CDC panel recommends HPV vaccine for men through age 26 and for some older adults

The US Centers for Disease Control and Prevention's Advisory Committee on Immunization...

Posted: Jun 27, 2019 3:51 AM
Updated: Jun 27, 2019 4:10 AM

The US Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices, known as ACIP, voted unanimously on Wednesday to recommend HPV vaccines for both boys and girls and men and women through age 26.

Previously the CDC recommended that teen girls and young women who had not been adequately vaccinated receive the human papillomavirus vaccine through age 26, but the recommendation for teen boys and young men only went through age 21. The CDC's recommendation that children start receiving two doses of the HPV vaccine around 11 or 12 years old has not changed.

In a 10-4 vote, the committee also recommended adults ages 27 through 45 who had not been adequately vaccinated make shared decisions with their doctors about getting vaccinated. Adults older than 45 who had not been vaccinated are not advised to do so, since HPV vaccines are not licensed for use in that age group.

The ACIP recommendations won't be official until they're approved by the CDC director.

The votes were made during a meeting at the CDC in Atlanta. The committee holds three meetings every year to review the most recent scientific data and vote on making possible updates to vaccine recommendations.

Several mothers and anti-vaccination advocates spoke out against vaccines during the public comment portion of the meeting, referencing concerns around vaccine safety and potential harms.

Following the vote, Dr. Christopher Zahn, vice president of practice activities at the American College of Obstetricians and Gynecologists, praised the ACIP decision in a written statement.

"Today's decision from ACIP emphasizes what the data has shown -- that the HPV vaccine is safe and effective for use in patients ages 27 to 45, and that use of the vaccine in this age group should be the result of shared decision-making between patients and their trusted physicians," Zahn said.

The recommendations for catch-up vaccinations to extend through age 26 "should match" between men and women, Dr. Anna-Barbara Moscicki, division chief of adolescent and young adult medicine at UCLA Health and professor of pediatrics at the University of California, Los Angeles, said in an email.

"The simpler the better," Moscicki, who was not involved in the ACIP meeting, said in the email.

HPV infection can lead to cancer

Human papillomavirus or HPV is a group of more than 200 related viruses, which can spread through sexual contact. In some cases, HPV infection can lead to six types of cancer: cervical, anal, penile, vaginal, vulvar and oropharyngeal (mouth and throat).

In the United States, high-risk HPV infections cause about 3% of all cancers in women and 2% in men, according to the National Cancer Institute.

Worldwide, the impact of HPV-related cancers is greater, with high-risk infections causing about 5% of all cancers globally, according to the institute.

The vaccine can protect against cancers since it works by preventing HPV infection -- and while most people think of HPV's relation to cervical cancer, "parents often don't know that HPV oropharyngeal cancers will outnumber cervical cancer" in around five years, Moscicki said.

About 10% of men and 3.6% of women have oral HPV, according to the CDC, and HPV is thought to cause 70% of oropharyngeal cancers in the United States.

Earlier this month, actress and "Desperate Housewives" star Marcia Cross opened up about her battle with anal cancer. Cross, 57, revealed her diagnosis in a series of Instagram photos in 2018. Her husband, Tom Mahoney, was diagnosed with throat cancer in 2009. Doctors now suspect that Cross' cancer and Mahoney's came from the same type of HPV.

Cross said at the time she planned to get her 12-year-old twin daughters vaccinated. The actress told CNN she cares deeply about being able to "educate the public about HPV."

"In spite of the optics, I care deeply about saving lives," Cross previously wrote in an email to CNN. "To that end, the important thing to do is to educate the public about HPV. It is so common that nearly every person who is sexually active will get it at some point in their lifetime. HPV can cause cervical and other cancers .... It can take years, even decades to develop."

'Strong evidence' for cervical cancer prevention

A new study, published in the journal The Lancet on Wednesday, found "compelling evidence" of HPV vaccination programs leading to significant declines in HPV infections.

The study was a review and analysis of 65 separate papers in 14 high-income countries previously published between 2014 and 2018 on certain HPV-related health consequences, such as infections or anogenital warts, before and after vaccination periods.

The analysis of these previous studies showed that, after five to eight years of vaccination, the prevalence of HPV 16 and 18 decreased significantly by 83% among girls aged 13 to 19, by 66% among women aged 20 to 24 and by 37% among women aged 25 to 29.

These types of HPV cause 70% of cervical cancers and pre-cancerous cervical lesions, according to the World Health Organization.

The study also found significant decreases in anogenital wart diagnoses in both girls and women and boys and men.

"Our results provide strong evidence that HPV vaccination works to prevent cervical cancer in real-world settings as both HPV infections that cause most cervical cancers and precancerous cervical lesions are decreasing," the study's first author Mélanie Drolet of the CHU de Quebec-Laval University Research Center said in a press release

"We saw that programmes with multiple age cohorts of girls vaccinated and high vaccination coverage have greater direct impact and herd effects. This finding reinforces WHO's recently revised position on HPV vaccination to recommend HPV vaccination of multiple age cohorts of girls aged 9-14 years old when the vaccine is introduced in a country, rather than vaccination of a single cohort," Drolet said.

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