Gardasil for Boys?

Should boys receive a vaccination that may prevent cervical cancer?

On the surface, the question seems ridiculous. Boys clearly lack a cervix, so why would boys require protection from cervical cancer?

The question isn't as ridiculous as it seems, though -- and it's one you may be pondering in the near future, given the fact that yesterday the FDA approved Gardasil vaccine for use in boys and young men ages 9-26.

Gardasil protects against HPV, or human papilloma infection. Certain strains of HPV are now known to cause cervical cancer; they also cause gential warts. Currently Gardasil is approved to prevent genital warts in males, although researchers hope that preventing HPV infection in boys will lead to a decrease in female HPV infection as well.

HPV, you see, is a sexually transmitted disease. An extremely common one. Almost all sexually active adults (75-80%) will acquire an HPV infection at some point in time. Most people manage to clear the virus on their own, without any apparent symptoms or complications. A small minority, though, go on to develop genital warts, cervical dysplasia or penile, anal or cervical cancers. No one is exactly sure why some people go on to develop serious complications while others clear the infection with no apparent problem.

In 2006, after extensive testing, the FDA approved the use of Gardasil in young girls. Of course, vaccinating young girls against a sexually tranmitted disease that may or may not cause them problems in later life is not without controversy. Add into the fray the fact that 32 deaths and numerous blood clots were reported after Gardasil vaccination and you can see why a number of parents are hesitant to vaccinate their daughters.

Parents of boys now face the same question. Should your son be vaccinated for a disease that may or may not affect him directly? Right now, the decision is completely up to you. To date, no government recommendations have been made regarding boys and HPV vaccination. (The government is expected to rule on that sometime later this month.)

Harvard researchers, meanwhile, have pointed out that vaccinating boys may be less cost-effective than vaccinating girls. Since girls are disproportionately affected by HPV complications, they say, it makes more sense to concentrate on vaccinating girls, not boys.

Where do I stand on this question? As a woman who's had an HPV infection that led to pre-cancerous cervical changes...that ultimately required treatment with a minor surgical procedure...that affected the ability of my cervix to dilate adequately during my last birth, I'll tell you this: HPV is no laughing matter. If vaccinating my boys means preserving the cervical health of my future daughter-in-laws, well, that's something to consider.

Clearly, I've made no decisions yet. Clearly, I need to know more about the risks, benefits and costs before making a final decision, and I hope that you too will take the time to study the issue carefully before making a decision on behalf of your sons.