HPV, which is short for human papilloma virus, is the most common sexually transmitted disease and the big problem with HPV is that once it is in your skin, it is there for life and can be passed on to a sexual partner through sexual intimacy. After the virus becomes established in the genital skin, the vagina or the cervix, it can either remain dormant or multiply to cause a genital wart. The wart is the most contagious stage but a dormant virus can be infectious too. The virus can remain in the body and be passed on before warts are noticeable or even after they have disappeared.
Even when safe sex is practiced by the use of condoms, the problem is that there are a number of places on the body where the virus can be found other than the area covered by a condom. The virus can spread from one partner to the other during sex and since there are over 12 genital viral types, you can become infected by more than one type. Genital warts in females can pose a serious health concern as they have been linked to cervical cancer and even other types of cancer.
Now there are 2 new vaccines – Gardasil and Cervaris TM. Both vaccines help the body fight infections with strains HPV16 and 18 while Gardasil also offers protection against HPV 6 and 11, which cause genital warts. These vaccines will protect against other cancers associated with HPV too. Gardasil is registered for use in girls and women aged 9 to 26 and boys between 9 and 17 while Cervaris is registered for females aged 10 to 55.
The emphasis up to now has been the vaccination of young girls, particularly between the ages of 12 and 13, primarily as a way to reduce the risk of cervical cancer. Cervical cancer is the second highest cancer killer of women after breast cancer. 10 000 women in the US annually are diagnosed of which 4 000 will die and now the HPV vaccine is part of the routine US childhood vaccines schedule in some states.
But what about the vaccination of teenage boys too? Males are after all the carriers of HPV. The vaccine for boys is already licensed in a number of countries and is currently being considered by the US Food and Drug Administration (FDA). They have to decide whether it will be cost effective. In the UK, only Cervarix is used and of course only girls are vaccinated.
In a paper published in BJOG, an International Journal of Obstetrics and Gynecology, a number of ongoing questions and challenges related to HPV vaccination are outlined. The paper notes that one of the problems of a sex specific vaccine is that it may fail to educate males about their role in transmitting the virus. It also states that HPV vaccination may also reduce the incidence of other less common cancers linked to HPV infection such as vulval, vaginal, penile, anal and oropharyngeal cancers. Men who have sex with men are particularly at risk of anal and oropharyngeal cancers. The web site for BJOG is www.bjog.org if you want to find out more.
It does all seem rather one sided. I think much of the media make the mistake of referring to the vaccine as the “cervical cancer vaccine” instead of the HPV vaccine. The vaccine is obviously supposed to target much more than cervical cancer. While no one wants to contract cervical cancer, neither do they want to develop genital warts or to carry or pass on the HPV virus. If countries are going to embrace the HPV vaccine for young girls, then they should go the whole way and embrace it for their young boys as well.

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