Men at “increased risk” of HPV

When I interviewed Dr Anne Szarewski, a clinical consultant at Cancer Research UK, she raised interesting points with regards to the effect that HPV has on men. Ideally, she would vaccinate all the boys with Gardasil and all the girls with Cervarix. Listen to this bit of our interview to find out how and why.

Audio transcript
Anne Szarewski – I’ve always been extremely in favour of vaccinating men for so many reasons. First of all I think on a public health equality basis I think it’s almost outrageous that we actually put all the burden as though it’s only women who transmit a sexually transmitted virus. On a public health message that is just wrong. Secondly, if we don’t vaccinate men then of course the men who have sex with men get nothing because they cannot benefit from the immunity from women, that’s impossible. So we just ignore them. Of course they are at increased risk: anal cancer, penile cancer, genital warts (obviously for them you would use Gardasil I’ve never suggested using anything other than Gardasil for men). I really do believe we should be vaccinating both. And of course now that the evidence is getting stronger for head and neck cancers, all these non-genital cancers associated with HPV, then again the message gets stronger to vaccinate men.

Débora Miranda – But as it is now your position is that the priority should be vaccinating women with Cervarix.

AS – I would not be averse – and I think it could be done – that we could actually vaccinate all the girls with Cervarix and all the boys with Gardasil. I don’t think this is impossible. What would I think then need to be done is they would need to come to an agreement that probably you would stretch the Cervarix schedule to make that 0, 2 and 6 months. I suspect that the Cervarix schedule (it would have to be done in agreement with the companies and everything), but I suspect that the Cervarix schedule could be stretched to become 0, 2 and 6 months so that it would be in line with the Gardasil schedule – and then you would not have a problem of the girls being vaccinated at a different time to the boys. So you would have to make a change, but I think that would be a change that was worth doing. And you wouldn’t mess up the follow-up of the girls because they would still be getting Cervarix.

2 thoughts on “Men at “increased risk” of HPV

  1. If you speak to any medical specialist, they will tell you that the diseases they treat in their speciality should be prioritised over other diseases.

    I would love to see HPV vaccination offered to all boys and girls. And to see them getting protection against genital warts as well as against cancers. If this can’t be offered by the state, at tax-payers’ expense, it would be good to see it available at cost price with minimum barriers (this would create exacerbate inequalities in health; but the harms this does would be to some extent offset by better herd immunity). And there may be some identifiable groups of boys who should be offered vaccine (although) I’ve little idea how to identify the group that would benefit most – those boys who are not yet sexually active, but who, when they do, will have sex with men}.

    But all the studies that I’m aware of to date find that vaccinating boys is not cost-effective. So, unless Dr Szarewski can find a source of funding for this, that does not take funding away from other areas where the same amount of money can bring greater benefit, we should spend the money where it will bring more benefits.

    It is possible that, as the role of HPV in other cancers becomes better understood, modelling studies incorporating the benefit of preventing these other cancers will show that it is, after all, cost-effective to vaccinate boys. Only then should the tax-payer pay for this to be done.

  2. Pingback: Should boys be vaccinated against the human papilloma virus (HPV)? – cancer

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