Gardasil is a newly released vaccine that protects against the four most common forms of the sexually transmitted infection, human papillomavirus (HPV), which can cause cervical cancer and genital warts. It can also cause anal and penile cancer, and men argue that receiving the vaccine would guard against these as well. As a result, many private clinics are offering the vaccine to men. One clinic in London says it has immunised dozens of men in the last six weeks.
As in America, Gardasil has caused controversy since it was launched in the UK because it is designed to be given to children before they become sexually active and can catch HPV. Gardasil is licensed for boys and girls aged nine to 15 and women aged 16 to 26. But doctors can give it to other people "off licence" if they wish.
"We've had a strong demand for it. I had a man come in for the vaccine this morning. He was 24. Then I have one this afternoon who is 67 years old," said Dr Sean Cummings at the Freedom Health clinic in Harley Street. "The motivation is to protect themselves and to prevent spreading HPV to their partners."
Some people believe there is no point immunizing people who are already sexually active, but Dr Paul Fox, a genito-urinary medicine expert at the Chelsea and Westminster and Ealing hospitals, says it can be worthwhile. He argues that it is unlikely a person will have encountered all of the four strains of HPV found in Gardasil, including the two linked to cancers, even if they are leading a very promiscuous sex life.
"Men who have sex with men are at a much higher risk than average of anal cancer and genital warts, particularly if they are HIV-positive," said Dr Anne Szarewski, clinical consultant for Cancer Research UK who has been involved in evaluating both Merck's Gardasil and GSK's rival jab Cervarix. "Clearly it would be very important if the vaccine could protect. The problem is we do need proof."
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Big Pharma keeping medicine away from the people!
Oh, right....
I think it's good that the article makes clear that you can't just start using a vaccination approved for one purpose or group of people for other purposes or groups of people. This seems to be something that many people have a hard time understanding.
Well, my understanding was that they had tried it in men and it was less efficacious. But even so an increase in herd immunity would be beneficial, even if small.
From what I've heard, they haven't tested it enough on men yet. They started off testing on the group of people it would help the most, and now are working on testing on other groups as well.
Here's a link to a great Gardasil study in the journal Pediatrics:
www.pediatrics.org/cgi/content/full/118/5/2135
In this study, boys actually had better antibody responses than women to all four HPV strains in the vaccine.
It seems like the key to approval in men will be whether this response actually translates to reduced infection. The cervix (being a mucosal surface) is protected by antibodies. The penis relies more on different kinds of immune defense.