HPV: WHO calls for countries to suspend vaccination of boys

[Toni]

H

That merely pushes back the location of the decision. Do you think a national government that provides HPV vaccines to boys will now stop providing them, and would you support and push for your own government to do so?

How many males will die if they don't get the vaccine verses how many females will die if they don't get the vaccine? Right now, it is about 300,000 annual deaths for women.

That isn't the question I asked. Does your country or state government provide HPV vaccines to boys, and (whether it did or not, supposing for these purposes that it did) would you lobby your government to stop providing them (or even forbid them) to boys, until the HPV vaccine shortages are resolved?

ronburgundy accused me of being illogical by asking if parents would deny it to their own sons (even though I already pointed out that people in wealthy countries do similarly self-focused things all the time). I assume it means ronburgundy would not deny it to his own sons if the situation arose. But that is what WHO is asking governments to do: deny it to a nation's sons. If ronburgundy believes that that's what should happen, he should lobby his own government to forbid HPV vaccines for boys.

In the US, the government doesn’t provide vaccinations. With regards to the HPV vaccine, it’s been a bigger challenge to convince parents that their darling children will likely not remain virgins who marry virgins and have secondly for the purpose of providing them with grandchildren and so probably really should be protected from future cancer risk.

It’s actually the way the vaccine is being ‘sold:’ as the first vaccine that can prevent some forms of cancer.

 

[Metaphor]

That isn't the question I asked. Does your country or state government provide HPV vaccines to boys, and (whether it did or not, supposing for these purposes that it did) would you lobby your government to stop providing them (or even forbid them) to boys, until the HPV vaccine shortages are resolved?

ronburgundy accused me of being illogical by asking if parents would deny it to their own sons (even though I already pointed out that people in wealthy countries do similarly self-focused things all the time). I assume it means ronburgundy would not deny it to his own sons if the situation arose. But that is what WHO is asking governments to do: deny it to a nation's sons. If ronburgundy believes that that's what should happen, he should lobby his own government to forbid HPV vaccines for boys.

WHO is not asking to deny vaccines to a nation's sons - it is asking them to get daughters done first. It is nuanced difference that you ought to be able to appreciate.

But you'd rather implicitly advocate for "equality of vaccination access" even if it means a dramatic decline in the health of a nation's daughters compared to that of the nation's sons.

No. It is specifically asking nations to deny HPV vaccinations to boys until all girls in all nations can get their vaccinations.

It is emphatically not saying to the UK 'make sure all your girls are vaccinated before you vaccinate boys'. They are saying 'make sure girls in other nations are vaccinated before you vaccinate boys in your own nation'.

 

[laughing dog]

That isn't the question I asked. Does your country or state government provide HPV vaccines to boys, and (whether it did or not, supposing for these purposes that it did) would you lobby your government to stop providing them (or even forbid them) to boys, until the HPV vaccine shortages are resolved?

ronburgundy accused me of being illogical by asking if parents would deny it to their own sons (even though I already pointed out that people in wealthy countries do similarly self-focused things all the time). I assume it means ronburgundy would not deny it to his own sons if the situation arose. But that is what WHO is asking governments to do: deny it to a nation's sons. If ronburgundy believes that that's what should happen, he should lobby his own government to forbid HPV vaccines for boys.

WHO is not asking to deny vaccines to a nation's sons - it is asking them to get daughters done first. It is nuanced difference that you ought to be able to appreciate.

But you'd rather implicitly advocate for "equality of vaccination access" even if it means a dramatic decline in the health of a nation's daughters compared to that of the nation's sons.

No. It is specifically asking nations to deny HPV vaccinations to boys until all girls in all nations can get their vaccinations.

It is emphatically not saying to the UK 'make sure all your girls are vaccinated before you vaccinate boys'. They are saying 'make sure girls in other nations are vaccinated before you vaccinate boys in your own nation'.

That is certainly an unreasonable request, since the UK is in no position to insure that all the girls in Mali (or Romania) are vaccinated. I would like to see the actual request from the WHO, not some other party's interpretation.

 

[Toni]

That isn't the question I asked. Does your country or state government provide HPV vaccines to boys, and (whether it did or not, supposing for these purposes that it did) would you lobby your government to stop providing them (or even forbid them) to boys, until the HPV vaccine shortages are resolved?

ronburgundy accused me of being illogical by asking if parents would deny it to their own sons (even though I already pointed out that people in wealthy countries do similarly self-focused things all the time). I assume it means ronburgundy would not deny it to his own sons if the situation arose. But that is what WHO is asking governments to do: deny it to a nation's sons. If ronburgundy believes that that's what should happen, he should lobby his own government to forbid HPV vaccines for boys.

WHO is not asking to deny vaccines to a nation's sons - it is asking them to get daughters done first. It is nuanced difference that you ought to be able to appreciate.

But you'd rather implicitly advocate for "equality of vaccination access" even if it means a dramatic decline in the health of a nation's daughters compared to that of the nation's sons.

No. It is specifically asking nations to deny HPV vaccinations to boys until all girls in all nations can get their vaccinations.

It is emphatically not saying to the UK 'make sure all your girls are vaccinated before you vaccinate boys'. They are saying 'make sure girls in other nations are vaccinated before you vaccinate boys in your own nation'.

I'm wondering if this is the best strategy to ensure that girls at risk in developing and poorer nations are properly vaccinated as the article didn't provide enough information to determine if the countries could not afford to get enough doses to protect its girls or whether there were other barriers, particularly social or religious ones.

As I wrote above, in the US, a lot of parents are concerned that by vaccinating their kids against a virus that can be transmitted sexually, they are telling their prepubescent children that they can have plenty of sex--something that few parents want to contemplate when their kid is 9 or 10 or 11.

Then, too, the article you linked does detail the high death rate due to cervical cancers in developing and poorer nations. This would be a good reason to redouble efforts to ensure that girls in those countries get vaccinated preferentially since they are at most risk of dying. It is, as the article mentioned, a temporary measure. I can understand the urgency, especially since in some countries, girls are often married off quite young to much older men who would be unlikely to be offered or benefit from vaccination. They are probably already infected and the strains of virus they carry may or may not cause them any harm--but could harm any female sex partner.

This must needs be a short term policy change. If boys are protected by the vaccine, they cannot grow up to infect girls (or other boys) , and girls who are vaccinated cannot infect boys. Both face a risk of certain cancers without the vaccination. For now, the risk is greater for girls than it is for boys.

But yes, it's a pretty horrifying prospect.

 

[laughing dog]

I went to the WHO's website and found the following from their October 2019 Sage Report (https://www.who.int/immunization/policy/sage/en/ on HPV:

Human papillomavirus vaccine
For the prevention of cervical cancer, SAGE reaffirmed WHO current recommendations2 for the use of HPV vaccines. The primary target population for HPV vacci¬nation should continue to be girls aged 9–14 years, before they become sexually active, with a 2-dose sche-dule using an interval of no less than 6 months between the 2 doses. An interval of no greater than 12–15 months is suggested in order to complete the schedule promptly. A 3-dose schedule (0, 1–2, 6 months) should be used for vaccination initiated at ≥15 years of age (although the issues for prioritization outlined below should be noted) and for people known to be immunocompromised or with HIV infection, regardless of whether they are receiving antiretroviral therapy.
SAGE reiterated that, from a public health perspective, all 3 licensed HPV vaccines have excellent safety profiles and offer comparable immunogenicity, efficacy and effectiveness for the prevention of cervical cancer, which is caused mainly by HPV types 16 and 18.
SAGE was deeply concerned that the current shortage of HPV vaccine could result in failure to introduce or sustain HPV vaccination programmes in some coun¬tries, particularly in those with a high burden of cervi¬cal cancer. In the context of a limited supply of HPV vaccine, SAGE recommends the following additional strategies.
1. All countries should temporarily pause implemen¬tation of gender-neutral, older age group (>15 years) and multi-age cohort (MAC) HPV vaccination strategies until vaccine supply allows equitable access to HPV vaccine by all countries. This will significantly relieve supply constraints in the short term and enable allocation of doses to high-burden countries that are currently planning to introduce or sustain HPV vaccination.
2. Countries may, in the context of constrained supply and in consultation with their NITAGs, consider alternative strategies to ensure that girls receive 2 doses of HPV vaccine before they become sexu¬ally active. Based on an analysis of efficiency, cost– effectiveness and disease impact, the following alternative strategies are recommended but will require consideration of country context and programmatic feasibility:
a. Countries could target girls who are 13 or 14 years old or in the equivalent school grade for 2-dose vaccination. The success of this approach depends on achieving high 2-dose coverage in this age group, and initiation of sexual activity after 14–15 years. The programme challenges of reaching older girls (e.g., in the setting of school vaccination, school enrolment rates and ability to reach out-of-school girls) and accurate record-keep¬ing through vaccination registers and vacci¬nation cards should be carefully considered. If targeting of this older cohort results in unacceptably low coverage or high drop-out rates for the second dose, it may be necessary to target girls aged 9 or 10 years or in the equivalent lower school grade instead.
b. Countries could adopt an extended interval of 3-5 years between the 2 doses, with the first dose being given to younger girls, such as those aged 9 or 10 years or in the equivalent lower school grade, and the second dose to 13–14-year-old girls or in the equivalent higher school grade. This strategy constitutes off-label use of the vaccine. Adoption of this approach will require careful consideration of programmatic challenges to achieving high 2-dose coverage, strong communications, accurate record-keeping in vaccination regis¬ters and vaccination cards and the assump¬tion of a low risk of exposure to HPV infec¬tion between doses 1 and 2. Countries should consider the median age of sexual debut and the availability of tools to track administra¬tion of dose 2 (e.g., vaccine registry for reminders) before using such a strategy.
c. Any country with a stock-out of HPV vaccine should maintain good records of coverage and ensure that girls who were missed are vaccinated as soon as the vaccine becomes available.
More equitable, transparent global allocation of the limited HPV vaccine supply to countries according to public health considerations is essential, particularly for girls in low- and middle-income countries where the burden of cervical cancer is greatest. SAGE called upon WHO and its partners to convene a dialogue on global access to HPV vaccine, engaging all stakeholders, includ¬ing vaccine manufacturers.
SAGE welcomed the ongoing and planned trials of single-dose schedules, as they will inform future policy recommendations. SAGE also welcomed studies of the outcomes of different vaccination schedules, including for special populations such as those with a high prev¬alence of HIV infection or at risk for HIV acquisition.

Nowhere does it call for suspending vaccinations to boys.

Seems like you got worked up over nothing. Reminds me of the Australian footballers equal pay.

 

[Metaphor]

Did you read anything in my OP?

The World Health Organization is calling on countries that are vaccinating boys against the human papillomavirus (HPV) to suspend these programmes until all girls who need the vaccine can get it.

Did you read your own quoted text?

1. All countries should temporarily pause implemen¬tation of gender-neutral, older age group (>15 years) and multi-age cohort (MAC) HPV vaccination strategies until vaccine supply allows equitable access to HPV vaccine by all countries.

I'm sorry laughing dog but it could not be plainer. Recommendations after this one make clear that countries should continue to vaccinate young girls.

I'm glad you disagree with WHO and agree with me that any particular country should not have to stop vaccinating its boys until all girls in other countries are vaccinated.

 

[krypton iodine sulfur]

I would like to see the actual request from the WHO, not some other party's interpretation.

(edit: I now see you found it already)

source:
https://www.who.int/wer/2019/wer9447/en/

(https://apps.who.int/iris/bitstream/handle/10665/329962/WER9447-eng-fre.pdf -- 10th page of the pdf)

Human papillomavirus vaccine

For the prevention of cervical cancer, SAGE reaffirmed WHO current recommendations2 for the use of HPV vaccines. The primary target population for HPV vaccination should continue to be girls aged 9–14 years, before they become sexually active, with a 2-dose sche-dule using an interval of no less than 6 months between the 2 doses. An interval of no greater than 12–15 months is suggested in order to complete the schedule promptly. A 3-dose schedule (0, 1–2, 6 months) should be used for vaccination initiated at ≥15 years of age (although the issues for prioritization outlined below should be noted) and for people known to be immunocompromised or with HIV infection, regardless of whether they are receiving antiretroviral therapy.

SAGE reiterated that, from a public health perspective, all 3 licensed HPV vaccines have excellent safety profiles and offer comparable immunogenicity, efficacy and effectiveness for the prevention of cervical cancer, which is caused mainly by HPV types 16 and 18.

SAGE was deeply concerned that the current shortage of HPV vaccine could result in failure to introduce or sustain HPV vaccination programmes in some countries, particularly in those with a high burden of cervical cancer. In the context of a limited supply of HPV vaccine, SAGE recommends the following additional strategies.

1. All countries should temporarily pause implementation of gender-neutral, older age group (>15 years) and multi-age cohort (MAC) HPV vaccination strategies until vaccine supply allows equitable access to HPV vaccine by all countries. This will significantly relieve supply constraints in the short term and enable allocation of doses to high-burden countries that are currently planning to introduce or sustain HPV vaccination.

2. Countries may, in the context of constrained supply and in consultation with their NITAGs, consider alternative strategies to ensure that girls receive 2 doses of HPV vaccine before they become sexually active. Based on an analysis of efficiency, cost– effectiveness and disease impact, the following alternative strategies are recommended but will require consideration of country context and programmatic feasibility:

a. Countries could target girls who are 13 or 14 years old or in the equivalent school grade for 2-dose vaccination. The success of this approach depends on achieving high 2-dose coverage in this age group, and initiation of sexual activity after 14–15 years. The programme challenges of reaching older girls (e.g., in the setting of school vaccination, school enrolment rates and ability to reach out-of-school girls) and accurate record-keeping through vaccination registers and vaccination cards should be carefully considered. If targeting of this older cohort results in unacceptably low coverage or high drop-out rates for the second dose, it may be necessary to target girls aged 9 or 10 years or in the equivalent lower school grade instead.

b. Countries could adopt an extended interval of 3-5 years between the 2 doses, with the first dose being given to younger girls, such as those aged 9 or 10 years or in the equivalent lower school grade, and the second dose to 13–14-year-old girls or in the equivalent higher school grade. This strategy constitutes off-label use of the vaccine. Adoption of this approach will require careful consideration of programmatic challenges to achieving high 2-dose coverage, strong communications, accurate record-keeping in vaccination registers and vaccination cards and the assumption of a low risk of exposure to HPV infection between doses 1 and 2. Countries should consider the median age of sexual debut and the availability of tools to track administration of dose 2 (e.g., vaccine registry for reminders) before using such a strategy.

c. Any country with a stock-out of HPV vaccine should maintain good records of coverage and ensure that girls who were missed are vaccinated as soon as the vaccine becomes available.

More equitable, transparent global allocation of the limited HPV vaccine supply to countries according to public health considerations is essential, particularly for girls in low- and middle-income countries where the burden of cervical cancer is greatest. SAGE called upon WHO and its partners to convene a dialogue on global access to HPV vaccine, engaging all stakeholders, including vaccine manufacturers.

SAGE welcomed the ongoing and planned trials of single-dose schedules, as they will inform future policy recommendations. SAGE also welcomed studies of the outcomes of different vaccination schedules, including for special populations such as those with a high prevalence of HIV infection or at risk for HIV acquisition.

 

[laughing dog]

Did you read anything in my OP?

The World Health Organization is calling on countries that are vaccinating boys against the human papillomavirus (HPV) to suspend these programmes until all girls who need the vaccine can get it.

Did you read your own quoted text?

1. All countries should temporarily pause implemen¬tation of gender-neutral, older age group (>15 years) and multi-age cohort (MAC) HPV vaccination strategies until vaccine supply allows equitable access to HPV vaccine by all countries.

I'm sorry laughing dog but it could not be plainer. Recommendations after this one make clear that countries should continue to vaccinate young girls.

It says nothing about boys in ages less than 14. The recommendations after refer to possible strategies (that is what the word "could" means).

I'm glad you disagree with WHO and agree with me that any particular country should not have to stop vaccinating its boys until all girls in other countries are vaccinated.

Yet another straw man. I think the request is completely unreasonable because it is not feasible. If it were feasible, I would not think it was unreasonable.

 

[Metaphor]

Did you read anything in my OP?



Did you read your own quoted text?



I'm sorry laughing dog but it could not be plainer. Recommendations after this one make clear that countries should continue to vaccinate young girls.

It says nothing about boys in ages less than 14.

You need to read it in conjunction with the other paragraphs, laughing dog. I know you have a university degree so this basic comprehension task should be easy for you.

The first paragraph says to suspend the gender neutral regimes. The following paragraphs describe the group that has first priority: 13-14 year old girls. Boys are not mentioned again.

 

[Metaphor]

I think the request is completely unreasonable because it is not feasible. If it were feasible, I would not think it was unreasonable.

Well, I think it's unreasonable, even if it were feasible (e.g. if WHO controlled the vaccinations of all nations).

 

[laughing dog]

Did you read anything in my OP?



Did you read your own quoted text?



I'm sorry laughing dog but it could not be plainer. Recommendations after this one make clear that countries should continue to vaccinate young girls.

It says nothing about boys in ages less than 14.

You need to read it in conjunction with the other paragraphs, laughing dog. I know you have a university degree so this basic comprehension task should be easy for you.

The first paragraph says to suspend the gender neutral regimes. The following paragraphs describe the group that has first priority: 13-14 year old girls. Boys are not mentioned again.

The problem is that unlike you I am not trying read between the lines, let alone between the lines with PPW lens.

But for argument's sake, let's say they are making that claim based on the scientific evidence that such a policy will alleviate much more overall suffering. If that is the case (which is what appears to be their rationale), then what exactly is your beef?

 

[Metaphor]

You need to read it in conjunction with the other paragraphs, laughing dog. I know you have a university degree so this basic comprehension task should be easy for you.

The first paragraph says to suspend the gender neutral regimes. The following paragraphs describe the group that has first priority: 13-14 year old girls. Boys are not mentioned again.

The problem is that unlike you I am not trying read between the lines, let alone between the lines with PPW lens.

I'm not reading between the lines. I am literally quoting the plain words of bmj and pointing out to you how to come to that ineluctable conclusion.

But for argument's sake, let's say they are making that claim based on the scientific evidence that such a policy will alleviate much more overall suffering. If that is the case (which is what appears to be their rationale), then what exactly is your beef?

For reasons I've already pointed out, this argument would never ever be used if the genders were swapped. It is inconceivable that girls would be asked to give up health care for the sake of boys in poorer countries. The Overton window of that kind of policy is not only not in the building, it's not even in the same universe.

And also, rich countries never do this. Rich countries don't give up even minor luxuries to alleviate suffering in poorer countries. But, it is apparently conceivable that rich countries might compromise the health care of its boys to help girls in other nations.

But the WHO request is strange to me. Why call on the Western cis heteropatriarchy that hates women, literally hates them, to do this? Don't they realise that all nations hate girls and women and would never ever entertain let alone concede to such a request? Are they still writing letters to Santa Claus?

 

[laughing dog]

I'm not reading between the lines. I am literally quoting the plain words of bmj and pointing out to you how to come to that ineluctable conclusion.

Since they do not make such a statment, you are literally imputing their policy. Get spinning.

For reasons I've already pointed out, this argument would never ever be used if the genders were swapped....

Charitably, your argument is pure conjecture based on your biased and conterfactual view of the position of women in this world.

But with howlers like "Why call on the Western cis heteropatriarchy that hates women, literally hates them, to do this?", a more reasoned description is bigoted crapola.

 

[Metaphor]

Since they do not make such a statment, you are literally imputing their policy. Get spinning.

I'm sorry you cannot read and understand the plain words that you yourself quoted.

Charitably, your argument is pure conjecture based on your biased and conterfactual view of the position of women in this world.

What's my view of women in the world?

But with howlers like "Why call on the Western cis heteropatriarchy that hates women, literally hates them, to do this?", a more reasoned description is bigoted crapola.

The 'literally hates us' is a quote from a feminist well known in computer gaming circles. "Society hates us [women], literally hates us".

And if you don't believe in the western cis heteropatriarchy, I'm glad. Neither do I. If you do believe in it, what's your problem with what I said?

 

[Metaphor]

In case it was ambiguous, I'm not actually afraid that western nations will compromise the health care of its boys to aid the health care of girls in other nations. As I've said, rich nations don't even forego minor luxuries to provide necessities elsewhere. What I am interested in is people's reactions to such a policy, and people's resistance to the idea that society centres the health and wellbeing of girls over boys.

 

[krypton iodine sulfur]

For reasons I've already pointed out, this argument would never ever be used if the genders were swapped. It is inconceivable that girls would be asked to give up health care for the sake of boys in poorer countries. The Overton window of that kind of policy is not only not in the building, it's not even in the same universe.

What they are calling on is for the greatest harm reduction. The practices they suggested suspending are gender neutral vaccination, ≥15 vaccination and multi-age cohort vaccination strategies, the latter two involving girls/ women not being vaccinated as planned.

The other group recognized as needing vaccination is gender neutral: those who are immunocompromised or are infected with HIV. I don't see a call from the WHO to suspend these vaccination programs until shortages are resolved.

But the WHO request is strange to me. Why call on the Western cis heteropatriarchy that hates women, literally hates them, to do this? Don't they realise that all nations hate girls and women and would never ever entertain let alone concede to such a request? Are they still writing letters to Santa Claus?

Because that isn't what they are doing. They are, as health authorities, looking at a vaccination scheme which has the greatest potential for harm reduction in terms of mitigating the greatest risk of cancer fatalities, and reducing the transmissibility of the virus in areas where effective vaccination programs can be implemented.

The WHO likely does not use you being a parody of yourself as a standard for recommendations on effective vaccination strategies with limited resources with inequitable distribution.

 

[laughing dog]

I'm sorry you cannot read and understand the plain words that you yourself quoted.

I understand fine. You are literally confusing your conclusion with fact.

The 'literally hates us' is a quote from a feminist well known in computer gaming circles. "Society hates us [women], literally hates us".

So what? It is not relevant to the discussion. And for some reason, you feel that is relevant because you have some axe to grind. Truly pathetic.

And if you don't believe in the western cis heteropatriarchy, I'm glad. Neither do I.

And yet you made a bullshit argument with it. Truly pathetic.

 

[laughing dog]

In case it was ambiguous, I'm not actually afraid that western nations will compromise the health care of its boys to aid the health care of girls in other nations. As I've said, rich nations don't even forego minor luxuries to provide necessities elsewhere. What I am interested in is people's reactions to such a policy, and people's resistance to the idea that society centres the health and wellbeing of girls over boys.

As you have said, people are not idiotic, so perhaps their resistance to the idea that society centres the health and wellbeing of girls over boys is because they know it is a bullshit idea.

 

[Metaphor]

I understand fine. You are literally confusing your conclusion with fact.


So what? It is not relevant to the discussion. And for some reason, you feel that is relevant because you have some axe to grind. Truly pathetic.

And if you don't believe in the western cis heteropatriarchy, I'm glad. Neither do I.

And yet you made a bullshit argument with it. Truly pathetic.

I didn't make an argument. I was mocking belief in it.

 

[Metaphor]

In case it was ambiguous, I'm not actually afraid that western nations will compromise the health care of its boys to aid the health care of girls in other nations. As I've said, rich nations don't even forego minor luxuries to provide necessities elsewhere. What I am interested in is people's reactions to such a policy, and people's resistance to the idea that society centres the health and wellbeing of girls over boys.

As you have said, people are not idiotic, so perhaps their resistance to the idea that society centres the health and wellbeing of girls over boys is because they know it is a bullshit idea.

The resources spent on women's health versus men's health belies the claim that it's bullshit.