Study Finds Few Physicians are Recommending HPV Vaccination for Boys

Research from Moffitt Cancer Center shows family physicians and pediatricians are not always recommending vaccination against human papillomavirus (HPV) for young male patients. Approximately 6 million people are newly infected with HPV each year, a virus that can lead to the development of cancer. There are also more than 600,000 new cases of cancer attributed to HPV each year worldwide.

“HPV is responsible for almost all cases of cervical and anal cancers, as well as 64 percent of vaginal cancers, 36 percent of penile cancers and 51 percent of vulvar cancers,” says Susan T. Vadaparampil, PhD, MPH, senior faculty member in the Health Outcomes and Behavior Program at Moffitt. “Women tend to be afflicted by HPV-induced cancer more than men; however, more men have genital and oral HPV infections than women.”

These observations helped scientists characterize the biology of HPV infection at each anatomic site and aid in the development of HPV prevention strategies, including the vaccines Cervarix® and Gardasil®.

Cervarix and Gardasil are approved for HPV prevention in young females aged 9 to 26 years. Gardasil is also approved for young males aged 9 to 21 years. The Centers for Disease and Prevention’s Advisory Committee on Immunization Practices issued a permissive recommendation to vaccinate males aged 9 to 26 years against HPV in 2009. Under this recommendation, physicians may immunize males against HPV, but are not required to.

Following the recommendation, a team of Moffitt researchers, including Vadaparampil, Anna R. Giuliano, PhD, and Teri L. Malo, PhD, MPH, conducted a survey of more than 600 family physicians and pediatricians to examine factors associated with physician recommendations for male HPV vaccination. The results helped to better understand physician beliefs and practices concerning HPV vaccination.

The team discovered that physicians recommended HPV vaccination to less than 15 percent of their male patients aged 9 to 26 years. Pediatric specialists and doctors who support new vaccines were more likely to recommend the vaccine.

They also found that physician HPV vaccine recommendations may also depend on insurance coverage. Many insurance companies choose not to cover vaccines when they are considered “optional” or “not required.”

According to Malo, “Public health interventions designed to increase HPV vaccine recommendation for males should focus on increasing recommendations by family practitioners and also identifying and supporting innovators and early adopters who may help diffuse HPV vaccination guidelines and encourage later adopters to support the recommendations.”

Moffitt’s Center for Infection Research in Cancer has partnered with U.S. Rep. Kathy Castor of Florida and other local healthcare organizations, to form the Tampa Bay HPV Vaccination Awareness Coalition to increase awareness of HPV-related cancer and its prevention through vaccination. Florida has one of the lowest HPV vaccination rates, according to the Centers for Disease Control and Prevention (CDC). The state also has among the highest incidence of HPV-related cervical cancer in the country.

The Advisory Committee on Immunization Practices now recommends routine HPV vaccination for both boys and girls. Most insurance companies cover the cost of the vaccination for children under the age of 18; the cost is also covered under the Affordable Care Act.

The study on HPV vaccination recommendations and young men was published July 15 in Cancer Epidemiology, Biomarkers & Prevention. It was supported by a grant from the National Institutes of Health (R01AI076440-01).

Source: Moffitt Cancer Center