HPV vaccine recommended for young males

For today’s youth, there is a way to prevent the most commonly occurring sexually transmitted disease, directly responsible for many cancers, even long before becoming sexually active. On Oct. 25, the Center for Disease Control and Prevention’s Advisory Committee on Immunization Practices extended their recommendation for the human papillomavirus quadrivalent vaccine to be routinely administered to 11 and 12-year-old boys.

Prior to this announcement, the vaccine was only recommended for females.

“[The ACIP] thought that there was likely to be additional benefit to girls and women by reducing the spread of the virus, but they did think that the burden of disease in males alone was sufficient to recommend the vaccine,” said Dr. Anne Schuchat, director of the CDC’s National Center for Immunization and Respiratory Diseases, in a press briefing.

The American College of Obstetricians and Gynecologists estimates that three out of four of those who are sexually active will acquire genital HPV, or human papillomavirus, which currently infects 20 million Americans.

There are more than 40 types of genital HPV, most of which are asymptomatic, according to the CDC.

Although there is no cure for the viral infection, 90 percent of HPV infections clear without medical intervention within two years.

However, persistent low-risk strains can cause genital warts, and high-risk strains can lead to several forms of cancer.

The National Cancer Institute claims that the leading causes of cervical and anal cancer are linked to ongoing infections with high-risk types of HPV.

These high-risk HPV types are also linked to cancers of the vulva, vagina, penis, throat, head and neck.

Gardasil and Cervarix are the only two vaccines currently approved by the Food and Drug Administration to prevent certain types of HPV and their associated complications when administered before exposure.

For those not vaccinated as children, the ACIP now recommends routine vaccinations for men up to age 21, as well as women up to age 26. A permissive recommendation for vaccination of men from age 22 to 26 still stands, according to Schuchat.

“It turns out that the age of 11 or 12 is a very good time to be vaccinated,” Schuchat told reporters. “Antibody or immune responses are the strongest and that’s well before girls or boys would become sexually active.”

In 2006, the ACIP recommended the quadrivalent vaccine Gardasil for routine use only in females, primarily to deter cervical cancer. Gardasil protects against HPV types 6 and 11, which are associated with 90 percent of genital wart cases, as well as types 16 and 18, which are responsible for causing 70 percent of all cervical cancers, according to the ACOG.

Shortly after the FDA first licensed Gardasil for use in males, the ACIP issued a permissive recommendation for males in 2009, according to the CDC’s Morbidity and Mortality Weekly Report.

The ACIP’s recent strengthening of the recommendation was primarily based upon clinical data that has since become available on the vaccine’s ability to prevent anal cancers, according to Schuchat.

The bivalent vaccine Cervarix was approved by the FDA in 2009 to protect females against the cancer-causing HPV types 16 and 18.

The recent ACIP recommendation applies only to Gardasil, as Cervarix has not yet been approved for use in males.

Either brand is recommended for routine use in females, but only Gardasil has been shown to protect against cancer of the vulva and vagina, according to the CDC.

There has been a disappointing uptake of the vaccine among young girls since the initial recommendation, according to Schuchat, who hopes that the universal recommendation will improve uptake among boys and girls.

Both vaccines are administered in three doses over a six-month period, according to patient information leaflets.

The CDC estimates 20,096 reports of adverse effects out of the 40 million Gardasil doses distributed as of Sept. 15, 2011.

Most were non-serious, including pain at the injection site, headache, fever, dizziness, nausea, and fainting. In 2009, the FDA revised precautionary labeling to include seizure-like activity that may occur in those who faint after vaccination.

There have been rare reports of more serious side effects such as muscle weakness and blood clots.

The 34 confirmed deaths following vaccination were mostly attributable to other factors, according to the CDC and FDA who claim that Gardasil is safe and whose benefits outweigh its risks.

“I am in favor of all children receiving this vaccine at age 11 or 12, whether male or female,” said Carole McCaskill, who teaches nursing at Santa Monica College. “The only reservation I have is cost, which is fairly expensive.”

According to the CDC, Gardasil currently retails for $130 per dose, or $390 for the series.

Many health insurance companies provide coverage for Gardasil, according to Merck & Co., Gardasil’s manufacturer.

In the absence of health insurance, or if a policy fails to cover immunizations, there are two programs to provide assistance to those who cannot afford the vaccine.

The Vaccines for Children Program uses federal funds to give free vaccines, including Gardasil, to qualifying children 18 and under.

The Merck Vaccine Patient Assistance Program, funded by Merck & Co., offers free vaccines to eligible adults 19 and over.

Vaccines are excluded from coverage in the current health insurance policy offered through SMC, by Renaissance Agencies, Inc. SMC requires that international students maintain health insurance coverage through Renaissance, while domestic students may do so on a voluntary basis.

Gardasil is available to both males and females up to age 26 at all 17 Planned Parenthood locations in the Los Angeles area, including the Santa Monica clinic located at 1316 3rd St. Promenade #201, according to the public affairs director for Planned Parenthood, Serena Josel.