Recently the Advisory Committee on Immunization Practices at the Centers for Disease Control (CDC) recommended that boys aged 11-12 be vaccinated against HPV, a recommendation already in place for girls. It also recommended that boys aged 13-21 received “catch up” doses if they were not vaccinated already. I’m not going to discuss the safety and efficacy of vaccines in general- mostly because I don’t have enough room- but Seattle Mama Doc has wonderful posts about this topic in her blog. This post is specifically to address the issues raised by recommending HPV vaccine for male pre-teens and teens.
- HPV is short for Human Papilloma Virus, which is an umbrella term for different virus strains with different effects on the body. HPV can lead to anything from a wart on your hand to cancer.
- HPV is divided into different types by numbers. For example, HPV Type 1 causes plantar warts, while HPV Type 16 can cause cancer in the mouth, cervix, anus, and genitalia. There are over 120 types.
What Type Does the Vaccine Prevent?
- There are two vaccines out there, but the one most commonly used (at least in this area) is Gardasil. It prevents contraction of HPV Type 6, 11, 16, and 18.
- Type 6 & 11 cause the majority of genital warts, and 16 & 18 cause the oral, cervical, anal, and genital cancers mentioned above.
- The HPV vaccine is given early (age 11-12) because the benefit of the vaccine is reduced once someone has been sexually active and possibly exposed.
Why Should Boys Get The HPV Vaccine?
- In boys, the HPV vaccine can prevent (or at least greatly lower the risk of) genital warts, HPV-related anal/ genital cancers, and HPV-related oral cancers.
- It also prevents boys from carrying and transmitting HPV to their female sexual partners.
What Are the Dangers of the HPV Vaccine?
- About 10% of vaccine recipients will get a mild fever, 3% report itching at the shot site, and 2% have a moderate fever.
- Dizziness, nausea, and headache have also been reported.
- A common effect of any vaccine in this age group is fainting; this isn’t related to the HPV vaccine specifically. You can read more about this reaction here.
- o.ooo5% of Gardasil vaccinations have resulted in adverse events reported to the CDC & FDA. However, even those adverse events are not proven to be caused by the vaccine. (If I get HPV, and contract a cold virus around the same time, I will have sneezing and coughing after the vaccine- but not because of the vaccine.)
- To date, there is no scientific evidence that the HPV vaccine has caused any deaths or serious adverse events.
What Are the Dangers of HPV Infection?
- Oral cancer: Oral cancers in non-smokers have tripled over the last 20 years, mostly due to the effects HPV. Some researchers are predicting that rates of HPV-related oral cancer will be more common than HPV-related cervical cancer in a decade. Oral HPV can be passed by oral sex.
- Penile cancer: This is a quite rare, but obviously unpleasant and painful cancer that has been linked to HPV infection.
- Genital warts: Genital warts are not fatal. However, treatment can be painful and costly, and it’s an embarrassing condition to have to disclose in a relationship. As a teen once said to us, “I don’t want warts on my junk!”
- Anal cancer: It is estimated that 85-90% of anal cancers are linked to HPV infection. There is a higher risk for people having receptive anal intercourse.
- Cervical cancer: A man who has been vaccinated against HPV will not contract and pass on certain types of HPV to his sexual partners. With current low HPV vaccination rates for girls, this can be significant in preventing a future partner from having cervical cancer.
Can’t People Just Have Safer Sex?
- While condoms work very well at preventing transmission of certain STDs in a sexually active population, they are not great protection against HPV.
- HPV exists on surfaces that condoms don’t cover, and can be passed between sexual partners even when condoms are in use.
What About Abstinence?
- Someone who is truly sexually abstinent is unlikely to catch HPV type 6, 11, 16, & 18.
- Remember that some teens don’t consider oral sex (and sometimes even anal sex) to be “real sex”, so they may be abstinent by their standards, but still at risk for infection by ours.
So Should I Vaccinate My Male Teen or Pre-Teen?
- As a health care worker, I usually recommend following CDC guidelines. That said, if you’re on the fence, I’ll wager your primary care provider would be happy to discuss this with you.
- Bring your pre-teen or teen along so they can get the information and be involved in the decision as well.
This is a big topic to address in a short space, and I’m already way over my word count! Please ask any questions or give opinions below.