A 16-Year-Old Boy Is Brought to the Office by His

question 86

Multiple Choice

A 16-year-old boy is brought to the office by his mother for a routine well visit.  The patient has been doing well in school and has not been in the office over the past year for any sick visits.  His mother says, "My son has had a girlfriend for the last few months, and I wonder if boys can receive the human papillomavirus vaccine.  I am friends with his girlfriend's mother and heard that she received the vaccine a few years ago."  The patient takes no daily medications and has no known drug allergies.  The mother leaves the room for the examination, and the patient says that he is considering vaginal intercourse with his girlfriend.  His parents have talked with him about abstinence and the importance of using a condom if having sex.  The patient was sexually active with a previous girlfriend and used condoms every time.  He is not sexually active with males and has never been tested for sexually transmitted infections.  There is no family history of cancer.  Physical examination shows no skin lesions, including in the genital area.  The penis is circumcised with no visible discharge.  The testes are descended bilaterally with no erythema or masses.  Counseling about the prevention of pregnancy and sexually transmitted infections is provided.  Which of the following is the most appropriate recommendation about the human papillomavirus vaccine in this patient?

• A)The patient is beyond the recommended age for administering the vaccine
• B)The risk for infection and the need for vaccination are low because the patient uses condoms
• C)The vaccine is not recommended due to the patient's prior sexual activity
• D)The vaccine is recommended to reduce the risk for anogenital cancers
• E)The vaccine should be given to prevent male factor infertility

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