HPV Vaccination of Boys Can Yield Substantial Health Benefits

MedicalResearch.com Interview with:
Dr. Johannes Berkhof
Department of Epidemiology and Biostatistics, VU University Medical Centre
Amsterdam
Centre for Infectious Disease Control,
National Institute for Public Health and the Environment, Bilthoven, Netherlands

Medical Research: What is the background for this study? What are the main findings?

Response: Vaccination against the sexually transmitted human papillomavirus (HPV) is offered free-of-charge to 12-year-old girls in the Netherlands.
There is strong evidence that HPV also causes cancer in men: the virus is associated with cancers of the penis, anus, and oropharynx, and possibly with a small proportion of oral cancers. A number of these cancers will be prevented because vaccination of girls leads to a decrease of  HPV in the general population and thus provides indirect protection to heterosexual men.

However, vaccine uptake among girls is only about 60 percent in the Netherlands. Moreover, men who have sex with men are at increased risk of HPV-related cancer and will not be protected by vaccination of girls.

On the basis of data from several epidemiological studies and a dynamic model for virus transmission, we calculated that, if the vaccine uptake is low, about 200 girls need to be vaccinated to prevent one case of cervical cancer and 470 boys need to be vaccinated to prevent one case of cancer in men.

An increase in vaccine uptake in girls will decrease the HPV infection risk in heterosexual men and if the uptake in girls is 60 percent, around 800 boys need to be vaccinated to prevent one additional case of cancer in men.

Medical Research: What should clinicians and patients take away from your report?

Response: Indirect protection of men through vaccination of girls is important to take into account, but vaccination of boys can still yield substantial health benefits. Therefore, we
suggest policy makers to evaluate future HPV vaccination strategies not only with a single focus on the protection of women. HPV-associated burden in men is lower than in women,
but vaccine prices have declined since market introduction that may change the perspective.

As a general take-home message, I’d like to state that protection of men against HPV-related cancer should be an integral part of the objective of an HPV vaccination program.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Future research should include an evaluation of the cost-effectiveness of gender-neutral vaccination as a function of vaccine uptake among girls and vaccine price.
For countries with organized HPV immunization programs in place, a comparative analysis contrasting gender-neutral vaccination to stimulated vaccine uptake in girls
can be very valuable to guide policy makers. Another recommendation is to delineate the prospects of targeted HPV vaccination of men who have sex with men, as these
will likely remain at increased risk of HPV-related cancers, even if boys aged 12 will be offered free vaccination.

Citation:

Direct benefit of vaccinating boys along with girls against oncogenic human papillomavirus: bayesian evidence synthesis

BMJ 2015; 350 doi: http://dx.doi.org/10.1136/bmj.h2016 (Published 12 May 2015) Cite this as: BMJ 2015;350:h2016

Johannes A Bogaards, senior researcher, Jacco Wallinga, senior researcher, Ruud H Brakenhoff, professor, Chris J L M Meijer, professor Johannes Berkhof, associate professor

 

MedicalResearch.com Interview with: Dr. Johannes Berkhof (2015). HPV Vaccination Of Boys Can Yield Substantial Health Benefits