HPV Shot Prevents Genital Warts in Boys and Men
Study Adds to Debate Over Vaccination of Males for Prevention of HPV Infection
HPV Vaccine for Males continued...
In addition, men who have sex with men are at increased risk for genital warts and anal cancer and likely would not benefit from female vaccination, he says.
Casting a wide net that vaccinates all boys aged 9-26 would cover such high-risk groups, he says.
So why not do it?
“The main disadvantage is cost, because thus far the vaccine appears to be safe,” he says. “It’s less cost-effective because most of the serious diseases such as cervical cancer occur in women, not men.”
“Theoretically, if you vaccinated all women, you wouldn't need to vaccinate men except for men who have sex with other men,” he says. Not every female who is eligible for the vaccine has received it, and many females -- and their current or future sexual partners -- remain unprotected.
Jane J Kim, PhD, an assistant professor of health decision science in the department of health policy and management at the Harvard School of Public Health in Boston, wrote an editorial that accompanied the new study.
“It’s telling us something quite promising. The [Gardasil] shot has strong potential to reduce genital wart cases in boys with high effectiveness,” she writes.
“More recent data that has resulted in the FDA expanding the use for prevention of anal lesions in women and men has resurfaced the debate about routine vaccination for everyone,” she writes.
"It’s going to be hard to target the boy who will grow up to be highest risk for anal cancer of anyone in the country -- men who have sex with men,” she says. “Our ability to target these males when they are really young and the vaccine is most beneficial is a hard sell and not feasible as people don’t necessarily become aware of their sexual orientation that early.”
With universal vaccination, this issue goes away, she says. “You wouldn’t have to think about it and you prevent HPV in everyone.”
Vaccines: Boys vs. Girls
But there is more to this discussion.
“The most cost-effective use of vaccine, as we know it today, is to vaccinate young girls before they get exposed to HPV,” she says. “Men who have sex with men would also benefit greatly, and the rest of the population of men would benefit in terms of reducing genital warts, possible anal lesions as well as anal and penile cancer, but they are at low risk for those cancers.”
“There is benefit, but are we willing to spend that much money on a vaccine to get that amount of benefit,” she says. “Most of the evidence suggests that it would not be a good use of health dollars to vaccinate all boys.”
This could all change if the vaccine cost comes down or if the uptake in young females remains low, she says. “It is trending upward, but if it remains low and we can cover boys instead, that may be a good cost-effective strategy.”