HPV? Why not guys?

Question

Just wondering. I know there is a vaccine for women to prevent HPV. From what I have read if vaccinated it helps prevent cervicle cancer. Is there a vaccine for guys? If not why so?

Answer 1

There is no vaccine for boys - yet.

According to the CDC:
"We do not yet know if the vaccine is effective in boys or men. Studies are being done to find out if the vaccine is effective in males. When more information is available, this vaccine may be licensed and recommended for boys/men as well."
http://www.cdc.gov/vaccines/vpd-vac/hpv/hpv-vacsafe-effic.htm

Answer 2

The damage is done to women so they get the vaccine. It works on guys too but the expence of the shots are not considered worthwhile. They just get warts that go away. Women can become sterile or get cancer that kills them

Answer 3

As Alie said the HPV vaccine is just now in clinical trails to see if it will prevent the virus in men. I have read (enclosed article from Atlanta) that some doctors are giving the vaccine off label. Studies are promising but no one is sure just how effective the vaccine will be in males.

The vaccine is not a treatment for HPV that you have. It works best if given before you engage in any sex. It only prevents 4 HPV types so it will not prevent all genital HPV types.

HPV in women do not cause sterility.

Masculine side of HPV
Human papillomavirus is common in men too. Studies are underway to determine if a male vaccine is needed.
By Shari Roan, Times Staff Writer
March 19, 2007

With human papillomavirus, girls and women have been getting all the attention.

Parents across the nation have rushed to have their daughters vaccinated against the virus. States are wrestling with whether to require that adolescents get the vaccine. And recent research found that many more girls and women are infected with human papillomavirus than was previously thought — more than one-quarter of females ages 14 to 59.

Now the attention is turning to boys and men.

As many as 60% of men ages 18 to 70 are infected with HPV, according to data not yet published, raising the question of whether the new vaccine will be effective in reducing diseases linked to the virus unless men, not just women, are immunized.

Several studies are underway to better understand the virus in males and whether the new HPV vaccine, Gardasil, also will work for them. As researchers already know and as the new data confirms, HPV is not just a women's issue.

"With any transmittable disease, you want to understand the entire cycle of how things spread," says Thomas Broker, an HPV expert and professor of biochemical and molecular genetics at the University of Alabama, Birmingham. "With HPV, men are clearly part of that equation."

Human papillomavirus is best known for causing cervical cancer, with about 9,700 cases diagnosed in women in the U.S. each year.

Gardasil, a three-shot regimen, was approved last year for girls and women ages 9 to 26. It protects against four strains of the HPV virus that are most likely to cause cervical cancer and genital warts in women.

But much less is known about the consequences of HPV infection in men.

"We know they transmit it to women, but what is the rate of transmission?" says Anna Giuliano, a researcher at the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Fla., who is leading three government-funded studies on HPV infection in men. She is also a paid speaker for Merck, the maker of Gardasil.

Several studies are attempting to address this question, as well as ones about what strains of HPV are most common in men. New data show that HPV infection is quite common in men of all ages, while the highest rates of infection in women tend to occur in the early 20s before declining and then spiking again in women in their 40s and 50s.

"We're seeing a really high prevalence in men, and we see little change in prevalence across the age span," says Giuliano, who found the 60% prevalence rate in one of her studies. That data will be published later this spring in the journal Cancer Epidemiology Biomarkers & Prevention. "We need to know if women in their 40s and 50s are acquiring new infections from their partners."

HPV infection isn't inconsequential in men. Certain strains of the virus are known to cause genital warts in men as well as women.

And those infections are estimated to be the cause of about half of all anal, penile, vulvar and vaginal cancers and about 20% of the cause of all oral cancers, says Dr. Dean Blumberg, an associate professor of pediatric infectious disease at UC Davis. Blumberg is a member of Merck's speakers bureau but does not get paid directly by Merck for his services. A speaker's bureau is a roster of experts who provide educational lectures on particular topics.

About 28,000 Americans are diagnosed with oral cancers each year, and about 4,650 are diagnosed with anal cancer. Penile cancer affects about 1,500 men each year. Although the overall risk of those diseases is low, anal cancer in gay and bisexual men has been rising in recent years.

Worldwide, the consequences of HPV infection in both men and women are even more severe than in the United States, notes Broker, president of the nonprofit International Papillomavirus Society.

More women in developing countries die of cervical cancer than in the United States, he says. Moreover, "we need to know how much real disease men are getting. If you look worldwide, there are about 100,000 new cases of penile cancer each year."

HPV-related cancer is also more common in people who have compromised immune systems, such as men who are HIV positive.

"This virus can cause cancers in a lot of different places," says Blumberg. "But in terms of numbers, it doesn't compare to the number of cervical cancer cases."

But even if reducing rates of cervical cancer was the singular goal of HPV vaccination, some experts suggest that herd immunity — vaccinating everybody to reduce circulation of the virus in the population — will turn out to be the most successful approach.

"If you decrease HPV infection in men, then there will be decreased transmission to women also," Blumberg says.

Merck is conducting studies of the vaccine's ability to prevent infection in boys and men. Data on those trials may become available later this year, and the company hopes to apply to market Gardasil to boys and men some time next year.

Studies of Gardasil show that the vaccine provokes an even stronger immune response in boys than in girls, which implies that the vaccine will also prevent HPV infections, Blumberg says. But they have yet to show that boys are protected from HPV infection at satisfactory rates. Researchers are also examining whether the vaccine reduces cases of anal cancer in gay men.

There is "no guarantee" an HPV vaccine will work in men, Broker says, because the skin cells infected by the virus differ greatly in men and women.

Some people aren't waiting for the results of those studies. High-risk men, such as gay and bisexual men, are reportedly requesting and receiving Gardasil vaccination from their physicians, Blumberg says.

Moreover, he says, "I've had nurses tell me they made sure their 15-year-old son was vaccinated because they wanted to decrease the chance of their future daughter-in-law having cervical cancer. They felt strongly about it."

Historically, vaccination programs have had the most impact when they are gender-neutral.

For example, when the rubella vaccine was introduced in the late 1960s, it was recommended initially for women of child-bearing age because — while anyone can become infected — rubella in pregnant women causes serious birth defects.

However, the campaign was only partially effective and eradication of the disease was only achieved after the vaccine was recommended to both boys and girls.

GlaxoSmithKline plans to seek Food and Drug Administration approval next month for its HPV vaccine for girls and women, Cervarix.

And legislation requiring California girls to complete HPV vaccination before entering seventh grade was introduced last week by Assemblyman Edward Hernandez (D-West Covina). Another bill was proposed that would require health insurers to cover the cost of the vaccinations.

Lawmakers in as many as 20 other states have introduced similar proposals. But mandatory vaccination of school-age girls has generated controversy because some parents believe their daughters will not be exposed to the virus or that having the vaccination might encourage sexual activity.

Others object to mandating vaccination for something that is not easily transmitted (unlike chickenpox or measles) and because the shots are costly, about $360 for the series.

"Some people resent the fact that a mandate is targeting just one gender," says Blumberg. "It does give the appearance of being unfair. We don't have any other vaccine mandates that are gender specific."

[e-mail]

'If you decrease HPV infection in men, then there will be decreased transmission to women also.'

— Dr. Dean Blumberg

Associate professor of pediatric infectious disease at UC Davis

Cervical cancer vaccine may benefit men, too

By GAYLE WHITE
The Atlanta Journal-Constitution
Published on: 02/21/07
A vaccine that prevents cervical cancer in women might also help men
avoid some forms of cancer — and an Atlanta doctor is already
administering it to male patients.

Internist Dr. Scott Parry of Intown Primary Care encourages his male
patients to take the vaccine against human papilloma virus, which was
approved by the Food and Drug Administration last summer only for
women and girls — ages 9 to 26 years old.

For now, the FDA has not approved the vaccine for men of any age, but
doctors are allowed to use the vaccine as they see appropriate.
Preliminary tests by Merck, which markets the vaccine under the brand
name Gardasil, seem to show it could be safe and effective in boys
and young men. Clinical studies for the vaccine's use on males are
still under way.

"I really push it for patients under 30," Parry said. "I encourage it
for those 30 to 50."

Parry said the vaccine, which prevents many strains of genital warts,
could benefit both the men who take it and their sex partners.

"Where are most women getting warts from?" he asked. "Men."

Because the human papilloma virus can lead to cancer in men, as well
as women, Parry is optimistic about Gardasil's potential to ward off
anal and penile cancer in his patients, many of whom are gay men. "I
believe firmly in it," Parry said.

Merck spokeswoman Jennifer Allen said some studies have been done in
boys and men ages 9 to 23, she said, and the company has presented a
first round of results to the FDA.

"We're still in the process of collecting data," she said.

The Centers for Disease Control and Prevention has recommended
administering the vaccine to young women before they become sexually
active. That would also probably prove to be the best course for
males, said Debbie Saslow, director of breast and gynecologic cancer
for the American Cancer Society.

Interest in the vaccine has spread across the country since the FDA
approved it last year because of its apparent effectiveness against
the strains of HPV that cause most cases of cervical cancer.

Some state legislatures are considering making it mandatory. Texas
Gov. Rick Perry, a Republican, issued an executive order requiring
the vaccine before girls will be admitted to sixth grade, but giving
parents the option of refusing the vaccine for their daughters as a
matter of conscience.

Some religious organizations are lobbying against the vaccine, saying
it could encourage girls to have sex and that sexual abstinence will
prevent transmission of the virus.

Dr. Daron Ferris, a researcher at the Medical College of Georgia in
Augusta, is involved in the clinical trials of the vaccine in males.
Early indications are that it could be even more effective in boys
than in girls, he said.

"Little boys actually produce more antibodies than little girls do
when given the vaccine," he said.

Without long-term cancer rates, researchers look at whether the body
reacts to the vaccine by producing antibodies against the virus, he
said.

But antibodies alone aren't enough evidence for approval, said Saslow
of the American Cancer Society.

"If you have no immune response, chances are the vaccine is not going
to work," she said, "but because you do, that doesn't mean the
vaccine is going to work."

In addition, Saslow said, cost is a concern in any push to increase
childhood vaccinations: "It's the most expensive vaccine ever, more
expensive than all other childhood vaccines put together."

Because of the lack of FDA approval for use in men, insurance plans
are not obligated to cover the cost of the vaccine for men. Parry
said he offers the vaccine at his cost with no markup, but it's still
expensive: $130 each for three doses.

That leaves many younger men unable to afford it, Parry said.

"Therein lies the problem," he said. "The people you really want to
target, under 30, have less money."

While the vaccine could be found to help all men, Ferris, the Medical
College of Georgia researcher, said he understands that gay men might
want the vaccine as soon as possible because some sexually active gay
men face a high risk of anal cancer.

"I would be troubled if I were a gay male being told I had to wait,"
Ferris said.