MONDAY, Feb. 27, 2012 (MedPage Today) — Boys ages 11 and 12 should routinely be immunized against human papillomavirus, according to the American Academy of Pediatrics.
And boys and men ages 13 to 21 should get vaccinated or finish the three-shot series if they started but did not complete it, the academy said in a policy statement in the March issue of Pediatrics.
The statement concurs with a CDC recommendation late last year. It replaces an earlier policy that permitted but did not recommend routine immunization of boys with the quadrivalent Gardasil vaccine, the only one approved for use in males.
The policy, drafted by the academy's committee on infectious diseases, also says:
- Men ages 22 to 26 who either have not been immunized or have not completed the series may receive the vaccine, but "cost-efficacy models do not justify a stronger recommendation."
- Doctors and health officials should make a special effort to immunize men up to age 26 who have sex with men, if they have not been immunized or completed the series of shots.
There are no changes to the policy regarding girls and women, which urges routine vaccination at 11 or 12, and says women up to 26 who have not been immunized should get the shots.
The rationale for early vaccination is two-fold, the academy argued — the vaccine works best before the onset of sexual activity, and antibody responses are greatest from ages nine to 15.
There is an immediate direct benefit to males because the vaccine has been shown to protect against genital warts and anal cancer. As well, the academy argued, there may be a herd immunity benefit to females.
The policy statement noted that there is precedent for vaccinating all children in order to protect women in their reproductive years. The rubella vaccine is "intended primarily" to prevent miscarriages and fetal malformations that can occur after rubella infection during pregnancy.
There also is a precedent for vaccinating children to prevent sexually transmitted infections and cancer — the hepatitis B vaccine prevents cirrhosis of the liver and hepatocellular carcinoma caused by the virus, whether acquired at birth or through later sexual relations.
As well, the pediatricians' policy statement noted, the vaccine appears to be safe: after some 50 million doses have been given to girls, investigators have found "no discernible, vaccine-specific adverse effect," except for rare cases of anaphylaxis.