HPV: Boys should also get vaccinated now

Christiane Fux studied journalism and psychology in Hamburg. The experienced medical editor has been writing magazine articles, news and factual texts on all conceivable health topics since 2001. In addition to her work for, Christiane Fux is also active in prose. Her first crime novel was published in 2012, and she also writes, designs and publishes her own crime plays.

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For girls, vaccination against HPV can save lives. Because it protects against cervical cancer. But men can also get life-threatening illnesses from the viruses - for example from cancer of the mouth, throat and anal area. The Standing Vaccination Commission (STIKO) at the Robert Koch Institute therefore now recommends vaccinating boys against HPV. Preferably between the ages of nine and 14 years.

"It was high time!", Comments Prof. Harald zur Hausen, long-time chairman of the board of the German Cancer Research Center (DKFZ), on the decision of the highest German vaccination committee. Zur Hausen, who together with other researchers received the Nobel Prize for Medicine in 2008 for the discovery of the first vaccine against HPV, has long been calling for boys to be vaccinated as well.

Health insurance companies should bear the costs

The recommendation of the STIKO clears the way for the health insurances to cover the costs for the vaccination. Boys between the ages of 9 and 14, and initially young people up to 17 years of age, are now also to be vaccinated. Such a recommendation has been in place for girls since 2007.

Vaccination protection before the first sex

Vaccination should be done before young people become sexually active. Because HP viruses are mainly transmitted during sexual intercourse. Not only the boys themselves benefit from the vaccination, but also their future partners.

Even more: "Without vaccinating the boys, we could never achieve what is known as herd immunity," says zur Hausen. This means immunity that is so widespread among the population that it prevents the infection from spreading further. "With HPV, we estimate that around 85 percent of all girls and boys have to be vaccinated in order to break the chain of infection," explains the scientist.

Only 40 percent of the girls were vaccinated

Such a vaccination quota is still a long way off in Germany, even among girls. Zur Hausen even describes the vaccination rate of just 40 percent on average as “scandalously low”. So far, only a tiny fraction of the young has been protected. Namely only if your pediatrician had arranged a vaccination with the parents at their own expense.

There are various reasons why so little is vaccinated against HPV. "Most parents apparently have difficulties imagining sexual activities in their nine to 14-year-old children and immediately put on their helicopter coats," said the Ärztezeitung in April, quoting Prof. Christian Jakisch, chairman of the Hessian Cancer Society.

Fear of vaccine damage

And one more discussion shakes the willingness to vaccinate: Reports keep appearing in the media that young women and girls are seriously ill after vaccination. The range of reported vaccine damage ranges from paralysis to chronic exhaustion and death.

In fact, a connection with the vaccination has not yet been proven in any of these cases. “The HPV vaccination is one of the safest vaccinations.” Much safer than the one that is usually given to children, says zur Hausen.

Large study gives the all-clear

This was only recently confirmed by a large overview study by the renowned Cochrane Institute, which examined 26 studies with 73,428 participants. Overall, the risk of serious side effects was low. Mortality among those vaccinated and among girls and women who received a placebo was about as low.

Much fewer precancerous lesions

Of course, it is no less important that the vaccination actually protects. This can currently only be proven for the precancerous stages, because manifest cancer develops so slowly that the studies are not yet able to record this protective effect.

Compared to their unvaccinated peers, girls and young women with vaccination are much less likely to develop the precursors of cancer in the subsequent three to nine years. Vaccination, for example, reduced the risk of pre-cancerous cancer associated with the high-risk types HPV 16 and 18 from 164 to 2 per 10,000 women. The number of all precancerous stages still fell from 287 to 106 per 10,000 women.

It is currently not clear whether the vaccination would protect boys equally reliably. Corresponding studies are lacking - mainly because of the small number of boys who have already been vaccinated.

1500 preventable deaths annually

Sexually transmitted human papillomavirus (HPV) infections are essential for cervical cancer to develop. According to the Robert Koch Institute in Germany, around 4,600 women develop it every year and 1,500 die as a result.

There are 40 different types of HP virus - and they are very common: Most sexually active women and men become infected at least once in their lifetime. Most of the time, however, the immune system copes well with the pathogens.

"Use the chance to vaccinate!"

Virologist zur Hausen now appeals to parents: "Take the chance and protect your son and his future partners from these preventable cancers!"

The STIKO recommendation applies when it is published in the epidemiological bulletin 34/2018 of the Robert Koch Institute in August. The Federal Joint Committee then examines the reimbursement of costs by the statutory health insurers. Parents who would like to have their sons vaccinated now should discuss possible reimbursement of costs directly with their health insurance company. The first health insurance companies have already announced that they will cover the cost of vaccinations for boys from July 1st.

Two vaccinations are available

Two vaccines are currently approved in Germany: a double vaccine against types HPV 16 and 18 and a nine-fold vaccine, which protects against other high-risk viruses and the main pathogens for genital warts. As a rule, two doses of vaccine at least five months apart are necessary for the primary vaccination.

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