Experts wrestle with vaccinating boys for HPV

* CDC panel considering several options

* Routine vaccination not currently recommended

* Cost remains an issue

By Julie Steenhuysen

CHICAGO, Oct 28 (BestGrowthStock) – U.S. vaccine advisers are
weighing whether boys and young men should be vaccinated
against the human wart virus that causes a number of cancers,
but some worry the vaccine is too costly to justify its use.

Merck & Co’s (MRK.N: ) Gardasil vaccine is approved for boys, safe
and it would be cost-effective, CDC researchers and vaccine experts
told a meeting of the Advisory Committee on Immunization Practices on
Thursday.

Some men would also benefit from the vaccine, including
homosexuals and bisexuals, who are at risk of developing anal
cancers and other conditions caused by the human
papillomavirus, or HPV, the experts said.

HPV infection is best known as the primary cause of
cervical cancer, but it can also lead to cancers of the anus,
penis, head and neck. Vaccinating men and boys could prevent
some of these cancers.

Currently, U.S. Centers for Disease Control and Prevention
recommends Gardasil vaccinations for girls and women between
the ages of 11 and 26.

And while doctors are free to use the vaccine for
preventing genital warts in boys and men ages 9 through 26,
U.S. vaccine advisers last year declined to recommend routine
vaccination for males.

But they did make it available to boys in the Vaccines for
Children Program, a government-funded system that provides
vaccines to children eligible for the state-federal Medicaid
health insurance plan and other uninsured children.

The main reason the vaccine was approved was to prevent
cervical cancer, which kills 4,000 women a year in the United
States. But various strains of HPV also cause disfiguring
genital warts and anal, penile, head and neck cancers.

Last year, the advisory committee only considered its use based
on its ability to prevent genital warts. In that case, the benefits
did not seem to justify the vaccine’s $360 cost.

Now, the CDC is taking up the issue again.

Dr. Lauri Markowitz, who heads the committee’s HPV working
group, told the meeting cases of anal cancers are increasing in
the United States, especially among women, and men who have sex
with men.

“Estimates from various studies indicate that the incidence
of anal cancer in men who have sex with men may be as high as
37 cases per 100,000 men,” she said.

Markowitz said her panel is considering several options.
They could make no change, or they could vote to recommend
routine immunization of boys at age 11 or 12.

“With either of these options, there could be a specific
recommendation of men who have sex with men,” she told the
meeting.

Many also feel vaccinating adolescent males before they
become sexually active is the best way to protect them without
requiring them to disclose their sexual orientation, she said.

Cost appears to be a major concern for those who oppose
routine vaccination, Markowitz said, but many members said they
would reconsider their position if the vaccine were cheaper.

The Vaccines for Children Program pays $108 per dose of the
vaccine, which is given in a series of three doses.

And there are practical reasons to expand coverage.

She said panel members who support routine vaccination cite
studies showing the vaccine is safe and effective and say
vaccinating both girls and boys at the same time would be
easier for doctors.

A national survey of doctors showed 36 percent of
pediatricians and 24 percent of family medicine physicians are
administering the vaccine to males, experts told the CDC
panel.

Experts wrestle with vaccinating boys for HPV