HPV Vaccinations for Males…and the Public Good

Vaccinating females against the human papillomavirus (HPV) has been strongly recommended since the vaccine became widely available in 2006. Now there is growing incentive to vaccinate males as well.

Earlier this year, the United Kingdom Joint Committee on Vaccination and Immunization announced another delay in the comprehensive HPV vaccination of teenage boys1,2. The news highlights misinformation concerning the HPV vaccine and the medical, social, and economic benefits of vaccinating males.

Medical incentives for vaccination

HPV is typically associated with cervical cancer, which only affects women. However, HPV is also associated with penile cancer, which only affects men. The virus is also a contributing factor to cancers that affect both males and females, such as head and neck cancer and anal cancer. Oropharyngeal—head and neck—cancer, is three times more prevalent in males than females. The prevalence of genital warts, another side effect of the human papillomavirus, has nearly equal incidence in males and females1. Vaccinating both males and females against HPV ensures that both demographics are protected against HPV-associated cancers and disease. Currently, only eight countries recommend the vaccination of both males and females.

Social motivation for vaccination

Many HPV male vaccination programs have failed because it is unclear if vaccinating males would be beneficial. It is not yet common knowledge that HPV-related diseases affect men. Also, if most women are vaccinated, herd immunity might make male vaccination programs both expensive and ineffective. This mentality operates on the idea that most of the world’s female population is vaccinated against HPV, which is certainly not the case. In fact, only a few countries have enough vaccinated females for herd immunity to be a viable consideration for unvaccinated males. As with contraceptive strategies, it is highly irresponsible for one partner to rely on the other’s prophylactic methods for their own protection. It is even more reprehensible for a government to advocate such risky behavior. Furthermore, without male vaccination, several populations remain at risk:

  • Unvaccinated men (or women) who have sex with unvaccinated partners
  • Men who have sex primarily with other men, as both partners are unlikely to be vaccinated
  • Unvaccinated men who have sex with men or women from countries that do not have HPV vaccination programs, as both partners are unlikely to be vaccinated

Even for the female population, barriers to vaccination remain. Medical professionals recommend vaccination in teenage females, which requires parental consent. Some parents shy away from vaccinating their children, for religious or cultural reasons. Some simply don’t understand the benefits of an HPV vaccination. And some adults who were sexually active before the HPV vaccine became widely available are satisfied with their current form of protection, or lack thereof.

Economic motivations for vaccination

The medical implications of untreated HPV-related diseases are costly. HPV-related disease costs the UK over £90 million a year. Vaccinating boys would cost £12-22 million1. Preventative medicine, such as vaccinations, will help offset the costs of treating deadly, prolonged disease, especially in an economy with increasing costs of healthcare.

The only way to ensure that an entire population is protected against a disease is universal vaccination. This is not only for the future health of our men, but for the common good.

References

  1. “HPV vaccination in boys—will the UK join the fight?”, Liam Masterson and Matt Lechner, Nature Reviews Clinical Oncology, News and Views, Link.
  1. “HPV vaccinations for men who have sex with men’, House of Commons Library, 6 June 2016. Link.

Photo credit: USACE Europe District

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