HPV Vaccination of Males Not Cost-Effective

  1. 0
    October 12, 2009-Vaccinating boys against human papillomavirus (HPV) in addition to girls is not likely to be cost-effective, conclude a new analysis and an accompanying editorial published online October 8 in the British Medical Journal.

    In the United States, this use of Gardasil-i.e., vaccinating boys to protect against genital warts-was recently recommended for approval by a US Food and Drug Administration Advisory Committee, as reported by Medscape Oncology.
    However, the new analysis concludes that "including boys in an HPV vaccination program is unlikely to provide good value for resources, compared with vaccinating girls only.
    Free registration to read article: http://www.medscape.com/viewarticle/...ne&uac=87363SX
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    Visit  sirI profile page

    About sirI, MSN, APRN, NP

    sirI has 'many' year(s) of experience and specializes in 'OB, FP, LNC, Forensics, ED, Education'. From 'USA'; Joined Jun '05; Posts: 92,085; Likes: 24,510.

    23 Comments so far...

  3. Visit  CEG profile page
    3
    I didn't read the article so forgive me if this is covered, but 70% of the population has HPV. How can it not be cost-effective if you figure that males are the ones passing to females? Cervical cancer screenings through pap smears is certainly not cost-effective and we do that because early detection of cervical cancer saves lives. Why not primary prevention through vaccines?
    sharpeimom, emmalou*, and hiddencatRN like this.
  4. Visit  hiddencatRN profile page
    2
    2nd CEG. There's no way to test men (as far as I know) so immunizing them seems like an extra (needed) step to protecting women from cervical cancer. And with many people not interested in vaccinating for HPV in the first place, are we really in any danger of running out of supplies by "wasting" it on the guys?
    lizmatt and sharpeimom like this.
  5. Visit  azhiker96 profile page
    0
    The study was looking at cost benefit. By their analysis it's more cost effective to concentrate efforts on vaccinating the girls.

    "Only under the most favorable assumptions for the benefits of adding male HPV vaccination to female vaccination did the cost fall below $100,000 per QALY [quality of life-year], the threshold below which an intervention is considered a good economic investment," the editorialist explain.
    Under no scenario did the cost of including males in HPV vaccination programs fall below $50,000 per QALY, which is perhaps a "more fiscally responsible threshold, given the need to lower healthcare costs and increase efficiency," they add.
    "By comparison, HPV vaccination of 12-year-old girls was always a good health investment," whatever the modeling, the editorial notes.
    It's true that either gender can pass this virus and if I were young and single I'd certainly want the vaccine. They're just looking at cost/benefit. In males it's relatively easy to spot as genital warts.
  6. Visit  hiddencatRN profile page
    1
    Quote from azhiker96
    It's true that either gender can pass this virus and if I were young and single I'd certainly want the vaccine. They're just looking at cost/benefit. In males it's relatively easy to spot as genital warts.
    The strains that cause cervical cancer don't cause genital warts, and genital warts can be visible externally on women too.
    Teresag_CNS likes this.
  7. Visit  mercedesbenz520 profile page
    3
    I am all for vaccinating males. HPV is a very common illness often without symptoms. Vaccinating boys will prevent this disease from being spread, hopefully eradicating it for the future.
    lizmatt, PeachPie, and sharpeimom like this.
  8. Visit  birdgardner profile page
    5
    If the entire female population were vaccinated, and everyone were heterosexual, it wouldn't be necessary to vaccinate the boys to protect the girls.

    Boys and men who have same-sex intercourse are at risk for anal and throat cancer.
  9. Visit  mercedesbenz520 profile page
    1
    This can happen to women too.
    sharpeimom likes this.
  10. Visit  CEG profile page
    3
    Quote from birdgardner
    If the entire female population were vaccinated, and everyone were heterosexual, it wouldn't be necessary to vaccinate the boys to protect the girls.

    Boys and men who have same-sex intercourse are at risk for anal and throat cancer.
    If the entire male population were vaccinated and everyone were heterosexual it wouldn't be necessary to vaccinate the girls against the disease that they were getting from the boys in the first place.

    But not everyone is heterosexual, not everyone has only vaginal-penile intercourse, and not everyone gets vaccinated. I don't see how it is less cost effective to vaccinate a male who has the potential to spread HPV to multiple partners.
    Kringe38, MikeyBSN, and hiddencatRN like this.
  11. Visit  MikeyBSN profile page
    3
    There could be political motives behind backing or using studies like this. They determine that not vaccinating men is not "cost effective". Then, the poorer women who have not been vaccinated due to lack of opportunity would have a greater risk of becoming infected. Also, this would do nothing to stop the spread of the disease among gay males. That way, the conservative movement now has another "gay" and "poor" disease to use in their arsenal.
    dreamon, DolceVita, and Teresag_CNS like this.
  12. Visit  azhiker96 profile page
    0
    This study has no bearing currently on whether boys in the US get the vaccine or not.
    In the United States, this use of Gardasil — i.e., vaccinating boys to protect against genital warts — was recently recommended for approval by a US Food and Drug Administration Advisory Committee, as reported by Medscape Oncology.
    The study was published in a British medical journal and might affect whether that health care system provides the vaccine for their males. They did point out that when resources are scarce, it is more cost effective to vaccinate young girls when trying to prevent cervical cancer.

    The editorialists make one other point. The majority of cervical cancer (>80%) occurs in developing countries and in areas of low resources, which cannot afford or access HPV vaccines. "Targeting young women in these populations for HPV vaccination and screening older women would have a bigger effect on reducing the burden of cervical cancer than widespread vaccination of young men from resource-rich areas," they state.
  13. Visit  Teresag_CNS profile page
    1
    "Good coverage of females obviates the need to vaccinate boys."

    This assumes that "covering" young women will be universal and, as said above, that men do not have sex with men. This is sexist and ill-informed.

    A methodological note on this study: Their main outcome, QALYs, is weighted against deaths from cervical cancers caused by HPV strains covered by the vaccine. Because men don't die of genital warts from any strain, it appears better to vaccinate women.
    azhiker96 likes this.
  14. Visit  D.R.A. profile page
    0
    Hmmm? I see, so when cost is the main motivator one must choose the lesser of two evils -------->possible death of women from cervical cancer OR letting men contract and pass genital warts to each other and unvaccinated women.

    Real win win situation there.........either scenario seems bleek. I hope the ones who don't receive the vaccine, be they male or female, get free abstinence information.


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