Health Answers

Should boys be vaccinated against HPV?

By Courtney Humphries
January 18, 2010

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Q. Shouldn’t boys be vaccinated against HPV too, to prevent them from spreading it to girls and putting them at higher risk of cervical cancer?

A. The human papillomavirus is a common virus that is transmitted through skin-to-skin contact. About a third of the 100 or so types of HPV are transmitted through sexual genital activity, and it’s the main cause of cervical cancer, which kills nearly 4,000 women in the US every year. It can also lead to rarer cancers and genital warts. Two HPV vaccines are licensed by the FDA, Cervarix and Gardasil, and vaccination is recommended for 11- and 12-year-old girls, and for girls and women ages 13 through 26 who have not yet been vaccinated.

In September, Gardasil was approved for use in males ages 9 to 26 to prevent genital warts as well as penile and anal cancers triggered by HPV. Because males can carry and transmit HPV, many health experts have advocated for widespread HPV vaccination of boys to prevent them from infecting their partners.

However, a study led by researchers at the Harvard School of Public Health cast doubt on the cost-effectiveness of vaccinating boys as a public health strategy. Jane Kim, a Harvard health policy researcher and an author of the study, says that as a national strategy, the costs of vaccinating boys will outweigh the added health benefits, and that “society’s resources may be better spent on other interventions to improve health.’’ Based on these findings, in October the Centers for Disease Control and Prevention recommended the vaccine for optional use in males.

But Kim notes that the analysis was meant to address overall policy, not individual health choices. The decision not to recommend routine vaccination for boys was based on costs rather than concerns about its effectiveness or safety. “Families considering HPV vaccination for boys may view the benefits of the vaccine worthwhile in terms of reducing the risk of genital warts and possibly other health conditions,’’ she says. It will take years to fully appreciate the health impact of HPV vaccination, and Kim notes that new data about the vaccine’s impact or changes in its price could influence recommendations.

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