HPV Shot Prevents Genital Warts in Boys and Men
Study Adds to Debate Over Vaccination of Males for Prevention of HPV Infection
By Denise Mann
WebMD Health News
Reviewed by Laura J. Martin, MD
nurse administering vaccine

Feb. 2, 2011 -- The human papillomavirus (HPV) vaccine can help stave off genital warts in boys and men, according to a new study in the Feb. 3 issue of the New England Journal of Medicine.

Of 4,065 boys and men aged 16 to 26 from 18 countries, vaccination with an HPV vaccine that targets four types of HPV infection -- HPV-6, HPV-11, HPV-16, and HPV-18 -- protects against infection with these types of HPV and potentially the development of related external genital warts or lesions.

HPV, a sexually transmitted disease, can be transmitted through vaginal, anal, and oral sex and has been linked to genital warts as well as cervical, vaginal, vulvar, oral, penile, and anal cancers.

Two HPV vaccines are now approved by the FDA: Cervarix and Gardasil.  Both of these vaccines are recommended to prevent cervical cancers. These vaccines are now on the CDC’s routine childhood vaccine schedule for girls starting at age 9.

The Gardasil vaccine has also received FDA approval for prevention of genital warts. The vaccine is recommended for optional use in boys and men.  The vaccine is used in girls and boys and young adults ages 9 to 26 for prevention of genital warts caused by HPV types 6 and 11.

“The most salient message is that the [Gardasil] vaccine can prevent HPV infection on the external genital region, which means that we can now prevent most cases of genital warts if the boy is vaccinated at a sufficiently early age,” says study researcher Joel Palefsky, MD, a professor of medicine at the University of California, San Francisco.
HPV Vaccine for Males

The new study does not address cancer risk in boys and men, he says. “These data provide evidence that the vaccine can be efficacious in males, and adds to the list of reasons to consider vaccinating boys and men,” he says. “In theory, this could cut down on cancers, but it hasn’t yet been proven.”

The big debate now is whether or not universal vaccination of young men should be encouraged, he says.

“HPV is a sexually transmitted infection, and the burden of vaccination should not fall solely on girls and women. HPV causes disease in men too,” he says.

In addition, men who have sex with men are at increased risk for genital warts and anal cancer and likely would not benefit from female vaccination, he says. 

Casting a wide net that vaccinates all boys aged 9-26 would cover such high-risk groups, he says.

So why not do it? 

“The main disadvantage is cost, because thus far the vaccine appears to be safe,” he says. “It’s less cost-effective because most of the serious diseases such as cervical cancer occur in women, not men.”

“Theoretically, if you vaccinated all women, you wouldn't need to vaccinate men except for men who have sex with other men,” he says. Not every female who is eligible for the vaccine has received it, and many females -- and their current or future sexual partners -- remain unprotected.