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Should boys receive the human papillomavirus vaccine? No

BMJ 2009; 339 doi: (Published 07 December 2009) Cite this as: BMJ 2009;339:b4921
  1. Kate Cuschieri, principal clinical scientist
  1. 1Scottish HPV Reference Laboratory, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA
  1. KateCuschieri{at}

    Many countries have implemented HPV vaccination programmes for girls. Sam Hibbitts (doi:10.1136/bmj.b4928) argues that they will not be fully effective unless extended to boys, but Kate Cuschieri says the benefit is insufficient

    The burden of human papillomavirus (HPV) mediated disease is borne by women in the form of cervical cancer and its precursor lesions. Globally, cervical cancer is the second most common cancer in women, with an estimated 493 000 new cases and 274 000 deaths in 2002.1 It is a devastating cancer with a peak incidence in young women in their 30s. HPV vaccines and associated immunisation programmes are hugely expensive, and including boys will double the cost for a small unjustifiable return. All efforts and resources must be channelled into ensuring high coverage rates are achieved and sustained in girls.

    Two HPV vaccines are currently available: a bivalent vaccine that protects against infection with HPV 16 and HPV 18 (the types responsible for about 70% of cervical cancer) and a quadrivalent vaccine that also protects against infection with HPV 6 and HPV 11 (which cause around 90% of genital warts). Data from clinical trials indicate that both are highly effective …

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