Good news from the Family Practice News:
ATLANTA — The human papillomavirus vaccine was efficacious in preventing persistent infections and genital warts caused by HPV strains 6, 11, 16, and 18 in a Merck-sponsored study of 4,065 males aged 16-26 years.
The findings were presented by Dr. Richard M. Haupt at a meeting of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices. Merck had previously reported immunogenicity and safety data for its HPV vaccine (Gardasil) in younger males aged 9-15 years, but these are the first data on efficacy in males and the first findings in older adolescent and adult males.
The rationale for use of Gardasil in males is twofold. There is intrinsic benefit to males themselves since HPV strain 18 causes penile, anal, and oropharyngeal cancer and HPV 6 and 11 are associated with genital warts. There is also a public health benefit to vaccinating males against HPV since coverage among girls is likely to be incomplete, transition of HPV occurs efficiently between sexual partners, and “gender-neutral” vaccination would be expected to reduce overall viral transmission in the entire population, noted Dr. Haupt of Merck Research Laboratories, Whitehouse Station, N.J.
ACIP is expected to recommend the vaccine for use in males aged 11-12 at the adolescent visit, just as it is now given to girls. This should simplify implementation, Dr. Doug Campos-Outcalt of the University of Arizona, Phoenix, said in an interview.
Since, besides cervical cancer and those mentioned above, the Human Papilloma Virus is also implicated as the cause of half of lung cancers in non-smokers, many oral and throat cancers, and some prostate cancers, the universal vaccination of boys and girls will most likely save lives and prevent millions of people from disfiguring disease.
I’ve never seen a case of bacterial meningitis since I left med school, thanks to the vaccine against Hemophilis influenza or Hib. Perhaps the future doctors will never see cervical cancer and will be surprised when and if they see lung cancers.
The problem is, it does not prevent all cervical cancers. Pap smears will still be needed yet the number needed to screen to prevent a cervical cancer death will rise as the incidence of cervical dysplasia/cancer declines. It could get to a point where cervical cancer is so rare we drop Pap tests and sacrifice those women who develop the cancers associated with the strains that are not included in the vaccine.
If HPV were not transmitted primarily sexually, the vaccine would be part of the standard list in most states and developed countries by now, and only health professionals would care.Shame it got so tangled up in politics.