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Tomorrow, advisers to the Centers for Disease Control and Prevention will decide whether boys should get the vaccine against the human papilloma virus, or HPV. The vaccine is currently recommended for girls when they reach the age of 11. It prevents genital warts and cervical cancer. While HPV also causes warts in boys and men, it leads to far fewer cases of cancer.
And as NPR's Brenda Wilson reports, the big question facing the CDC is whether it makes economic sense to vaccinate boys.
BRENDA WILSON: Both girls and boys, men and women, transmit HPV. At least half of sexually active people will get the infection at some point in life. Men often have no symptoms of the disease, or they may get genital warts that can be easily treated. In very rare instances, they develop genital cancers. Untreated cases in women, however, do more frequently lead to cervical cancer.
Professor JOHN EDMUNDS (London School of Hygiene and Tropical Medicine): Both sides are requiring infection from the other. So, clearly it's a shared responsibility, but clearly, the risks are far greater for girls.
WILSON: That's Professor John Edmunds of the London School of Hygiene and Tropical Medicine, who has examined the question that will confront the advisory committee at the CDC tomorrow. Is it really cost-effective to vaccinate both boys and girls?
Prof. EDMUNDS: It's pretty clear it's not cost-effective to vaccinate boys just in general. The risk of the (unintelligible) serious diseases is so rare in the general male population that it's kind of not worth it.
WILSON: Numerous studies have concluded that generally, vaccinating boys would cost more than any health benefit it might actually provide, even preventing infections in girls. That's if most girls get the vaccine. But the rate of vaccination in girls is low, in part because it costs $130 a shot, and three shots are needed.
Merck makes the vaccine. Its health economist Erik Dasbach says vaccinating boys would be cost-effective. Ultimately, he says, what's spent on the vaccine and screening for disease is offset by preventing HPV.
Dr. ERIK DASBACH (Health Economist, Merck): All the costs that would be avoided with the HPV diseases that would be prevented. So cervical cancer is prevented, the vulvar cancers, the vaginal cancers, the genital wart cases all have significant costs associated with it.
WILSON: But John Edmunds says it would be better to spend the money getting as many girls vaccinated as possible. He says there is one instance that does make it cost-effective to vaccinate boys.
Prof. EDMUNDS: And that would be high-risk, young, gay men. They are also at an increased risk of sever outcomes from HPV infections. So, they're rare, but the anal cancer and penile cancers are much more common in gay men than they are in heterosexual men.
WILSON: And Dr. Neal Halsey, a professor at the Johns Hopkins School of Public Health, says there's another ethical argument for vaccinating boys as well as girls against HPV.
Dr. NEAL HALSEY (Johns Hopkins School of Public Health): I think most parents would want their sons to not transmit disease to their potential or already existing daughters-in-law and prevent early death due to cervical cancer in the mother of their grandchildren.
WILSON: And he says Merck could make vaccinating boys more cost-effective by offering the vaccine universally at a lower price to adolescents of both genders.
Brenda Wilson, NPR News.
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