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Medicine Science

HPV Vaccine Recommended For Boys 569

Posted by timothy
from the pushed-by-big-pharma-and-not-a-cure-all dept.
necro81 writes "An advisory committee to the U.S. Centers for Disease Control and Prevention will soon issue new recommendations that pre-adolescent boys be vaccinated against Human Papilloma Virus (HPV). The disease is sexually transmitted, endemic in the sexually active, can cause genital warts in both men and women, and is the primary cause of cervical cancer, which kills hundreds of thousands of women globally each year. The three-dose vaccination has been available for several years and is already recommended for pre-adolescent girls. Vaccinating boys should further reduce transmission."
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HPV Vaccine Recommended For Boys

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  • Good (Score:5, Insightful)

    by geekoid (135745) <dadinportland&yahoo,com> on Tuesday October 25, 2011 @01:20PM (#37833304) Homepage Journal

    This is no surprise, but I am glad it's been approved. Once again science making the world safer.

    Science isn't about asking "why?", it's about asking "why not?". Cave Johnson, I'm done here.

  • by fuzzyfuzzyfungus (1223518) on Tuesday October 25, 2011 @01:20PM (#37833310) Journal
    What a sensible idea.(Incidentally, males aren't strictly carriers; but penile cancer is much less common than cervical for some reason)
    • by fwice (841569) on Tuesday October 25, 2011 @01:25PM (#37833368)

      It's not just penile cancer. Also, depending on how transferred, HPV can cause rectal and oral (throat) cancers.

      I also ready today (here [nytimes.com]) that HPV may lead to future heart trouble.

      • by whoever57 (658626)
        It's also about common warts: plantar warts and warts on the hands and face.
    • by Myopic (18616)

      I am not a doctor. My guess is that urine keeps the penis cleaner than the cervix. Are there any doctors who can comment on my guess?

      • by ColdWetDog (752185) on Tuesday October 25, 2011 @01:39PM (#37833574) Homepage

        I am not a doctor. My guess is that urine keeps the penis cleaner than the cervix. Are there any doctors who can comment on my guess?

        I will avoid making snarky comments about your elimination habits (although it is rather tempting).....

        The Standard Model of cervical cancer (I made the term up, we don't call it that) goes like this:

        The cervix [wikimedia.org] has two different types of epithelial (skin) cells. The area where these two types intersect (called the 'transitional zone) is a region of high cell turnover - cells are dying and being replaced, lots of chemical and genetic activity. This makes it an ideal place for the HPV virus to switch cell growth from normal to abnormal. So even though you can get HPV infections in other parts of the cervix / vagina / anus / penis it is the activity in the transitional zone that cause problems.

        Males don't have a cervix (no, don't go there, this is a quality, family oriented web site), no transition zone. LESS (not zero) cancers.

        Most HPV induced cancers in males are found in the anal regions where again, cell division and turnover are relatively high. HPV associated cancers in the mouth and throat are rarer still, but they do happen.

        The major thrust (so to speak) for immunizing males is that they are typically 50% of the sexually active couple (more or less) and decreasing the amount of viral load will lead to a decrease in infections which will lead to a decrease in HPV associated disease.

        • by Myopic (18616)

          I appreciate that response. That is very informative. Can you say whether the cell turnover on the cervix is definitely greater than the cell turnover in the male urethra?

          Also, you didn't say so explicitly, but you used the word "we", which implies that you are a doctor. You can convert your post from +5 Interesting to +5 Informative if you can say that you are actually a doctor.

          • by Hatta (162192) on Tuesday October 25, 2011 @02:13PM (#37834084) Journal

            You don't have to be a doctor to read and understand the literature. In fact, it helps. By and large med students don't care about anything not on the test, and doctors get most of their continuing education from pharmaceutical companies. Anyone with college level chemistry and biology, and an actual interest in science, is better prepared to interpret the literature than most doctors are.

            What would actually improve the post a lot is a link to a peer reviewed article.

    • by DeadCatX2 (950953)

      Yeah, who would have ever thought something like herd immunity [wikipedia.org] would be sensible...

  • Wasn't there a story on /. a while back how this vaccine also protects from throat cancer in males?

  • by HockeyPuck (141947) on Tuesday October 25, 2011 @01:24PM (#37833360)

    If we had celebrities coming out and saying "I think the vaccine could have more side effects than the disease..."

    We'd still have polio...

    measles...
    mumps..
    Rubella...
    Tuberculosis
    Whooping Cough...

    and a bunch of other nasty diseases flying around like the common cold. I think many parents (atleast around here in Northern California, think you need 200 years of concrete data, or Oprah to claim a vaccine is needed).

    • by tool462 (677306) on Tuesday October 25, 2011 @01:50PM (#37833704)

      And thanks in part to the anti-vaccination folks, some of those are making a bit of a comeback. Whooping cough and measles are the ones our pediatrician mentioned.

    • by Vellmont (569020)

      The problem isn't the celebrities, it's a public more willing to listen to celebrities than scientists about an issue that's almost entirely scientific. We have an endemic fear culture that embraces worry over knowledge. People only listen to the celebrities because they're spreading a message that the public is primed to receive. We have to eliminate the culture that embraces this message of ignorance and fear, and anti-intellectualism. The celebrities are merely a symptom of our broken culture.

      • by geekoid (135745)

        It's the media. They show the debate in a light of 'everyone's an experts'. So Dr Oz gets the same credit as an doctor whose specialty is immunology.

    • by afidel (530433) on Tuesday October 25, 2011 @01:54PM (#37833780)
      Dude, where have you been TB is still here and is scarier than ever because most cases are now resilient to all but a cocktail of the most infrequently used antibiotics with the most severe side effects.
    • by elrous0 (869638) *

      I'm sorry, but Jenny McCarthy and Charley Sheen are not exactly typical celebrities. Holding up Queen Bimbo and King Himbo as typical is an insult to Matt Damon, Ben Affleck, and everyone else who's ever been in a Kevin Smith movie (with the possible exception of Jason Mewes).

    • If there was a vaccination that prevented your child from becoming a celebrity, this would all take care of itself in a couple decades.
  • What about male swingers in their mid-30s? Not saying this is me, but. . . If these people are possibly spreading disease, wouldn't it make sense to vax them too?
    • by iceperson (582205)
      I think the argument is most of the adult population already has HPV so it's too late for them.
      • Is there not a test for HPV- for those HPV negative- they could be vaccinated.

        • by rthille (8526)

          According to the CDC website, no there is no test to say whether an individual is HPV infected or not.
          Interestingly though it also seems to indicate that the HPV infection can go away of its own accord in time.
          http://www.cdc.gov/std/HPV/STDFact-HPV.htm [cdc.gov]
          "There is no general test for men or women to check one’s overall "HPV status," nor is there an approved HPV test to find HPV on the genitals or in the mouth or throat."

          and from http://www.cdc.gov/std/hpv/stdfact-hpv-and-men.htm [cdc.gov]
          "There is no test for men

      • by ClintJCL (264898)
        I think you need to read the other response to my question.
      • by Altus (1034)

        given that there are hundreds of strains of HPV and the 2 vaccines cover something like 16 strains between them it is quite possible for this vaccine to be useful even to someone who has been exposed. Many men could be carrying very common strains of HPV but not be carrying one of the most dangerous strains (some of which are targeted by these vaccines).

        Of course the problem isn't that you can't get the vaccine, you can, but your insurance won't pay for it. What it comes down to is its not financially ben

    • From what I understand of it, the argument is that once you've become sexually active there's little point as you've probably already been exposed.
      • by hedwards (940851)

        Right, at present I don't believe there's much evidence to support any benefit for people already infected, however if you're only infected with one of the strains that is included, there would likely still be some benefit.

        But, as others have said, it's not just sex, these strains do sometimes cause throat cancer as well as penile, cervical and anal cancers so, hypothetically there should be some risk just from kissing.

    • Re:swingers? (Score:5, Informative)

      by fwice (841569) on Tuesday October 25, 2011 @01:35PM (#37833508)

      I got the HPV vaccine last year as a male at the age of 26. There is the overall thought that if you are sexually active (ie, not a non-infected virgin with another non-infected virgin), you will have obtained some strain of HPV (there are more than 150, most are relatively benign). Your body can "clear" most of these, and they will never be an issue. I thought it was still appropriate for me to get the vaccine, as there are some benefits:

      • if you aren't infected with certain strains, you are vaccinated from 2 high-risk (HPV 16&18, cancer causing) and 2 high-trauma (HPV 6&11, wart causing) strains of HPV. These strains account for ~70% of HPV-related cancers and ~90% of warts, if I recall the numbers correctly.
      • if you are infected with HPV 6/11/16/18, the vaccine may help your body to clear and infection if it lingers, and may reduce (or eliminate) outbreaks of warts

      Vaccination was uncovered by my insurance (gee, thanks!) but I figured it was worth the $510, to protect myself and any partners (should I be a carrier).

      • by ClintJCL (264898)
        Thanks. That's PRECISELY the type of answer I was looking for. Very informative. They really oughtta cover those for males then. Glad to see the medical community is finally accepting what needs to be done, but what's in it for the insurance companies?
        • by fwice (841569)

          what's in it for the insurance companies?

          Less infections requiring procedures would mean less money spent on treatments, and would reduce the amount of money they would have to pay out for treatment.

          Oh wait, that's probably not what they want, since that means less money passing through their hands for them to skim off of.

      • by afidel (530433)
        Was $510 the cost of just the shot(s) or did that also include the doctors office visits?
        • Was $510 the cost of just the shot(s) or did that also include the doctors office visits?

          My daughter just got the second of the three shot series. The first visit is a 'doctor visit', while the last two shots are 'nurse visit' and somewhat cheaper.

          $510 sounds like well under the cost of three such short 'checkup' visits. Also: wiki says [wikipedia.org] that all three shots 'retail/list' for $360.

  • by Anonymous Coward on Tuesday October 25, 2011 @01:27PM (#37833406)

    Can we invent vaccines for sexually transmitted diseases that get transmitted sexually? Imagine the distribution efficacy and cost benefits we could realize with STVs!

    • by Jeng (926980)

      Hell, if that starts up I may go into the vaccination racket, preferably at an all women's college.

    • Can we invent vaccines for sexually transmitted diseases that get transmitted sexually?

      Someone should invent a vaccine that could go on condoms. Could call them White Hats.

  • by Taibhsear (1286214) on Tuesday October 25, 2011 @01:35PM (#37833512)

    Last I heard they didn't have a way to test men for HPV. Men are almost, if not always, asymptomatic and wouldn't have enough viral material accessible to test for it. Have they refined this? How much testing has been done to show the effectiveness of this on boys? I'm all for this vaccine and I'd get it myself if I'm not already a carrier, but it's expensive and unless they can effectively test for this it's possibly just a cash grab.

    • by Microlith (54737)

      This is why they have an age limit on the vaccine. The goal is to get boys and girls vaccinated before they become sexually active and are exposed to the virus. The assumption being that after a certain age, the likelihood of exposure approaches one and by then it's too late (combined with the difficulty in testing for the virus.)

      • by Reziac (43301) *

        But should still be of value to persons who have not been sexually active, yes? regardless of age.

        And I'd been wondering why they didn't vaccinate males; after all, carriers are half the equation.

    • by fwice (841569)

      testing for males is very difficult, as an asymptomatic male will show no signs of being infected, and, if I recall properly, the FDA does not have any approved tests for HPV in men. I believe the effectiveness in this comes from "Herd Immunity".

  • by fermion (181285) on Tuesday October 25, 2011 @01:35PM (#37833518) Homepage Journal
    On one hand it will prevent many caners in future generations, thus decreasing suffering and medical expenses.

    OTOH, SEX!

    On one hand it will allow many couples to have children that may not have otherwise due to cancer, which most agree is a good thing

    OTOH, SEX!

    And really isn't that what is all about? Preventing anyone from having sex outside a state defined and mandated relationship. We can't have people going around enjoying themselves without the approval of the feds, can we?

    I was amazed at the opposition to HPV for vaccines. Do people really think that kids alone in the backyard are going to limit themselves to mutual handjobs because they are afraid they might give each other cancer? Do they really think that kids are going to be more likely to want to see what all the fuss is about because they have the vaccine? Sure I understand the implicit idea is that the vaccine assumes multiple partners over a life time, but isn't that the status quo that is modeled? Newt Gingrich has slept with at least three women. If marriage is between one man and one women, and we promise god that we will be faithful untile death do us part, isn't any number more than one kind of morally equivalent.

    One hesitates to suggest that if this was a vaccine against prostate cancer there would not be so much discussion.

  • by roman_mir (125474) on Tuesday October 25, 2011 @01:36PM (#37833530) Homepage Journal

    Recommendation is one thing. Mandate is another altogether. I don't have a problem with somebody recommending something. I have a problem with somebody taking over your decisions about your body and your health (and yes, I think an individual rights are more important than the society, because individual is the smallest minority).

    • by h4rr4r (612664)

      So then I should be allowed to spread disease if I want?

      What if I want to infect myself with TB and walk around infecting others?

      I think you should be allowed to opt out of the vaccine, then you should of course be legally responsible for anything that happens because of it. Including an insurance company refusing to pay for your cancer.

    • by halivar (535827)

      If you choose to put a chink in the armor of herd immunity, I agree it should be your right. Somewhere else. Maybe we can make an island for people who like smallpox and polio, too.

      I jest, but you're coming at this from the angle of a person who has already benefited from government-mandated vaccinations given to your parents and grandparents; vaccinations which may have saved your life.

  • Warning (Score:5, Funny)

    by CheerfulMacFanboy (1900788) on Tuesday October 25, 2011 @01:51PM (#37833726) Journal
    Vaccination can lead to retardation in mothers, up to voting for Michele Bachmann.
  • I'm tired of getting warts frozen off the bottoms of my feet. Now that I work in a lab with access to liquid N2 I might just start freezing the bastards off my self.
  • by stating_the_obvious (1340413) on Tuesday October 25, 2011 @02:10PM (#37834030)
    In 2000, there were approximately 40 million people in the US between the ages of 10 and 24 (censusscope.org). The 3 dose Gardacil cycles costs approx $360 (cervicalcancer.about.com). Total cost of HPV public health vaccinations: 14Billion in the first year, and maybe $1Bn per year in each subsequent year.

    There are approximately 12000 cases per year and 4300 deaths per year from cervical cancer (cancer.gov).

    If Gardacil prevents 90% of those cases (it's a very effective vaccine), then vaccination has an effective cost of approximately $157,000 per case (assuming we amortize the initial 14Bn hit over 20 years).

    I understand there are other public health benefits than simply prevention of cervical cancer, but let's hope we get a biosimilar quickly to drive the cost of vaccination down significantly.
  • by u19925 (613350) on Tuesday October 25, 2011 @02:25PM (#37834252)

    "The disease is sexually transmitted, endemic in the sexually active, can cause genital warts in both men and women, and is the primary cause of cervical cancer, which kills hundreds of thousands of women globally each year."

    Let us look at the figures at wiki. 4800 women died in US of cervical cancer. 70% of these are caused by HPV and the vaccines are 90% effective. It means that if everyone is vaccinated, it will prevent about 3000 deaths. Remember CDC is recommending for US men and women and has no effect on global deaths which is around 250k/yr of which 70% are due to HPV, which is about 175k. That figure does not qualify as "hundreds of thousands".

    Also, with the cost ranging in the region of $100-200 and effectiveness of 4-6 years, this is one of the most expensive preventive medicines ever.

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