Boys should routinely be vaccinated against the sexually transmitted human papillomavirus (HPV) at age 11 or 12 to protect them against genital warts and certain cancers and to reduce the chances that they will spread the virus, a federal advisory panel recommended Tuesday.
The Advisory Committee on Immunization Practices (ACIP), which helps set standards for childhood and other vaccinations, voted overwhelmingly to bring the recommendation for boys in line with that for girls. The vote was 13 in favor, with one member abstaining.
Since 2006, federal officials have recommended that girls be vaccinated at 11 or 12 to help reduce their risk of cervical cancer. The vaccine was approved for boys in 2009, but previous guidelines did not call for their routine vaccination.
Citing additional data on the vaccine’s safety and ability to prevent precancerous growths, the committee recommended boys could begin receiving the Gardasil vaccine for HPV as early as 9. Boys 13 to 21 who have not been vaccinated should get “catch-up” shots, the panel added in a separate vote of 8 to 5.
“Today is another milestone in the nation’s battle against cancer,” said Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases at the federal Centers for Disease Control and Prevention in Atlanta, which will issue a final set of recommendations.
The agency’s recommendations play a crucial role in encouraging vaccine use. Doctors tend to follow the agency’s guidelines, and insurance companies use the information to decide which vaccines to cover. The new federal health law requires insurers in new exchanges to provide recommended vaccines. Gardasil requires three vaccine doses that cost about $400 total.
The vaccine protects against HPV, which is the most common sexually transmitted infection. An estimated 20 million Americans are infected with HPV. For most people, the virus never causes problems. But it can cause genital warts, which in women can lead to cervical cancer — a disease that strikes about 12,000 American women a year and kills about 4,000. The virus causes perhaps an additional 6,000 cases of cancer of the vulva, head and neck in females each year.
Among males, the vaccine is aimed at protecting against genital warts and less-common malignancies that HPV can cause such as penile and anal cancer, as well as cancers of the mouth and throat, which have been increasing, in part possibly because of oral sex. The virus causes at least 250,000 new cases of genital warts and an estimated 7,000 cancers in males each year, leading to perhaps about 1,000 deaths.
Vaccinating boys and men would also help prevent the spread of the virus to sexual partners. Gay men, particularly those who are also infected with the AIDS virus, are especially at risk.
In 2006, the Food and Drug Administration approved Gardasil for girls as young as 9. Medical authorities then recommended that girls be vaccinated at 11 or 12, to protect them before they start having intercourse. Critics worried that vaccinating children would send a subtle signal that their parents were assuming they would become sexually active and that it would give youngsters a false sense of security.
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