You say boys SHOULD get the anti-HPV jab

Should boys be vaccinated to prevent the spread of the infection that causes cervical cancer? Most malehealth readers thought so.

In last month's snap survey on the site, 55% of men and 88% of women said boys should be vaccinated against HPV, the virus that cause the majority of cases of the cancer.

The government has already announced that girls aged 12-13 will be vaccinated from September 2008 with a 'catch-up campaign' offering the vaccine to females up 18. Most malehealth readers (92% of men and 94% of women) agreed that girls should be vaccinated. 

Malehealth editor Jim Pollard apologised for a slight oversimplification of the issue in the malehealth online debate. 'Thanks to those of you who pointed out that we omitted to mention that the HPV virus not only causes 70% of cases of cervical cancer and 95% of cases of genital warts but also most cases of anal cancer,' he said.

'Having said that, given that 80% of the UK population will be infected with the HPV virus at some time during their lifetime and yet there are only about 800 diagnoses of anal cancer every year, there are clearly other factors involved. As indeed, there are with the other cancers.'

Vaccines 'not without risk'

Meanwhile a reminder this month that vaccines are not without risk with the news in the New England Journal of Medicine that compensation in the USA for the health problems caused by existing vaccines (MMR and DPT) is approaching $2 billion. (This is money that has been paid out when a clear link has been shown between the vaccine and the problem. It does not include autism because there is no proof of a link.)

As of June 2007, at least three girls were known to have died after being given Merck's HPV vaccine Gardasil. (British Medical Journal)

Readers' Comments 

Readers comments in what is developing into a fascinating and many sided debate included:

'Somewhat heterosexual presentation'

Comments on this topic included:

• 'The vaccine is actually against the HPV virus which men can catch and can contribute to throat cancer and anal cancer in gay men.'
• 'This virus is also linked to anal cancer in men - particularly gay men. I suppose I am not impressed with this somewhat heterosexual presentation of the facts. I do read your forum as a gay men and perhaps you could include us from time to time! I have no problems with vaccination.'

I would happilly pay for vaccination

• 'It doesn't really make sense NOT to vaccinate boys. Genital Warts are still a problem and it may go some way to producing some sort of herd immunity. I realise there will be the extra expense but the prevalence of HPV is so very high albeit mainly asymptomatic in young men. I would happily pay to vaccinate all my children of either sex.'
• 'The drug, if proven, is an excellent addition to the health protection armoury. 100% vaccine coverage is girls should reduce the number of cases of cervical cancer. Vaccinated males will receive a marginal benefit, but only marginal, and the risk of genital warts can, I believe, be minimised by following good sexual health practice. I don't believe that this marginal benefit would warrant the additional (a) risks and (b) cost of this new drug.'
• 'Would be a bit selfish not to vaccinate men? It could be your mother or sister getting it from a man who wasn't vaccinated.'
• 'I work in cancer care and have seen the devastating effects on young women of cervical cancer. The vaccine for women will be less effective or, at worse, wasted if women can still contract HPV from sex with unvaccinated men.'

Creating a climate of fear

• 'Just because people can die from a disease does not warrant a widespread, high-cost, invasive reaction by public health agencies. More people likely die from speeding than from cervical cancer, but we don't put a governor on motors to prevent any speeds over 30 mph. Why not? Because we've learned to accept the risks as an unwelcome but acceptable part of being human. HIV/AIDS is epidemic and deadly - what kind of message does it give to vaccinate people against HPV? Are they supposed to believe that they are "protected" from STDs. Can they forget about condom use? I think that the vaccination proposal is an attempt to generate market demand through creating a climate of fear. The vaccines against HPV are essentially experimental and should not be widely disseminated in order to "solve" a situation that is not a public health "crisis".'
• 'The only reason the vaccine is not given to boys is because it's marketed as a cancer prevention and not HPV. Who would think/want to get their 13 year old daughter a vaccine for a sexually transmitted infection?'

What are the real side effects?

• 'I think more investigations should be undertaken before applying this drug on a blanket basis - what are the real side effects?'
• 'All vaccinations should be voluntary.'
• 'The vaccination in question has not yet been licenced for use with boys. The argument in favour which compares the greater good is valid but unlicenced medication should only be used in emergencies not as a preventative public health measure.'

The vaccine doesn't work

• 'As ever - if vaccination actually worked then there would be no need to vaccinate boys would there - as all the girls would be protected - so I can only conclude that is not effective. Resist if you can boys! Sexual health education and open dialogue from an early age is the key to preventing sexually transmitted diseases.'

The vaccine is a duty

• 'Vacination is a duty - and I say this as someone who is, at heart, an anarchist. No excuse - 'freedom', 'choice' or 'religion' - should exempt anyone from this.'

It's still not too late to tell us what you think. Full background to the debate here.