Seeking protection: With HPV vaccine now recommended for males, some young men are taking heed
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After two days of rain, the sun was shining on an early summer weekday, with cool breezes and temperatures in the mid-70s. Matthew and Nick Soto of Springfield and two of their friends could have been out playing basketball or baseball. Instead, the four were sitting in the Tapestry Health clinic in Holyoke waiting to get vaccinated against a sexually transmitted disease.
"It's about being responsible, like knowing who your partners are," said Matthew Soto, 20. "I'm protecting myself."
The men were receiving the first of three injections of Gardasil, a vaccine which the Food and Drug Administration approved for females in 2006, and recently approved for males age 9 to 26. The shots are aimed at preventing the spread of the human papillomavirus, HPV for short. The most common sexually transmitted disease in the United States, HPV annually infects approximately 6.2 million people, according to the Centers for Disease Control and Prevention in Atlanta.
Known for its only visible symptom, genital warts, the virus is also known to cause cervical cancers in women and anal and genital cancers in both sexes. Recent studies have shown that HPV can also increase the risk for HIV exposure for men who have sex with men, according to the CDC.
The Sotos - Nick is 19 - may be more aware of the danger than most men their age. Their mother, Barbara Cruz, works at Tapestry, and has been urging them to get the vaccine since the FDA approved it last October. Her daughter, 25, got the shots after the vaccine was approved for females.
Nick Soto says his mother's encouragement helped, but getting the vaccination was his decision. "It wasn't something I had to do. It was something I wanted to do," he said. In fact he and his brother called their friends, Felix Acevedo, 17, and Jordan Rodriguez, 16, and got them interested.
"HIV is the most scary," said Matthew Soto. "But I just don't want to get genital warts."
Though Gardasil is an optional vaccination, both the FDA and the CDC recommend males get it before becoming sexually active. Tapestry Health has administered 118 Gardasil vaccinations - eight to males and 110 to females - over the last six months.
The FDA first approved Gardasil for females because they are more at risk for cervical cancers than men are for anogenital cancers, says Amanda Collings Van, a sexual health educator at the University of Massachusetts at Amherst.
Though some object to the vaccine being given to children as young as 9, worrying that it could encourage promiscuity, there has been no data to support that concern, says Van. "Most people think a vaccination against cervical cancer is a good thing," she said.
Cruz has attempted to educate her children about the need for protection since they were young. She says she keeps a bowl of condoms in the family bathroom. She also encourages her sons to get tested regularly for sexually transmitted diseases.
When the four friends learned about the Gardasil vaccine, they took the practical approach. No one wanted HPV, and all four said they were better safe than sorry, even though some of them joked they couldn't even pronounce "papillomavirus."
Matthew Soto says that not having the vaccination is like going into a fight while blind. "Knowing I have the vaccination, I'm ready," he said.
Nick Soto, who has a daughter on the way, says that when he heard he could pass HPV on to his partner without knowing it, he wanted to get the Gardasil shot. "Anything could happen," he said. "Better to have it than not. I never want an STD." Jordan Rodriguez adds he was not familiar with HPV before he talked to his friends about it. Like the Sotos, he says, he gets tested for STDs often, but HPV was a new danger. "People worry more about AIDS or gonorrhea," he said.
Acevedo says that although he is not sexually active, the vaccine will help him stay healthy in the future. "There's a lot of diseases out there. Before you do anything with a girl it's up to you to wear a condom," he said.
Vaccines for Children, a federal program administered in Massachusetts by the state, helps clinics like Tapestry provide a limited number of free vaccinations for males under 18. Despite the state program, says Robert Reardon, director of the male health program at Tapestry, there was "no substantial influx" of patients wanting the vaccine, which generally costs $390. "Gardasil is a wonderful tool to have, but because of insurance limits many people cannot get vaccinated," he said.
Acevedo and Rodriguez's vaccines were covered by the Vaccines for Children grant, while Blue Cross Blue Shield paid for the Soto brothers' shots. Tapestry billing manager Jeff LaFlamme says, however, that it takes time for many health insurance companies to agree to cover a product that is new to the health-care market. "Nobody wants to pay for it," he said. "They resist everything until they have to pay for it."
As he left the nurse's office, Rodriguez was smiling. "That's it. It's easy," he said, lifting his shirt sleeve to show Nick Soto his new Band-Aid. When Soto asked how long the needle was, Rodriguez estimated with his two index fingers. "I like long needles," Soto said. Everybody laughed.
"It feels like water going into your skin," Rodriguez joked.
Matthew Soto says he wishes more men his age were aware of Gardasil. "It's a vaccine. I'm glad it can help us. It's gotta be known to more people."
