Source: www.statesmanjournal.com
Author: staff

It’s been hard enough to persuade parents to get their preteen girls vaccinated against the virus that causes cervical cancer. Now, health-care providers have an even harder sell: reaching the parents of boys.

The vaccine that protects against human papillomavirus, or HPV, has been approved for use in boys since it hit the market in 2006. And while boys don’t share the cervical cancer risk, the vaccination can help stop the virus’ spread, as well as protect boys from other cancers. But as of last fall, just more than 1 percent of all eligible boys had received the vaccine.

Since then, the Centers for Disease Control and Prevention has more strongly recommended that boys get it. And the American Academy of Pediatrics threw its support behind the series of three shots for 11- and 12-year-old boys. But experts don’t expect to see a significant increase in the number of boys who have received the vaccine when the CDC releases new vaccination statistics late this summer.

Why are so many parents reluctant to have their children vaccinated? Because HPV is transmitted through intimate skin-to-skin contact, parents may fear that vaccinating their children sends the message that premarital sex is OK.

Nationwide, 49 percent of girls ages 13 to 17 have received at least one shot, and about 32 percent of girls have received the three doses required for complete protection, according to a CDC report.

For girls, doctors cite statistics about how the vaccine protects against the two most prevalent viral types that lead to the bulk of cervical cancers. Boys receive protection against genital warts and oral, anal and penile cancers, which are not as common as cervical cancer.

But vaccinating boys against HPV also will reduce the presence of the virus, which can be transmitted even if it does not show up as warts.

Still, many parents willing to have their daughters vaccinated balk at doing the same for their sons, doctors say.

“It’s funny. They’re a little hesitant to do it,” said Dr. Sarah Stelzner, a clinical assistant professor of pediatrics at Indiana University School of Medicine. “They see it as a problem for girls. They understand preventing cervical cancer, but I don’t think that they understand the public health part.”

No studies have found any safety issues with the vaccines. But with all the parent sentiment against the shot, experts say doctors must push extra hard to persuade boys’ parents.

However, many physicians don’t advise their patients to consider the shot, said Dr. Darron Brown, a professor of medicine, microbiology and immunology at the Indiana University School of Medicine, who was instrumental in developing the vaccine.

“Doctors are not in tune with recommending it,” Brown said. “They’re not aware of the importance. They’re not aware of the benefits to boys and the health of the population.”

Some physicians agree that vaccinating boys hasn’t been a priority.

“Right now it’s still a big drive to get the girls vaccinated,” said Dr. Carrie Melloh, a family medicine doctor with Community Physician Network in Fishers, Ind. “It hasn’t been a big drive to get the boys vaccinated.”

One obstacle: insurance. Most insurance covers the vaccine for girls, and Medicaid covers it for boys. But Melloh has encountered patients who must pay out of pocket. The cost of the three shots needed for full protection can range from $360 to $400.

Economics aside, the vaccine does not speak to parents of boys the same way it does parents of girls, Melloh said.

“With girls, we see the cancer benefit. With boys, the only indication is for genital warts,” she said. “I don’t think we look at it the same because it’s a prevention of cancer versus prevention of warts.”

Part of the problem could be the young age of targeted patients. The idea is to protect patients before they are exposed to HPV, so experts target their efforts to the preteen crowd in the hope that they could reach them before they become sexually intimate.

At IU’s clinics, which serve 13- to 17-year-olds, doctors routinely offer — and patients and their parents routinely accept — the shot. Nationally, vaccination rates are higher for 15- to 16-year-olds than for younger teens, said Dr. Gregory Zimet, co-leader of the Cancer Control Program at Indiana University Simon Cancer Center and principal investigator of Cervical Cancer-Free Indiana.

And some parents welcome the shot. Ami Anderson of Indianapolis remembers a mother at her children’s preschool who died of cervical cancer. When her fifth-grade son brought home a flier about the shot, she had no doubt she would have him vaccinated.

Anderson doesn’t recall whether her son’s pediatrician has mentioned the shot, but she plans to bring it up at his next appointment. She wants her child to wait to have sex, but she doesn’t see the shot as encouraging sexual activity.

“I am hopeful that is true (that he abstains), but I’m not willing to take that risk,” she said.

Beth Deane, mother of an 11- and 14-year-old, said she may not tell her sons what the shots are for.

Instead, she’ll just say, “It’s another vaccine to keep you healthy.”