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A recent study has found that half of all males in the USA are infected with the human papillomavirus, also known as HPV, leading to questions of whether boys, as well as girls, in their teens should also receive vaccinations.

Should Boys Also Get HPV Vaccine?

HPV infection is the underlying cause of cervical cancer, which is diagnosed in about 12,000 women every year. It's also the underlying cause of anal, cervical, and vaginal cancers in women, anal and penile cancers in men, and certain kinds of mouth and throat cancers in both sexes, all of which are considerably rarer. But the term "human papillomavirus" actually refers to over 200 strains of the virus, about 40 of which cause cancer, and only two of which are included in the vaccine.

One literally needs a scorecard to keep up with the effects of various strains:

  • HPV-6 and HPV-11 can cause warts on the larynx, which in rare cases progress to throat cancer.
  • HPV-16, -18, -31, and -45 cause most cases of cervical, vaginal, anal, and penile cancer.
  • HPV-1, -2, -4, -26, -27, -29, -41, -57, and -65 cause common warts on the outside of the genital organs.
  • HPV-6, -11, -30, -42, -43, -44, -45, -51, -52, and -54 cause genital warts.
  • HPV-6 and -11 can cause "giant genital warts."
  • HPV-13 and -32 cause warts inside the mouth.

Two strains of HPV, however, are especially dangerous. HPV-16 and HPV-18 are associated with:

  • Squamous cell carcinoma of the lung,
  • Cancer of the larynx,
  • Cancer of the sinuses, and
  • Cancers of the cervix, vagina, anus, and penis.

These two strains of HPV, however, are not the only strains of HPV that cause cancer. They are just the main strains of HPV, along with HPV-6 and HPV-11 covered by the Gardasil vaccination.

Would Giving Boys Gardasil Really Protect Against Cancer?

Reporting findings in the medical journal Lancet, Anna Giuliano of the H Lee Moffitt Cancer Center and Research Institute in Tampa, Florida and her colleagues studied 1,100 men aged 18 to 70 in Brazil, Mexico, and the United States. The researchers found that 50 per cent of men had been exposed to HPV before their enrollment in the study, and every year an additional 6 per cent of men in the study who had not previously been exposed to HPV got an infection with HPV-16.

Since HPV-16 is a strain of the virus associated with many forms of cancer, Dr. Guiliano's team suggests that vaccinating boys, as well as girls, may prevent future cancers in men as well as women. Women, the researchers state, have an ability to clear the virus from their bodies as they age, but men do not, especially if they are constantly re-infected.

So, far, the US FDA does not entirely agree. Gardasil has been recommended as a preventive measure for anal cancer in men who have sex with men. It has not yet acted on information about the vaccine for heterosexual men.
Another study, funded by the vaccine's maker, Merck, has found that vaccination results 60 per cent reduction in the number of cases of genital warts in sexually active men aged 16 to 20, and 85 per cent effective in preventing persistent HPV infections that could, over a period of years, lead to other forms of cancer. (Some news report state the figure as 90 per cent, but the study actually says 60 per cent.) Men who are not infected, of course, do not transmit the virus. And it is well established that people who are "not quite over" their HPV infections are especially at risk for reinfection from unprotected sex, for at least two years. But perhaps 5 to 10 per cent of men who get Gardasil get infected with other forms of HPV.

There is another way to be sure one doesn't have the virus: Abstinence. But in men who are not abstinent, Gardasil offers good, although not perfect, protection against catching and spreading HPV.

  • Giuliano AR, Palefsky JM, Goldstone S, Moreira ED Jr, Penny ME, Aranda C, Vardas E, Moi H, Jessen H, Hillman R, Chang YH, Ferris D, Rouleau D, Bryan J, Marshall JB, Vuocolo S, Barr E, Radley D, Haupt RM, Guris D. Efficacy of quadrivalent HPV vaccine against HPV Infection and disease in males. N Engl J Med. 2011 Feb 3,364(5):401-11
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