The debate about the safety and social implications of the Human papillomavirus (HPV) vaccine for young girls continues—and reached a frenzied pitch with the death of a British teen hours after getting the cervical cancer vaccine, despite initial evidence that her demise was the result of a “serious underlying medical condition.” Yet in the meantime, some public health officials and agencies around the world, including the U.S.’ Food and Drug Administration, are considering the vaccine’s possible application among boys. (Though HPV-related penile cancer is more rare than cervical cancer, boys are carriers of HPV and vaccinating them could strengthen the “herd effect” of HPV protection for both genders.)
Yet a study from the Harvard School of Public Health published online this week in the British Medical Journal suggests that, at present anyhow, the possible benefits of recommending universal vaccination for boys are outweighed by the costs. Assuming that 75% of girls get vaccinated, the protective effects cost an average of $40,310 for “quality adjusted life year”—a measurement that takes into account both preventable mortality and overall quality of life—gained by vaccinating girls, compared with cervical cancer and HPV screening alone. When adding boys into the calculations, the researchers found that the cost efficiency surged to $290,290, as compared to vaccinating girls only. (Generally, a cost efficiency ratio between $50,000–$100,000 per quality year of life is considered good value.)
At the moment, the researchers conclude, “including boys in an HPV vaccination programme [sic] generally exceeds conventional thresholds of good value for money.” Yet, they are quick to add, future developments—in cost efficiency of delivering the vaccine, or long term efficacy in preventing cancers and genital warts, for example—could alter that assessment in the future.