HPV vaccination: why does it make sense to do it in males too?

Source: Africa Studio

It was one of the novelties of the National Vaccine Plan 2022-2022: the extension to males of the recommendation to vaccinate against HPV in the twelfth year of age, previously envisaged only for girls.

It is still too early to know how this vaccination is going - actively offered (the ASL should send direct communication to the parents of the interested parties) and free - but the data tell us that in our country the female one has so far had very little success. “Probably because of the (unjustified) fear of serious side effects,” he comments Pier Luigi Lopalco, epidemiologist and professor of hygiene at the University of Pisa, to whom we asked to answer the frequently asked questions about the HPV vaccine for males.

1. The HPV vaccine has been proposed as a vaccine capable of preventing cervical cancer, which is obviously a female-only disease. So why does it make sense to vaccinate males too?

For two reasons. The first is that if you want to reduce the impact of a disease caused by a virus that is transmitted from person to person, everyone must be vaccinated: not only the female half of the population, but also the male one. Otherwise the virus continues to circulate.

It is the same strategy used against the rubella virus, whose infection is particularly relevant in women (particularly if pregnant), but against which males are also vaccinated. In this sense, I think it was a wrong communicative approach to focus everything on the concept of cervical cancer prevention, rather than on the concept of elimination of the virus.

By now, many studies and models demonstrate this without a shadow of a doubt: if males are not vaccinated, the circulation of the virus in women will not decrease.

But there is also a second reason, and that is the fact that even in the male this vaccination has a direct protective meaning, compared to the risk of getting sick from tumors in which HPV is always involved. It is about genital tumors (to the testicle), but also to the mouth, pharynx, larynx: infrequent forms, of course, but also very serious, and for which there is no screening test, as there is for cervical cancer.

Not to mention the protection from warts, i genital warts, which for a boy can be very annoying and have heavy psychological repercussions.

Read also: Human papillomavirus: 32 questions and answers to know everything about HPV

2. There are various types of HPV vaccine: bivalent (against oncogenic strains 16 and 18, which alone are responsible for 70% of cervical cancer cases), tetravalent (which also protects against two other strains non-oncogenic), or 9-valent (which protects against five additional high-risk tumor strains). Which vaccine to use in males?

The vaccines on the market are all good: at the moment the 9-valent one is spreading a lot, but the others also offer excellent coverage, against the main high-risk strains. If vaccination is carried out within the public health system, this will be the one to choose, also on the basis of dynamics linked to costs.

3. Are we sure that HPV vaccines are also safe in males?

Yes: the available data confirm this safety. It is true that initially the experimentation concerned only females, but since the vaccine received the indication also for males have been carried out clinical trials also in males, with equally positive results.

4. In our country, the anti-HPV vaccination for females is not very popular, and the coverage rate is even lowering from year to year. Why do you think?

True: it is an extraordinarily little accepted vaccination. In part it depends on the organization of thevaccination offer, who is perhaps still a little "shy". Indeed, the data show that where trials of active and well-organized provision have been made - for example in schools - adherence to vaccination goes up.

In part, however, I believe that this situation is also to be attributed to a great - but unjustified - fear of side effects. Against this vaccine a great deal has been artfully mounted disinformation campaign (started in Japan and amplified in some northern countries) which attributed the risk of developing chronic pain, autonomic syndromes, motor problems to these drugs.

In reality, the EMA, the European medicines agency, has carried out a painstaking work of checking and reviewing all the studies carried out and all the safety reports that arrived after their placing on the market, excluding this type of effects. Not that the people who made the reports did not have the listed disorders, but the analysis of the circumstances reveals no cause-and-effect correlation with vaccination.

Read also: Papillomavirus: what science says

  • papillomavirus
  • papilloma virus
  • prevention
  • 6-14 children years
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