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August 20, 2010

Should Boys Also Get Vaccinated for HPV?


NPR on Aug 20, 2010 aired a story whether boys should also get vaccinated for HPV. It is well established that vaccines like Gardasil (FDA approved for boys in 2009) and Cervarix protect against two of the HPV types (HPV-16 and HPV-18) that can cause cervical cancer and some other genital cancers including anal, vulvar, vaginal, and penile cancers.

However, it may potentially prevent other types of HPV related disorders (NOT mentioned in the NPR story) involving the head & neck in both men and women, including:

Respiratory Papillomas (benign)
Throat Cancer
Oral Cancer (tongue, tonsil, salivary gland)
Oral ulcers/lesions/warts (benign)

According to epidemiological studies, there has been a dramatic increase in cancer involving the salivary glands and tongue attributed to HPV and were of squamous, acinar, and mucoepidermoid morphologic types. This increase in oral cavity cancer has occurred mainly in the 10-40 years age group and suspected to be secondary to increased acceptance of oral-genital sexual practices.

What is my personal feeling on whether boys should get vaccinated? I believe the answer is yes.

In order to receive the beneficial effect of the vaccine, the vaccine needs to be given in 3 doses (at $130 per dose) ideally between ages 9-26.

Read the NPR article here.

Of note there are currently 3 FDA approved HPV vaccines:

• The bivalent HPV vaccine (Cervarix) which addresses HPV 16 and 18;
• The quadrivalent HPV vaccine (Gardasil) which prevents four HPV types: HPV 16 and 18, as well as HPV 6 and 11;
• And finally Gardasil 9 which prevents 9 HPV types: 6, 11, 16, 18, 31, 33, 45, 52, and 58.

References:
Cancer of the oral cavity and pharynx in young females: increasing incidence, role of human papilloma virus, and lack of survival improvement. Semin Oncol. 36 (5), 451-9.

Prevention of human papillomavirus infections and associated diseases by vaccination: a new hope for global public health. Public Health Genomics. 12 (5-6), 319-30.

The epidemiology behind the HPV vaccine discovery. Ann Epidemiol. 19 (4), 239-44.
Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. Google+ Christopher Chang, MD Bio

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