Dear Dr. Roach: Thank you for your recent column about the benefits of HPV vaccine for males. I would like to add that, from a public-health perspective, there is little controversy about the idea that the HPV vaccine prevents cancers in all the parts of the body that can be infected by high-risk types of HPV 鈥� not only the cervix, vagina and vulva in women and the anus in both men and women, but also the oropharynx (a region of the throat) in both sexes, especially men.
The reason we can鈥檛 say that there is absolute proof of HPV vaccine preventing HPV-related oropharyngeal cancer is that there is no early sign of this type of cancer that researchers could look for when testing the vaccine鈥檚 effects. They would have to wait for the cancer itself to develop, which can take decades. But there is no biological reason why HPV vaccine would not prevent HPV-related oropharyngeal cancer. (Smoking is another cause of oropharyngeal cancer, but HPV vaccine can鈥檛 do anything about that.) HPV-related oropharyngeal cancer is becoming very common 鈥� soon to surpass cervical cancer 鈥� and it鈥檚 important for your readers to know that HPV vaccine almost certainly will reduce young people鈥檚 chances of ever getting this type of cancer.
I also want to mention that all the evidence points to HPV vaccine being very long-lasting. Unlike other vaccines that are known to wane over time, there is nothing in the past nine years鈥� worth of data on HPV vaccine to suggest that booster doses will be necessary. This is all the more reason to give the vaccine at the recommended age of 11-12 years, well before a person is likely to be exposed to the virus. There is nothing to be gained by waiting until the person is older.
Kristen R. Ehresmann, RN, director of Infectious Disease Epidemiology, Prevention and Control at the Minnesota Department of Health
I thank Ms. Ehresmann for providing additional information on the HPV vaccine. I believe that the benefits of the vaccine just for reduction in cervical cancer make it worthwhile, considering the safety of the vaccine. I agree with you that it is likely there will be additional benefit in reducing the risk of other HPV-associated disease, such as head and neck cancer. I also appreciate the information that the newest data show the immunity is very long-lasting.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected].
