Do males require the Human Papillomavirus (HPV) vaccine?

From the Guidelines

Yes, males require the Human Papillomavirus (HPV) vaccine, as it is recommended for all boys and men through age 26 to protect against HPV types that can cause genital warts and several cancers, including penile, anal, and oropharyngeal cancers. The vaccine, available as Gardasil 9, is typically given as a two-dose series for those who start before age 15 (doses at 0 and 6-12 months) or as a three-dose series for those who start at age 15 or older (doses at 0,1-2, and 6 months) 1. The vaccine is most effective when given before potential exposure to HPV through sexual activity, which is why it's routinely recommended for adolescents at age 11-12.

Some key points to consider:

• The HPV vaccine protects against HPV types 6,11,16, and 18, which are responsible for approximately 70% of HPV-related cancers in the United States 1.
• The vaccine also helps reduce transmission of HPV to sexual partners.
• For men ages 27-45, the decision to vaccinate should be made on an individual basis after discussing risks and benefits with a healthcare provider 1.
• The vaccine is generally safe with minimal side effects, typically limited to injection site pain, swelling, or redness.

It's essential to note that the Advisory Committee on Immunization Practices (ACIP) recommends routine HPV vaccination at age 11-12 years, and catch-up vaccination is recommended for all persons through age 26 years 1. Men who have sex with men, people living with HIV, and immunocompromised persons should be vaccinated through age 26 years 1.

Overall, the HPV vaccine is a crucial tool in preventing HPV-related diseases and cancers, and males should receive the vaccine to protect themselves and their sexual partners.

From the FDA Drug Label

Effectiveness of GARDASIL 9 against persistent infection and disease related to vaccine HPV types in 9- through 15-year-old girls and boys was inferred from non-inferiority comparison conducted in the PPI population in Study 2 of GMTs following vaccination with GARDASIL 9 among 9- through 15-year-old girls and boys with those among 16- through 26-year-old girls and women. Effectiveness of GARDASIL 9 against persistent infection and disease related to vaccine HPV types in 16- through 26-year-old boys and men was inferred from non-inferiority comparison conducted in the PPI population in Study 7 of GMTs following vaccination with GARDASIL 9 among 16- through 26-year-old HM with those among 16- through 26-year-old girls and women.

• Males can benefit from the HPV vaccine, as shown by the non-inferiority comparisons in Study 2 for 9- through 15-year-old boys and Study 7 for 16- through 26-year-old boys and men.
• The vaccine's effectiveness in males is supported by the immune response data, which demonstrate non-inferiority to the immune response in females.
• The FDA drug label supports the use of the HPV vaccine in males, as evidenced by the studies mentioned above 2.

From the Research

HPV Vaccine Efficacy in Males

• The quadrivalent HPV vaccine has been shown to reduce the incidence of external genital lesions and persistent infection with HPV 6/11/16/18 in males 3.
• A study found that the quadrivalent HPV vaccine was effective in preventing anal intraepithelial neoplasia associated with HPV-6,11,16, or 18 infection in men who have sex with men, with an efficacy of 50.3% in the intention-to-treat population and 77.5% in the per-protocol efficacy population 4.
• Another study found that HPV vaccination was effective in reducing the prevalence of vaccine-type HPV in anal or oral specimens among men who have sex with men, with a vaccine effectiveness of 59% for those who initiated vaccination at age ≤18 years and 18% for those who initiated vaccination at age >18 years 5.

Benefits of HPV Vaccination in Males

• HPV vaccination can provide protection against HPV-related diseases such as anal cancer, genital warts, and oropharyngeal cancers in males 6, 7.
• Vaccination can also provide herd protection, reducing the transmission of HPV to others 3.
• A study found that the quadrivalent HPV vaccine had a favorable safety profile and may help to reduce the risk of anal cancer in men who have sex with men 4.

Barriers to HPV Vaccination in Males

• Low awareness and knowledge about HPV vaccination among males are significant barriers to vaccination 6.
• Underestimating and embodying risk are also common themes among males, with many engaging in sexual activities while misinformed or denying the risk for contracting HPV 6.
• Strategies to increase awareness and vaccination rates among males include early, frequent, and consistent messaging on HPV, as well as gender-sensitive interventions targeting college-age men 6.