Adina Nack, author of Damaged Goods? Women Living with Incurable Sexually Transmitted Diseases, draws on her expertise as a sexual health researcher to discuss the impact of human papillomavirus (HPV) on men and the need for gender-neutral STD vaccines.
When I wrote my book, Damaged Goods? I focused on how living with contagious, stigmatizing, medically incurable (though highly treatable) infections transformed women’s lives – medically, socially and psychologically. I had included a discussion of the Gardasil vaccine, which had received FDA-approval and CDC recommendation for ‘routine’ use in girls and women (ages 9 to 26) back in 2006, and I had articulated some of my concerns about the delayed testing and approval process for ‘male’ Gardasil.
A family of viruses, HPV is an ‘equal opportunity infector,’ so why have HPV vaccines not been equally accessible for men as well as women? In a recent interview on Huffington Post, several blog posts of my own, and my new feature article, “Why Men’s Health Is a Feminist Issue” (Ms. Magazine, Winter 2010), I investigate the substantial public health costs that result from HPV vaccines, such as Gardasil, not having been originally developed, tested and approved as gender-neutral vaccines.
The narrow and inaccurate marketing of Gardasil as a female-only, “cervical cancer” vaccine has distracted us from public discourse about this family of sexually transmitted viruses that are not only a U.S. epidemic but also a global pandemic. In the U.S., HPV is estimated to affect 75% of adults and certain strains are known to cause potentially fatal oral, cervical, anal, and penile cancers. Researchers are finding that HPV-related male cancers are: on the rise, often fatal due to lack of accurate testing/screening, and, in the U.S., likely result in more combined deaths in men than in women.
Still, Gardasil— primarily branded and marketed as a cervical cancer vaccine for girls and women—remains fairly inaccessible to boys and men. The CDC recommends “routine” Gardasil vaccination for females ages 9-26 for the prevention of cervical cancer and other HPV diseases. But, last October, after the FDA approved Gardasil solely for the prevention of genital warts in boys/men, the CDC’s Advisory Committee on Immunization Practices (ACIP), which makes recommendations for the routine administration of vaccines, voted for a lesser recommendation of “permissive” use in males that is likely to keep the vaccine less affordable for male patients.
Last month, the makers of Gardasil released a study which showed the vaccine to be effective at preventing anal precancers in men. This new evidence, which supports the case for a male vaccination schedule, was presented on February 24 at a meeting of the CDC’s ACIP. As evidence mounts that HPV vaccines (e.g., Gardasil and Cervarix) may prevent a range of serious HPV-related male cancers—including types of oral cancer, which are on the rise—I will be watching to see if the FDA reevaluates its original narrow approval of ‘male’ Gardasil (only for the prevention of genital), which could shape future CDC/ACIP vaccination recommendations.
As a medical sociologist, I am neither pro- nor anti-vaccine, but I do support:
(1) equal access to vaccines
(2) medical studies of vaccines that reveal full ranges of potential health benefits and costs
(3) and a HPV public health campaign that fully educates about the range of treatable and serious health consequences for boys and girls, men and women.
Even the most successful vaccine is not 100% effective, so it is imperative that we expand the discussion of HPV prevention beyond vaccination. Whether or not you are pro- or anti-Gardasil, we all have much to gain from de-stigmatizing STDs and from making comprehensive HPV education more accessible.
This post was inspired by Nack’s posts on Girlw/Pen.