Human papillomavirus vaccination for men: advancing policy and practice

Abstract

ABSTRACT  The quadrivalent HPV vaccine (HPV4) is safe and highly efficacious, and can significantly reduce the burden of HPV-related genital warts and cancers among men, in addition to promoting herd immunity. Nevertheless, HPV4 coverage among boys remains low in most settings. Research to date has focused predominantly on HPV vaccination of girls to prevent cervical cancer. Most countries with publicly funded healthcare where HPV4 is licensed cover the costs of HPV vaccination programs for girls only. We critically review the evidence for extending publicly funded HPV vaccination programs to boys in addition to girls. After an overview of research on HPV prevalence and associated cancers among men, we review cost–effectiveness studies, benefits of universal versus targeted vaccination approaches and multifaceted health equity concerns, along with directions in vaccine delivery programs and intervention research to promote HPV vaccine uptake for boys. Comprehensive evaluation of the systematic exclusion of boys from publicly financed HPV vaccination programs is warranted given tremendous public health implications of new infections and subsequent cancers that could have otherwise been averted.