ACIP takes permissive stance on HPV vaccine for males

The Advisory Committee on Immunization Practices voted to recommend the CDC permit use of the quadrivalent human papillomavirus (Gardasil, Merck) vaccine in boys and men ages 9 through 26 years, but stopped short of universally recommending the vaccine.

The committee agreed on a statement that advises clinicians: “Quadrivalent HPV vaccine may be given to males aged 9 through 26 year to reduce their likelihood of acquiring genital warts.”

Lance Rodewald, MD, of the CDC, explained that the permissive recommendation by the ACIP still empowers the Vaccines for Children program to purchase this vaccine for boys up to age 19 who qualify for the program.

Rodewald said the “64,000 question” likely will be whether or not managed care would provide reimbursement under a permissive recommendation. He said even in those children who are underinsured, the VFC program may be able to intercede and pay for their vaccinations if these patients were were referred to a federally qualified health center.

Before the committee’s vote, Amy Middleman, MD, an Infectious Diseases in Children Editorial Board member and the Society for Adolescent Medicine’s liaison to the committee, urged a universal recommendation for both males and females for HPV vaccination.

She said universally recommending the vaccine in boys and girls would not only serve to reduce genital warts in males and females, it would also be likely to have the added benefit of increasing somewhat low adolescent immunization rates. She cited data that showed a 72% coverage rate in 2008 for the combined tetanus and diphtheria and TDaP vaccinations, despite a long-standing universal recommendation for this vaccine.

In an interview with Infectious Diseases in Children after the vote, Middleman, who was on Merck’s speakers bureau until 2008, said she was disappointed by the committee’s recommendation.

“The vaccine has clear benefits for males, but coverage rates among females for the near future makes universal immunization of males an important part of protecting females,” Middleman said. – by Colleen Zacharyczuk