HPV vaccine now recommended for boys: American Academy of Pediatrics

By Dr. Ananya Mandal, MDFeb 28 2012

Pediatricians in the U.S. say it's now time for boys, as well as girls, to be vaccinated against human papillomavirus or HPV. The American Academy of Pediatrics has updated its guidance to parents and doctors in favor of routine immunization for boys against the virus. Earlier the AAP had said it was OK to vaccinate boys against the HPV, but it only became part of the pediatricians' official schedule of recommended vaccines this month.

It's estimated that HPV types 16 and 18 are responsible for 7,000 cases of cancer in men every year in the U.S. and 15,000 cases in women, most of them cervical cancers. But the sexually transmitted virus also causes genital warts and anal cancers. It's also been implicated in the recent increase in oral cancers, though the HPV vaccines aren't approved to reduce that risk.

The vaccine is most potent if given before the onset of sexual activity. Boys and girls should be vaccinated when they're 11 or 12, the doctors say. Older boys and young men, ages 13-21, should get the vaccine, if they weren't immunized earlier.

Side effects, such as pain and redness at the site of injection, are generally mild. The vaccination is expensive. Full immunization takes three shots (either with Merck's Gardasil or GlaxoSmithKline's Cervarix), which run about $100 or more each.

The cost-effectiveness of vaccination for boys is an issue. The recommendation notes that “a range of assumptions,” including the vaccination rates for girls, can affect how much each prevented case of illness costs. Still, the group concluded HPV vaccination would be worthwhile for boys and men up to 21.

In response to a question about potential financial conflicts, the American Academy of Pediatrics said that the members of its policy-writing committees have to provide disclosures to the group. “Neither Rodney Willoughby, the lead author of the HPV policy, or Michael Brady, the chair of the Committee on Infectious Diseases, had any financial disclosures,” a spokeswoman for the group said.

“What we are hoping will come out of this is that we can push this as a cancer vaccine,” said Dr. Michael Brady of the American Academy of Pediatrics. “We now have the ability to interrupt the transmission and the development of cancer.”

Most private insurance companies don't currently cover the shots for men.