediatrics group. The HPV vaccine has been available and recommended for girls and young women since 2006, because it was believed that the vaccine would be most effective at preventing cervical cancer. Since then, other cancers thought to be caused by HPV have been on the increase, 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," said Dr. Michael T. Brady, chairman of the AAP's Committee on Infectious Diseases and chairman of the department of pediatrics at Nationwide Children's Hospital in Columbus, Ohio.
"Currently, our approach isn't effective from a public health perspective since males are also participants in the transmission of HPV," he said. "If we include both girls and boys, we could have a potential impact on HPV transmission."
The new guidelines mirror a recommendation released last October by the U.S. Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP).
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 that the vaccine be given in the pre-teen 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 also cautioned that this 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 blood from them, it's likely that they will faint more often 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 expert agreed with the new guideline.
"What the AAP is doing is being consistent with the ACIP 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 thought that by providing the vaccine to both girls and boys, the vaccine might become less controversial. And, because the ACIP recommended it, both said that insurance coverage likely wouldn't be an issue.
The other noteworthy changes to the AAP schedule included adding a meningococcal booster shot (against meningitis) at age 16. Brady said the initial vaccine is given around 11 or 12 years, and it was initially thought that it would last 10 years. Now, scientists know that immunity begins to wane after five years. Teens and young adults are most at risk for infectious meningitis when they're living in communal situations, such as college dormitories.
The AAP is also recommending that children between the ages of 6 months and 8 years who didn't receive a flu vaccine for the 2010-11 season should receive two doses of flu vaccine this year.
The new AAP recommendations are published in the February issue of Pediatrics.
SOURCES:
Michael T. Brady, M.D., chairman, American Academy of Pediatrics' Committee on Infectious Diseases, and chairman, department of pediatrics, 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; February 2012 Pediatrics
That's the most significant change in the latest immunization schedules, released Wednesday by the pediatrics group. The HPV vaccine has been available and recommended for girls and young women since 2006, because it was believed that the vaccine would be most effective at preventing cervical cancer. Since then, other cancers thought to be caused by HPV have been on the increase, 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," said Dr. Michael T. Brady, chairman of the AAP's Committee on Infectious Diseases and chairman of the department of pediatrics at Nationwide Children's Hospital in Columbus, Ohio.
"Currently, our approach isn't effective from a public health perspective since males are also participants in the transmission of HPV," he said. "If we include both girls and boys, we could have a potential impact on HPV transmission."
The new guidelines mirror a recommendation released last October by the U.S. Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP).
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 that the vaccine be given in the pre-teen 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 also cautioned that this 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 blood from them, it's likely that they will faint more often 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 expert agreed with the new guideline.
"What the AAP is doing is being consistent with the ACIP 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 thought that by providing the vaccine to both girls and boys, the vaccine might become less controversial. And, because the ACIP recommended it, both said that insurance coverage likely wouldn't be an issue.
The other noteworthy changes to the AAP schedule included adding a meningococcal booster shot (against meningitis) at age 16. Brady said the initial vaccine is given around 11 or 12 years, and it was initially thought that it would last 10 years. Now, scientists know that immunity begins to wane after five years. Teens and young adults are most at risk for infectious meningitis when they're living in communal situations, such as college dormitories.
The AAP is also recommending that children between the ages of 6 months and 8 years who didn't receive a flu vaccine for the 2010-11 season should receive two doses of flu vaccine this year.
The new AAP recommendations are published in the February issue of Pediatrics.
SOURCES:
Michael T. Brady, M.D., chairman, American Academy of Pediatrics' Committee on Infectious Diseases, and chairman, department of pediatrics, 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; February 2012 Pediatrics
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