HPV Vaccine for Men: Necessary or Not?

Although the results of a new, four year international study of over 4,000 healthy male participants make a compelling case for giving the human papillomavirus (HPV) vaccine to men, health officials and other experts are still divided about making it a requirement.

There are more than 40 types of HPV, a sexually transmitted disease (STD), which can be passed on through vaginal, anal, and oral sex and can infect the mouth, throat, and genital areas of men. In addition to genital warts, HPV has been linked to cervical, vaginal, vulvar, oral, penile, head, neck, and anal cancers.

The study, led by the H. Lee Moffitt Cancer Center and the University of California San Francisco (UCSF), found that the HPV vaccine can prevent 90 percent of genital warts in men when offered before exposure to the four HPV strains covered by the vaccine.

Genital HPV is fairly common. The Centers for Disease Control and Prevention (CDC) says half of all sexually active people in the United States will contract HPV at some time in their lives but a large percentage never develop any symptoms or health problems as a result.

Genital warts can appear as raised or flat growths on the penis, testicles, groin, thighs, or anus. Though they usually aren't painful and are not life threatening, Joel Palesfesky, MD, a UCSF professor of medicine who co-led the research said in a press release that genital warts are often associated with depression, social stigma, and loss of self-esteem.

In 2009, data from this study informed the Food and Drug Administrations decision to approve the vaccine for boys and men ages 9 though 26 to prevent warts. Results from a sub-study led the FDA to expand approval in 2010 to prevent anal cancer. However the CDC has yet to recommend it as a routine immunization. (In 2006, the HPV vaccine was approved for girls to prevent cervical cancer.)

The Case for the HPV Vaccine in Men

  1. Vaccinating males early-before exposure to the HPV strains in the immunization-will prevent most cases of external genital warts.
  2. Vaccinating boys and men also protects women. Palefsky said girls have a poor record of receiving the full round of Gardasil, the HPV vaccine for women. Just 30 to 40 percent of teenage girls in the U.S. have received even one of the three recommended doses of the vaccine.
  3. Prevention is vital because HPV can spread easily and has the potential to cause illness.
  4. Studies have found that oral and anal cancers are on the rise among men, and researchers believe HPV is partially to blame.
  5. There are no screening tests for HPV-related cancers in men as there are for women.
  6. Young men who have sex with men might benefit more from the vaccine since they are more likely to develop HPV-related disease than heterosexual men.
  7. Condoms may lower your chances of passing HPV to a partner or developing HPV-related diseases, but HPV can still infect areas that are not covered by a condom.

The Case Against the HPV Vaccine

  1. Genital warts affect a small part of the population-just one percent. They do not turn into cancer, although some cancers are associated with HPV.
  2. Visible genital warts can be removed by surgery, frozen off, or treated with medications that can be applied at home. If left untreated, genital warts may go away on their own.
  3. An HPV infection found today will mostly likely go away by itself in a year or two.
  4. The vaccine prevents only four common types of HPV.
  5. The vaccine does not cure existing HPV infections or genital warts.
  6. Though vaccinating men against HPV would benefit women by reducing the spread of HPV to their sexual partners, women can already get the vaccine on their own in addition to routine Pap testing which has already greatly reduced the incidence of cervical cancer.
  7. The vaccine is expensive. Gardasil is administered in a series of three shots-each one costing about $1300-over a period of several months. (Insurance may cover most of the cost.)
  8. Penile cancer is extremely rare.

Until health officials conclude the debate, Merck and Company, Inc. continues to study and gather additional information on the safety and effectiveness of Gardasil in boys and men.

If you'd like to receive the vaccine, speak with your doctor. If you don't have health insurance or if your plan doesn't cover it, check with your local health department.

Sources:

The Centers for Disease Control and Prevention
http://www.CDC.gov

The University of California San Fransisco
http://www.ucsf.edu/news/2008/02/7723/hpv-vaccine-men

Ohio State University
www.shc.osu.edu

The National Cancer Institute
www.cancer.gov