Boys could be next for HPV vaccine

With the world's first mass immunisation of girls against cervical cancer set to begin in Australia next week, experts are considering extending the treatment to boys.

Although the effectiveness of inoculating boys against the human papillomavirus (HPV) is not yet known, many health professionals contacted by ninemsn say male vaccination is the next logical step.

"The drug companies want to get money out of this as soon as possible and the part of the population that wants the vaccine the most is obviously women, so that's what they focus on first," Dr Julia Brotherton of the National Centre for Immunisation Research (NCIRS) said.

Men cannot suffer cervical cancer but they do carry HPV and spread the disease through sexual intercourse.

They can also contract anal and tonsillar cancers from the virus, while the vaccine protects both genders from genital warts.

Dr Brotherton drew a parallel between cervical cancer treatment and rubella inoculations, which used to be given only to schoolgirls but are now issued to both genders to stop carriers spreading the disease.

Last year's Australian of the Year, Professor Ian Frazer, who led the research programme that developed the breakthrough vaccine, has already had both his sons vaccinated.

Nevertheless, he warns there is some way to go before both sexes can expect publicly-funded inoculation.

"The benefits for boys are as yet unproven — the vaccine is safe in boys, and produces a good antibody response, but the efficacy trials in boys are still in progress," he told ninemsn from Singapore, where he is addressing a conference on his work.

"Therefore, it may be premature to debate the virtues of vaccinating boys till we know it works in the boys like it does in the girls."

Professor Frazer pointed to an experimental herpes vaccine that seemed equally effective for both sexes in theory, but worked much better in girls than in boys in trials.

"Also, the cost benefit is not so obvious for boys as it is for girls so it may be a personal decision for boys and their parents whether to pay," he said. The female vaccination programme was announced by the Federal Government in November and will target girls aged 12 and 13, with a secondary two year "catch-up" programme for older girls and women aged up to 26 years through schools and clinics starting in July.

A similar scheme is being instituted in Germany, where state insurance companies will take over the cost of injections as of this week, but Dr Brotherton says "the eyes of the world" are on Australia's programme.

Australia already has a proud history in the fight against cervical cancer: what was once the second-highest killer of Australian women has dropped over the past 20 years to the 15th most common cause of death, with 327 fatal cases in 1984 falling to 212 in 2004, thanks to a national pap smear programme.

"But even though it's been really successful, we're interested in the vaccine because pap smears really can be quite painful," Dr Brotherton says. "We want to get to the point where pap smears won't be necessary."

Professor Freddy Sitas of the NSW Cancer Council believes pap smears will continue to be a part of cervical cancer prevention, and says that any moves to immunise boys are conditional on controlling the virus in females.

"Vaccinating boys may provide some additional protection for women getting cervical cancer in the future by reducing the amount of HPV in the population overall, but the amount of additional protection will depend on how many girls and women are vaccinated," he said.

"Several important studies are currently being conducted on the rates of HPV infection in men of varying ages and on the effectiveness of the vaccine in preventing this infection in men, so when these studies have been completed we will be better able to determine the benefits of HPV vaccination for males."