Experts Debate Giving HPV Vaccine to Boys

Gardasil's maker, Merck & Co., is largely responsible for pulling that data together. However, according to Bookman, "they took a more conservative stance when they approached the FDA for licensure, registration and vaccine recommendations -- their safety data base was stronger for girls than boys."

Saslow also is doubtful whether Gardasil -- which costs $360 per three-shot regimen -- would prove to be cost-effective if provided to boys as well, at least in terms of preventing the biggest threat, cervical cancer.

"It may be cost-effective to vaccinate boys if not that many girls get vaccinated," she said. "But if most of the female population ends up getting vaccinated, then vaccinating boys won't add very much."

But what about the vaccine's cost-effectiveness in preventing anal and throat cancers, plus genital warts, among boys? Saslow said that since Gardasil has not yet been proven to be effective in boys, or to be effective against cancers outside the cervix, those points remain up in the air. "We still have all these questions that we need to look at," she said.

Another expert, Dr. Robert Frenck, a professor of pediatrics at Cincinnati Children's Hospital, was equally noncommittal. Frenck, who sits on the American Academy of Pediatrics' committee on infectious diseases, said his group is "in the process of developing the recommendations for HPV vaccine use." He said the AAP recommendations would focus only on the vaccine's "currently [FDA] licensed usage," which is exclusively for females.

Still, Bookman believes that, should Gardasil prove effective in boys, widening its use to both sexes "is the correct way to try and do things."

"What about everything that we know about controlling any other type of infectious process? Where we wouldn't discriminate on the basis of sex, we would vaccinate universally," he said. "Yes, in women cervical cancer is a more serious risk statistically than other cancers in men. But I think that the best way of controlling it with a vaccine is to use it broadly."

More information

Learn more about HPV and cervical cancer at the U.S. Centers for Disease Control and Prevention.

SOURCES: Michael Bookman, M.D., director, medical gynecologic oncology, Fox Chase Cancer Center, Philadelphia; Debbie Saslow, director, breast and gynecological cancers, American Cancer Society, Atlanta; Robert Frenck, M.D., professor, pediatrics, Cincinnati Children's Hospital Medical Center