CDC believes recommendation could represent `milestone in the nation`s battle against cancer.`
CDC announced during a media briefing on October 25 that the Advisory Committee on Immunization Practices (ACIP) has recommended routine vaccination of male patients age 11 to 12 years with three doses of quadrivalent human papillomavirus (HPV4) vaccine to prevent HPV infection and HPV-related disease.
The committee recommended that HPV4 be administered to boys as young as 9 years of age and that boys and young men aged 13 to 21 years who have not already received the vaccine should also be vaccinated.
During the briefing, Anne Schuchat, MD, Director of the CDC National Center for Immunization and Respiratory Disease, described the HPV vaccine as a "strong weapon in cancer prevention" and the ACIP recommendation as a "milestone in the nation`s battle against cancer." HPV4 vaccine protects the types of HPV that cause cervical cancer in women and anal cancer and genital warts in both women and men, stated Schuchat.
"Immunizations have dramatically reduced the occurrence of infectious diseases in the U.S.," said Schuchat. "It is a truly exciting to have vaccines that can also tackle cancers." She added that it was CDC`s hope that the recommendation would be a reminder to parents and health care providers of the opportunity "to prevent a generation today from the cancers of tomorrow."
The current ACIP recommendations result from a lengthy period of data review. In June 2006, ACIP recommended HPV vaccine for girls aged 11 to 12 years and for teen girls/women through age 26 years who had not already received the vaccine. In October 2009, ACIP supported permissive use of HPV4 also among boys and young men. HPV4 is covered for both girls and boys through the Vaccines for Children program.
Clinical trial evidence has become available to ACIP following its initial permissive recommendation for use of HPV4 among boys and young men in October 2009. Recent trials have shown HPV4 vaccine to be very effective in males and that the vaccine generates maximum immune response when administered at ages 11 to 12 years. In addition, the vaccine is most effective when given prior to virus exposure, which occurs through sexual contact.
CDC also noted that HPV vaccine uptake among teenage girls has been poor. The agency`s hope is that vaccinating males at an early age will help decrease the burden of HPV-related disease in both males and females (e.g., by preventing future genital warts or anal cancer). About 20 million Americans are infected with HPV, and the virus has been associated with several different types of cancer, including cancer of the cervix, vulva, vagina, penis, anus, head, and neck. CDC also noted the following facts regarding HPV:
About 18,000 HPV-associated cancers affect U.S. women annually, with cervical cancer being most common.Around 7,000 HPV-associated cancers affect U.S. men in the U.S. each year; head and neck cancers are the most common.HPV is responsible for most cases of genital warts in both men and women. Approximately 1 in 100 sexually active adults in the United States has genital warts at any one time.Men who have sex with men and people with HIV are at the highest risk for HPV-related disease.Greater than 80% of anal cancers are caused by HPV.
Review of data by ACIP revealed that vaccinating males with HPV4 is most cost effective when coverage among females is low and that coverage is currently low among females.
Schuchat noted that through September 2011, nearly 40 million of doses of HPV vaccine have been distributed throughout the United States. Regarding vaccine safety, the most common adverse events seen in clinical trials have included mild or moderate adverse reactions such as injection site reactions, headache, and fever.
The recent ACIP recommendations will need to be submitted to CDC in written form, and following agency approval, the recommendations will be published in Morbidity and Mortality Weekly Report.