Dear Dr. Roach: What are your thoughts on the pros and cons of HPV vaccine for boys?
L.P.B.
There are risks and benefits to the individual, but also benefits to society.
The HPV vaccine should really be considered an anti-cancer vaccine, since its goal is to reduce infection from the kinds of human papilloma virus strains that can lead to cancer. Cervical cancer is the most common HPV-related cancer, but some throat cancers, anal cancers and genital cancers also are HPV-related. The U.S. Centers for Disease Control and Prevention estimates that there are about 30,000 HPV-related cancers in the U.S. annually. It is possible, but unproven, that the HPV vaccine will provide protection against some or all of these.
When given to girls or women who have not been infected with HPV, the vaccine is nearly 100 per cent effective at preventing persistent infection with the strains of HPV most likely to lead to cancer. In males age 16-26, the efficacy of the vaccine at preventing high-risk HPV-related warts was about 90 per cent. However, the HPV vaccine is relatively new and it is not clear how long immunity will last. It is possible that additional boosters may be necessary.
All vaccines have some degree of risk. The most serious risk of HPV vaccine is anaphylaxis, a possibly fatal allergic reaction. There have been 67 million doses given around the world, with a 0.003 per cent rate of all adverse events, 90 per cent of which were not considered serious. The most common non-serious adverse events in men were redness and soreness at the injection site, dizziness, headache and fainting. Among the adverse events considered serious, the most common were headache, nausea, vomiting and fever.
The societal benefit to vaccinating boys is that they are less likely to spread infection to others. Since essentially all cases of cervical cancer are HPV-related, males are the most common source of infection.
By vaccinating your boy, you are reducing his risk of developing HPV infection and might be decreasing his risk of several types of HPV-related cancer. Probably the most compelling reason is to protect your son鈥檚 future sexual partners. Put in the starkest terms, you are reducing the risk that your future daughter-in-law will develop cervical cancer.
听
Dear Dr. Roach: I have just read your question- and-answer about the shingles vaccine. I am an English person living in the U.S. Last time I was back in England and visiting my old doctor, I asked about getting the shingles vaccine. I was informed that there was no such vaccine in England. This made me wonder about the legitimacy of the vaccine. Is this just a way for doctors to cash in on health insurance payments?
C.B.
The National Health Service in the United Kingdom recommends the same shingles vaccine, Zostavax, that is used in sa国际传媒 and the U.S. Most doctors make little or no money on vaccination. We recommend them because we care about our patients.
听
Email questions to [email protected].
