Is Human Papillomavirus (HPV) vaccination available for men?

HPV Vaccination is Available and Recommended for Men

Yes, HPV vaccination is available for men and is routinely recommended starting at age 11-12 years, with catch-up vaccination recommended through age 26 years for all males. 1

Routine Vaccination Schedule for Males

• Males should receive routine HPV vaccination at age 11-12 years, with the series starting as early as age 9 years 1, 2
• The vaccine formulations approved for males include quadrivalent HPV vaccine (4vHPV) and 9-valent HPV vaccine (9vHPV) 1
• For boys starting vaccination before age 15, a 2-dose schedule is recommended with doses given 6-12 months apart 2
• For males starting at age 15 or older, a 3-dose schedule is required at 0,1-2, and 6 months 2

Catch-Up Vaccination Recommendations

The guidelines distinguish between routine recommendations and permissive recommendations based on age:

• Males aged 13-21 years who have not been vaccinated should receive catch-up vaccination 1
• Males aged 22-26 years may be vaccinated, though this represents a permissive rather than routine recommendation 1
• Providers should inform men aged 22-26 years that vaccination at older ages is less effective in lowering cancer risk, as most sexually active adults have already been exposed to some HPV types 1

Special Populations Requiring Extended Vaccination

Two specific male populations warrant routine vaccination through age 26 years:

• Men who have sex with men (MSM) should be routinely vaccinated through age 26 years due to higher burden of HPV infection and HPV-related cancers, particularly anal cancer and precancers 1, 2
• Immunocompromised males, including those with HIV infection, should be vaccinated through age 26 years with a 3-dose schedule regardless of age at initiation 1, 2

Adults Aged 27-45 Years

• For adults aged 27-45 years, shared clinical decision-making is recommended rather than routine vaccination 1
• The public health benefit of HPV vaccination in this age range is minimal because most adults have already been exposed to HPV types 1
• Vaccination does not treat existing HPV infections or prevent progression of current infections to disease—it only prevents new infections 1

Clinical Benefits of Male Vaccination

The evidence supporting male vaccination includes both direct protection and population-level benefits:

• HPV vaccination prevents HPV-related cancers in males, including anal cancer (89% HPV-associated), penile cancer (63% HPV-associated), and oropharyngeal cancer (72% HPV-associated in males) 2
• Vaccination prevents genital warts, with 90% caused by HPV types 6 and 11 2
• Male vaccination provides herd immunity, offering additional protection to females—Australia demonstrated an 80% decrease in genital warts among adolescent boys before males were included in their national vaccination program 1

Evidence Base and Rationale

The American Cancer Society endorsement of male vaccination is based on several key findings:

• Vaccine efficacy and immunogenicity in males has been demonstrated with safety comparable to females 1
• While there is no direct evidence of efficacy for cancer prevention in average-risk men (due to small number of disease outcomes), efficacy against persistent infections and anogenital warts in young males, plus efficacy against precancers in MSM, supports the conclusion that vaccination will be effective against cancer outcomes 1
• Vaccination is most effective when given before exposure to HPV through sexual activity, as nearly 40% of individuals acquire HPV infection within the first 2 years after sexual initiation 2

Common Pitfalls to Avoid

• Do not delay vaccination waiting for "optimal" timing—approximately 24% of adolescents report sexual intercourse by 9th grade 3
• Do not perform prevaccination testing—no clinical antibody test can determine immunity status, and testing is not recommended 1, 2
• Do not assume sexually active males cannot benefit—while effectiveness is lower in those already exposed to some HPV types, most individuals have not been exposed to all vaccine-type HPV types 1
• Do not restart the series if interrupted—continue from where you left off while maintaining minimum intervals 3

Practical Implementation

• HPV vaccine can be administered at the same visit as other age-appropriate vaccines (such as Tdap and MCV4) using separate syringes at different anatomic sites 3, 2
• Observe patients for 15 minutes post-vaccination due to risk of syncope in adolescents 3, 2
• Vaccination does not replace the need for cervical cancer screening in female partners, as vaccines do not protect against all oncogenic HPV types 3