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CDC: Partial OK of Gardasil for Boys
Oct. 21, 2009 -- Parents of boys may get federal funds to pay for the Gardasil HPV vaccine to prevent sexually transmitted genital warts, a CDC advisory panel today ruled.
But the Advisory Committee on Immunization Practices (ACIP) did not fully recommend the vaccine to boys, as it does for girls. Full recommendation would make the vaccine routine and mandate energetic efforts by doctors and vaccination programs to encourage boys to get the vaccine. It would also require doctors to give the vaccine to patients who request it for themselves or for their children.
The "permissive recommendation" today extended by the ACIP means that doctors may or may not offer the vaccine. If they choose not to give it, they need only refer patients to a doctor or program that does.
The ACIP also recommended that parents or women may choose either Gardasil or the newly approved Cervarix for prevention of cervical cancer. Both vaccines protect against the two human papilloma virus (HPV) strains most likely to cause cancer.
Parents or young women may choose Gardasil if they also want protection against the two genital wart HPV viruses included in Gardasil but not in Cervarix. But the ACIP declined to recommend one vaccine over the other.
Both vaccines are most effective if given to children before they become sexually active. The ACIP recommends them for girls at age 11 or 12. But they can be given as early as age 9 and as late as age 26.
The ruling by the ACIP now includes Gardasil for boys in the federal Vaccines for Children program. The FDA recently approved Gardasil for use in boys and men ages 9 to 26.
There's no argument that Gardasil can't prevent genital warts in boys -- it does. But the vaccine is expensive, and cost-benefit analyses suggest that making the vaccine routine for boys would add to soaring U.S. health care costs.
Moreover, the ACIP has not yet seen definitive studies showing that the vaccine will prevent penile, anal, and oral cancers in men, although experts tell WebMD that HPV is a major cause of these cancers. Pending such evidence -- scheduled for presentation to the ACIP next February -- the panel was skittish about full approval of the costly vaccine for boys.
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