Roll up your sleeves, gentlemen! Via docfiles @ Flickr.
Since I seem to be on a tear with women’s health issues this week, the WashingtonPost.com really grabbed my attention with a post on the compelling question “Will Men Get Gardasil?”
Gardasil, in case you don’t know, is the new vaccine against the sexually transmitted human papilloma virus, or HPV, which is the main cause of cervical cancer, killing over a quarter million women worldwide every year. The health risks of HPV for men, though, are relatively minor. In rare cases, it can cause penile cancer, but it’s generally harmless and men simply act as carriers, passing along the virus to women. Public health experts hope that by vaccinating men as well as women, they can doubly reduce the spread of the virus. But since HPV doesn’t really affect them, will men get vaccinated just to protect us women? A recent survey on posed that very question to a group of men between the ages of 18 and 20 at FSU:
Mary Gerend of Florida State University and a graduate student surveyed 356 male students, asking them to rate on a scale from 1 to 6 their likelihood of getting the vaccine–with 1 equaling “very unlikely” and 6 equaling “very likely.”
The men who were told about the vaccine’s potential benefits for their partners were no more likely to say they’d be interested in the vaccine than those who were just told about the benefits for themselves. Both groups had a mean score of just below 4, the researchers reported in the journal Sexually Transmitted Diseases. (ed: Fun reading!.) Even those who said they were in committed relationships were no more inclined to get the shots.
This isn’t terribly surprising to me; 18 to 20 year old men are about the least altruistic beings on the planet, with a notoriously poor grasp of long-term planning and consequences, especially when it comes to sex. So asking them if they would hypothetically get a shot–ouch!–that might in the long run prevent their sexual partners from maybe getting cancer from a virus they might be carrying….eh, I can see where these guys might not connect the dots. The article also notes that given their age, it’s questionable what constitutes a “committed relationship” to them. A better group of people to ask would be parents of young boys, since the vaccine ideally should be administered just before or during puberty. It’s really parents who make the call on Gardasil these days, not young men.
Regardless, the article makes an extremely valid point:
…the researchers say the findings suggest a more forceful education campaign will be needed if the vaccine’s manufacturer, Merck, wins approval of the vaccine for men.
This is absolutely true. Everyone needs to be better educated about HPV. Because women are the primary victims of HPV-related cancer, the marketing and education efforts have been directed at them, which is fair. You have to start where the need is greatest. But men need it just as much–if not more–than we do, as I know all too well from personal experience.
When I was diagnosed with HPV I was fairly sure who I had gotten it from–because we’d been in a monogamous relationship for some time–but when I told him, he literally had no idea what I was talking about. Still, even though he didn’t really know what HPV was and there isn’t a definitive HPV test for men, he immediately disclaimed all responsibility–he was sure he couldn’t have given it to me. He’d never had an STI before and was sure I must have gotten it from someone else, and anyway, it wasn’t really his problem, since we were no longer together. I was stunned by both his ignorance and his complete disinterest. And this was an Ivy League-educated man in his late 40s, not a dumbass college dude. Needless to say, I’m 100% convinced that we have some heavy lifting to do when it comes to educating men about HPV prevention.
But besides the crucial need for education, there’s the issue of requiring vaccination. Although this article doesn’t tackle the issue head-on, it begs a critical question: should men–or boys, really–be required to get a vaccine to prevent them from spreading a possibly deadly virus, even if the virus would only harm others and not them?
My answer is HELL YES.* The goal of widespread immunization is twofold: to protect the individual from infection and to protect society from the spread of infections. This is true whether you’re talking measles or polio or HPV. Creating herd immunity is in everyone’s best interests. Men may not die of HPV-related cancers the way women do, but men are certainly affected when their wives, mothers and daughters die. Our communities are hurt by those illnesses and deaths. They devastate families, which always adversely affects society. And not to be crass, but failing to prevent disease always costs our health care system a lot of money, which drives up the cost of health care for the rest of us.
The ethics are a no-brainer—if you can stop the spread of a deadly disease by vaccinating the carriers as well as the potential victims, you are morally obligated to do so. Men need to understand the importance of being immunized against HPV, our public health system needs to require it, and we women need to promote it in every way we can, especially if we have sons who can be vaccinated. Ultimately, women will pay the price for non-vaccination, so we need to make sure that HPV vaccination–for men as well as women–is a top priority for policy-makers, parents and, frankly, everyone.
* You libertarians who hate compulsory vaccination can just shut the fuck up.
I completely agree. However, the vaccine has already resulted in so much slut-shaming from moral conservative fucktards relying on the classic woman-is-responsible-for-all-sex-related-outcomes argument. If this rhetoric has come out in full force when we’re talking about vaccinating women, I can’t even imagine the vitriol that would bubble to the surface if we started requiring, or even suggesting, this vaccine for men. Heavy lifting, indeed.
You said exactly what I have been trying to put into words. It is ridiculous for men (or parents of boys) to disclaim all responsibilty in this matter. I have HPV, and so do many of my friends. It is frighteningly common, can cause cancer, and can possibly be prevented. My son WILL be vaccinated when he reaches puberty.
@Martha The sad part is that the only discussion about giving the vaccine to men so far has been of the “is it safe” variety not of the “OH NOEZ it will make them sluts!” variety.
Of course, this wouldn’t even be a question if mostly men were affected by HPV. Can you imagine what would happen if some parents balked at giving their daughter a vaccine that would keep men healthy?
I don’t have all the facts on the vaccine, but if time and research bears out that it is safe, I would definitely have my son vaccinated. And any future, hypothetical daughter I might have.
Oops, hit submit before I was done.
I believe that the HPV vaccine also prevents the types of HPV that cause penile cancer, which, while rare, does happen, and happens more in uncircumcised men. Perhaps this is a hook to interest the parents of boys who otherwise wouldn’t care.
@Maritsa: The science behind Gardasil is solid, which is why it was approved by the FDA and other organizations like the WHO and the CDC are encouraging its use. There are some reports of a statistically tiny people having bad reactions to the shot, but that happens with every type of vaccine.
If I were able to be vaccinated, I would be first in line, and if I had children, they’d be in line with me.
@Maritsa: Okay, I hit submit too early too!
I agree about penile cancer being a possible way to hook men into getting immunized, but it’s so rare that I think it still might be a tough sell.
I got the vaccine when I was 26 – just before my insurance would stop covering it – for two reasons:
1. Despite being in a committed long term relationship, I wanted to protect myself from HPV should that relationship end or in the event of sexual assault, and;
2. When/if I have children, I would like them to get it too – boys AND girls. By getting the vaccine myself, and having absolutely no side effects thus far, I am more comfortable with the idea of giving it to my children.
I think that the vaccine is a GREAT tool for women to protect themselves and their health – if you’re under 26, seriously consider getting the vaccine! It protects against the 4 most common varieties of HPV – even if you’ve been diagnosed with one strain of HPV before, the vaccine is still effective against other strains.
I had heard anecdotally about the side effects, which is why I wasn’t sure. I know the FDA approved it, but they approved Vioxx and Fosamax too (says the product liability lawyer who has seen to many adverse incident reports).
I’m definitely very pro-vaccine generally. But when it comes to newer products that don’t have the benefit of years of use, I am a little more cautious, meaning I need to do my own research.
I can’t understand why any parent wouldn’t want to protect someone else’s child from CANCER. So your kid wouldn’t get sick – so what?
It’s interesting, some parents that circumcise their boys cite the reduction in the incidence penile cancer thing as a reason for doing it. I’m not sure I actually believe that’s their reason for doing it, but I wonder if the availability of Gardasil would change their minds.
@Maritsa: Yeah, the FDA has definitely approved drugs/treatments that they then had to unapprove. Personally, I got the short-lived Lymerix vaccine for Lyme disease before they had to pull it off the market!
The truth is, even the vaccines for polio and smallpox made a tiny number of people who became very ill, but they were vindicated after they helped eradicate disease within a generation. It takes many years before the effect of immunization can be proven beyond a doubt…but you have to start somewhere.
I’m suspicious of people who claim to circumsize their sons because of penile cancer…I think most decisions about circumcision are made for other reasons, even when parents say ‘oh, it was a medical decision.’ If you said, “you know, you could give your son a shot when he’s 10 that would prevent him from getting penile cancer’, would they circumsize anyway? I’d be curious to find out.
You know, I agree with you, but here’s my issue with Gardasil: it is so expensive that I don’t even know how much this type of survey matters. At the age at which I was still eligible, I didn’t have the money to afford it. Heck, I still don’t have that much cash lying around. How likely are we to get herd immunity with something that costs people [with crappy student insurance] $400? I mean, it would be lovely if we could, but if we can’t even convince insurance companies that this is important to pay up for, how likely are we to convince men to get it? If the survey asked if the college students would pay $400 for it, the answer would drop far lower than a 4.
Not helping, just venting, sorry.
@DangerMouse: That speaks to my point about why the public health system needs to make Gardasil vaccination compulsory. If it’s mandated the way other vaccines are, insurers will have no choice but to cover it, and children on state health plans will be covered as well. But people need to demand it, and our policy-makers need to back them up, in order to see change.
@Becky Sharper My understanding is that women of any age are eligible to receive it as long as a) you pay for it out of pocket and b) you sign a consent form stating that you understand that it hasn’t been approved for someone at your age. If I were out of the age range to receive it I think I would consider it based on how little is known about the virus in terms of how long it can live in your body at low levels and whether or not you’ve actually gotten rid of it just because you don’t show abnormal cells anymore. But this also comes from my experience having moderate to severe dysplasia and a LEEP.
@misscalculate: Unfortunately, because I’ve already had one of the strains of HPV that the vaccine prevents, I’m pretty strongly counterindicated for Gardasil. I’ve asked my (feminist, pro-Gardasil) gynecologist and she’s really cautioned me against it and as good as said she wouldn’t give it to me because even though the virus (as far as we know) has left my body, there’s a chance that Gardasil might lead to cervical lesions for me. Yikes!
If I had never been diagnosed with HPV, I would definitely get it, even though I’m 34.
@BeckySharper I hadn’t heard that information about sort of an interaction between the strain you’ve already come in contact with and the ones contained in the vaccine; that’s interesting. I don’t know think I was even tested for which strain because it was so obviously a cancer-causing one.
I would hate for women to feel like they don’t have the choice if they are over age 26. I know it requires significant out-of-pocket costs and finding a physician willing but from everything I’ve read it seems like 26 was an arbitrary cut-point that I’m not sure was even part of the original experimental design. It may have just been that they didn’t have women older than that participating under the assumption that they’d already had some higher level of exposure or that no one older volunteered. But that’s mostly speculation on my part.
As the mother of a son, even if I’m just looking at his best interest, there’s his emotional best interest. If he gets HPV, he’s going to face uncomfortable discussions with future partners that I’d like him to avoid. I dated a guy whose last girlfriend had almost certainly infected him with HPV, and those were not happy conversations for him. I genuinely didn’t know much about it at the time, and having to stop and ask, “Can I go down on you or will that risk exposure for me?” kind of kills the mood.
He was careful and responsible and I never got it. But it definitely added stress to an already struggling relationship. Why wouldn’t I want my son to avoid those complications even if I didn’t care about his partners?
@BackySharper: I totally agree you have to start somewhere. As I said, I just haven’t had the chance to do any reading to clear up the anecdotal – and probably unfounded – stuff I heard, but I plan on giving this to my son. I just like to read up first.
But I think there is a knee-jerk reaction to new things, and that coupled with the unreasonable and unjustified paranoia about vaccines worries me.
Like you I am generally really, REALLY skeptical of people who claim they circumcised for medical reasons like reduced likelihood of penile cancer or the minutely-reduced chances of HIV transmission (condoms are MUCH more effective, obviously).
I read a lot about this before we decided not to circumcise, and the experts seemed to say those are not signficant. I think most people who choose it just do so for other reasons, so I tend to think Gardasil won’t change their minds.
@misscalculate @BeckySharper: I asked a doctor at my student health clinic whether I should look into Gardasil — I’m 29, and just started a relationship with a dude who has HPV (warts and all). Plus a friend of mine had a hysterectomy a couple of years ago due to cervical cancer, so I’m pretty antsy about HPV.
She told me I would be wasting my money, since by 29 I would almost certainly already have been exposed to and “shaken off” the virus. Which is ridiculous because I have had a grand total of 3 partners, and I bet a lot of 25-year-olds have had more than that and still get vaccinated! But she clearly just wanted me out of her office as soon as possible, so I didn’t pursue the matter. I wonder if I should get a second opinion?
@Kari I really dislike this idea that you will have gotten in all of your promiscuity, and thus exposure, by age 26 so there’s no point in vaccinating beyond that. How many partners you’ve had and how much exposure you might have yet to come is something you know best. Age 26 is a pretty arbitrary number.
I’ve read that HPV also can cause anal and throat cancers in men (and can be transmitted to men through oral sex with a female partner). Not that these topics will get much discussion in the MSM! But other points in favor of vaccinating boys.
There’s been a definite “backing off” regarding any action to make HPV vaccines mandatory (for girls). Only one state, Virginia, has passed such a law, and it was not without a fight. There was a flurry of activity when Gardasil was approved, but then came the media backlash and reports of Merck’s heavy lobbying influence. While several states have passed HPV-related legislation, it is on the order of education campaigns or, in a few cases, requiring insurance coverage of the vaccine. Which is all good, but there’s a long way to go to reach herd immunity. Especially once (if) boys are in the picture.
And, while this is of huge importance in the U.S., HPV/Cervical cancer is a problem on a whole other stratosphere in developing countries. Cervical cancer is the 2nd most common cause of cancer-related death in women worldwide (in the U.S. it is not among the top five). While this may be a broad generalization, I think the issue of “convincing” men to be vaccinated for disease that primarily kills women will be a whole different fight in other parts of the world.
Becky I could kiss you on the mouth for being so unapologetically pro-vaccine. I have a toddler and the amount of vaccine backlash these days unbefuckinglievable.
And Marista,- I can’t understand why any parent wouldn’t want to protect someone else’s child from CANCER. So your kid wouldn’t get sick – so what – it’s becuase they have magical middle-class powers that prevent them from being a public health menace with their frathouse STDs and their unvaccinated measles, unlike, say, the child in the public housing down the block with her state-funded healthcare who’s clearly a scourge on the neighbourhood.
They need to market this to mothers, not just men. It’s much easier to convince mothers to protect everyone’s children by having their sons vaccinated than convincing men to protect their partners. Assuming the vaccine’s effectiveness and safety prove out, I’ll have my son vaccinated when the time comes.
Also, re: circumcision, it’s not a medically-based decision. It’s cultural practice, and it’s not cool in my opinion. I’m anti-genital cutting for female, male, & intersex. No one should make those decisions for someone else.
The one other thing I didn’t mention in the post, ladies, is that there’s some pretty strong evidence now that certain forms of oral cancer are linked to HPV. Which is not surprising when you think about it (and I do, as the penis that gave me HPV definitely went into my mouth more than a few times).
When more evidence of a solid link between oral cancer and HPV comes out, maybe that would encourage universal vaccination?
On teh menz thing: the current system of services and expectations has a long long LONG way to go before we get to the point of expecting guys to actually endure some bother for the sake of not spreading HPV. Awhile back I had a scare when it seemed like two recent partners had been diagnosed w/ HPV around the same time; it seemed pretty likely I had it, too, so I wanted confirmation/advice/etc. The student health center doctor basically said there wasn’t a test available for men, and that I shouldn’t worry about it. End of story.
Bah. I agree that cost is a huge issue here–it’s just not currently priced at a mass-vaccination level–but health providers certainly aren’t helping encourage responsibility.
On the other hand, I *can* understand concern over walking the line between encouraging concern & responsibility versus further stigmatizing an already over-stigmatized condition. Any time you have such a wide gap between incidence and awareness, especially with an STD, this is a real worry…
I’m sorry if someone mentioned this already, as I just skimmed comments (as I really should be working at the moment), but I had a discussion about this with my new gyno, she’s actually a women’s health nurse practitioner, not a doctor, but she’s more honest, thorough, and emotionally-invested in me than any doctor I’ve seen in my 29 years. Anyway, she initially recommended I get the vaccine, even though I was 28 at the time, and had had a decent number of partners. It turned out, as a result of the pap during that same exam, that I have HPV, and am now on an every 6-month pap schedule to make sure abnormal doesn’t become cancer. Scary, but also common.
Anyway, she told me that vaccine makers added the strains that prevent warts specifically to get men to want the vaccine. Warts have no health implications, but have serious social/mental/sex-life implications, and vaccine-makers knew they stood a better chance appealing to men’s vanity then to their concern about their female sex partners’ risk of cancer. Sad, but apparently true.
Everyone out there who hasn’t had the vaccine and is eligible for it and can afford it should get it. Cancer-watch is no fun. Every-six-month paps are really no fun. Colposcopies (spelling) suck. And these can be avoided almost entirely with the vaccine.
@SkiptomyLou – I am sooo with you on the vaccine stuff. I recommended our pediatrician, who is pro-vaccine, to a friend. Later she said “Someone in my prenatal yoga class said you can’t go to him if you don’t vaccinate!!” Um, yeah. He has a responsibility to his patients to do what is best AND he has a responsibility to his patients to not have hordes of unvaccinated kids running around his waiting room. I can’t believe the anti-vaccine people have gotten so much traction.
People really do live in bubbles, don’t they? Or maybe I am just f’ed up, but I am scared shitless of cancer (killed my dad too young, as well as his mother, even younger) and will do anything to avoid it. I don’t think there’s much I can do to help others prevent it, but here’s one thing I can do.
@Becky – maybe the oral cancer angle would encourage some, but I still think a lot of people will think “Ew, my kid’s never having oral sex!!” But it might encourage some guys to get it? I don’t know.
Oral cancers are bad news. My dad died of head and neck cancer that started on his tongue. It was horrific. It can affect your eating, breathing, and speech. By the end my dad could not talk or eat, he had a trach and a G-tube.
Like many others here, I’m not completely convinced that it should be given at all, much less made mandatory. Not because I don’t think young girls shouldn’t be protected from cancer, but becausw the FDA is so gorram corrupt, I know they aprrove shit they know they have no business approving.
Sor
@Ceegee: If you really think the FDA is that untrustworthy, you shouldn’t take any prescription or OTC drugs, use any medical devices (e.g. pacemakers or hip replacements) or receive any vaccines. All of them have been FDA approved.
The rate of young men who would actually get themselves vaccinated is probably lower, even, than the survey reports, as people tend to report themselves as nicer and more responsible than they are. I don’t think it’s just college age guys, either. I think the numbers would be similar for men of any age, and judging from comments at non-fem blogs, mothers of boys are far more concerned about their boys than their future partners. That’s just because men are socialized to advocate for themselves, while women are taught to take care of men.
BeckySharper, Oh yes, of course, because that’s exactly what I meant… NOT.
Was commenting from my blackberry, got cut off. To continue…
Sorry but I’m still in a “wait and see” mode in regards to this drug. Current OTCs have been on the market for decades, with no major side effects. However in recent years, it seems the FDA is most concerned with help Big Pharma sell drugs rather than making sure they are safe.