Vaccinating girls, not boys, against HPV is best bet
Harvard University researchers have found that public health authorities would do better to extend the vaccination of adolescent girls against human papillomavirus (HPV) than to launch a campaign to get boys and young men vaccinated as well. The study, published in the British Medical Journal, comes as the Food and Drug Administration considers a proposal from Merck, the makers of the HPV vaccine Gardasil, to approve the vaccine for boys between the ages of nine and 15.
Two professors of health decision science considered the cost of two public health campaigns and compared their effectiveness in reducing HPV-related diseases: one would focus on extending HPV vaccination in girls and women nine to 26 years old to three-quarters of the U.S. population; the other would focus on girls and boys nine to 26. In driving down HPV-related cancers and a disease called recurrent respiratory papillomatosis, focusing on girls only won the contest handily, providing far more bang for the buck than routinely giving boys the shot as well.
The latest study comes as the FDA considers approval of a new "indication" for Gardasil -- to protect boys and men ages nine to 26. If approved, Merck would be free to launch an advertising campaign aimed at men akin to its "One Less" juggernaut that has focused on convincing young women to get the shot. In spite of massive advertising, Gardasil sales have slumped in recent months, and drug industry wags have indicated Merck is eager to expand the market for the vaccine.
In public hearings last month, Merck made its case for FDA's approval of Gardasil for boys and men, arguing that cancers of the anus, penis, rectum and mouth and throat -- most of them attributable to HPV -- are newly diagnosed in 8,600 men per year. In the absence of screening tests for such cancers, men vaccinated with Gardasil could prevent infection with HPV and avert many such cancers, Merck representatives told an FDA advisory panel, which went on to recommend approval of the new use for Gardasil. Vaccinated men would also be less likely to contract and spread genital and anal HPV warts to female partners, thereby reducing cases of cervical cancer, they added.
But Harvard Public Health School's Jane Kim and Dr. Sue Goldie said a public campaign aimed at vaccinating both boys and girls would cost more than seven times as much as a campaign that focused only on girls, and would be no more effective at driving down HPV-related diseases.
The authors of the British Medical Journal analysis underscored that their study did not judge the value to individual families in having their their boys vaccinated against HPV.
-- Melissa Healy