Draft recommendations have been approved for routine vaccination of 11- and 12-year-old boys with Gardasil to protect them against Human papillomavirus (HPV).

The advisory committee on immunization practices of the US Centers for Disease Control and Prevention (CDC; Atlanta, GA, USA) approved the recommendations for vaccination with Gardasil following several studies showing that both boys and adult men would benefit from the immunization, which protects against genital warts and cancers of the vagina, penis, vulva, throat, and anus. HPV rarely causes symptoms, but it is the most common sexually transmitted infection in the United States, with more than six million new infections each year.

Some of the strongest evidence supporting an expansion of the vaccine guidelines to males comes from recent studies of cancers of the throat and tonsils, which show that roughly 80% of such cancers are traceable to an HPV infection following oral sex; and while less common, anal cancer is also increasing at a rate of 2% per year. The CDC plans better education programs to promote the vaccine, following lackluster demand for vaccination in girls that stems from factors such as parental resistance to a vaccine for youngsters that protects against a sexually transmitted virus, difficulties in getting teens to visit a doctor for immunizations, and the vaccine's high cost for those not covered by insurance.

“Part of our challenge has been a misunderstanding that has led parents to think their daughters don't need a shot until they are sexually active, when in fact the shot can't protect them once they contract the virus,” said CDC immunization chief Anne Schuchat, MD. “One reason health officials promote the vaccine at such a young age is that immune responses are strongest then.”

Gardasil, a product of Merck (Whitehouse Station; NJ, USA) triggers an immune response against HPV types 16 and 18, limiting the formation of precancerous anal lesions, and also protects against two other types that cause genital warts. However, it does not seem to work against an HPV that has already infected an individual. HPV 16 and 18 are responsible for about 70% of cervical cancers and 90% of anal cancers, while HPV 16 accounts for most throat cancers. Gardasil is given in three 0.5 mL shots over six months; the second shot is two months after the first, and the third is four months later.

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