STEVE INSKEEP, host:
Okay, let's look at one of those vaccines - the HPV vaccine, which is given mainly to adolescent girls. NPR's Brenda Wilson has been following the debate among scientists about also immunizing boys.
BRENDA WILSON: If this were a high school debate, it would go something like this. Be it resolved�that all adolescent girls and boys should be vaccinated against HPV, the virus that causes cervical cancer, before they are sexually active, since more than half of all sexually active men and women will get HPV at some point in their lives.
In the affirmative, there's Dr. Doug Lowy, co-inventor of the HPV vaccine, who works at the National Cancer Institute. He says that since just 11 percent of girls now get all three doses of�the vaccine, and less than half get even one dose, rates of HPV in the U.S. are unlikely to come down very much. So, let's offer the vaccine to boys as well.��
Dr. DOUG LOWY (National Cancer Institute): When the percentage of girls that are getting vaccinated are in the 30 to 40 percent range, vaccinating boys is suggested to have a substantial enhancing impact on trying to protect those girls who are not vaccinated.
WILSON: He says it would provide herd immunity. Boys don't get cervical cancer but they transmit HPV. Vaccinating boys would reduce the amount of HPV circulating in the population.�
Speaking for the opposing side, Dr. Matt Daley, a pediatrician and professor at the University of Colorado School of Medicine, would tell you that the Centers for Disease Control and Prevention recommended that 11 and 12-year-old girls get the vaccine because it's girls that get cervical cancer. It just takes time for new vaccines to catch on, particularly vaccines for adolescents.
Dr. MATT DALEY (Pediatrician, University of Colorado School of Medicine): Some adolescents don't have health insurance. Some adolescents don't have a medical home; and even adolescents who have a medical home, adolescents who have health insurance, they just don't go to the doctor very often. And so if they're not seen, then it's a lot harder�for us to vaccinate them.
WILSON: And when they get to the office, Daley says, pediatricians don't often offer the vaccine because they don't like talking to 11 and 12-year-olds about sex.�Some have suggested making the HPV vaccine part of a series of shots that adolescents get the way infants get their shots.��
Dr. Diane Solomon, who is in charge of prevention at NCI, says the CDC's recommendation on whether to vaccinate boys really comes down to cost effectiveness. There's just not much benefit in vaccinating boys.
Dr. DIANE SOLOMON (National Cancer Institute): The greatest�benefit in terms of health care costs is with decreasing cervical cancer and cervical abnormalities. Men don't have a cervix.
WILSON: Even though the HPV vaccine protects against anal cancer and genital warts in men as well, vaccinating boys still doesn't bring down costs enough.
In Australia, where the vast majority of adolescent girls in schools and young women as well, were vaccinated, cases of vaginal and precancerous lesions are already declining. And NCI's Lowy points out, boys also benefited. He says there are also increasing cases of oral cancer caused by HPV - about half cases as many cases as cervical cancer - that the vaccine may protect against as well.
Dr. LOWY: At the moment, there just are no data indicating whether or not the vaccine will protect even against oral infection by the virus. On the other hand, there is every reason to presume that that would be the case.
WILSON: Without the data, the Food and Drug Administration is unlikely to license the HPV vaccine as protection against oropharyngeal cancers. But University of Colorado's Dr. Matt Daley still says the best bet is a stronger effort to reach girls, perhaps by vaccinating them where's it's easier to find them - at school.
Dr. DALEY: Kids are there, and they're there every day. They're a captive audience.
WILSON: Of course, he says, you'd have to create a better system for financing childhood vaccines to make that work.
Brenda Wilson, NPR News.
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