A vaccine against a human wart virus that causes a number of cancers is the latest topic for debate among U.S. vaccine advisers. They are weighing how and whether boys and young men should take the vaccine.

The Merck & Co's Gardasil vaccine is currently approved for boys, safe and it would be cost-effective, CDC researchers and vaccine experts told a meeting of the Advisory Committee on Immunization Practices.

Experts noted that men would also benefit from the vaccine, including homosexuals and bisexuals, who are at risk of developing anal cancers and other conditions caused by the human papillomavirus, or HPV.

HPV infection, often best known as the primary cause of cervical cancer, can also lead to cancers of the anus, penis, head and neck. Vaccinating men and boys could prevent some of these cancers.

Currently, U.S. Centers for Disease Control and Prevention recommends Gardasil vaccinations for girls and women between the ages of 11 and 26.

The vaccine was approved mainly to prevent cervical cancer, which kills 4,000 women a year in the United States.

Last year, the advisory committee only considered its use based on its ability to prevent genital warts. In that case, the benefits did not seem to justify the vaccine's $360 cost. The issue has been taken up once again.
Dr. Lauri Markowitz, who heads the committee's HPV working group, noted that cases of anal cancers are increasing in the United States, especially among women, and men who have sex with men.

"Estimates from various studies indicate that the incidence of anal cancer in men who have sex with men may be as high as 37 cases per 100,000 men," she said.

Markowitz said the panel is considering several options. They could make no change, or they could vote to recommend routine immunization of boys at age 11 or 12.

"With either of these options, there could be a specific recommendation of men who have sex with men," she told the meeting.

She noted that vaccinating adolescent males before they get sexually active is one of the best ways to protect them. Cost remains to be a major cause for concern.

The Vaccines for Children Program pays $108 per dose of the vaccine, which is given in a series of three doses.

Panel members who support routine vaccination cite studies showing the vaccine is safe and effective and say vaccinating both girls and boys at the same time would be easier for doctors.

A recent survey of doctors suggested showed 36 per cent of pediatricians and 24 per cent of family medicine physicians are administering the vaccine to males, experts told the CDC panel.