A decade after UK health officials first implemented routine human papillomavirus (HPV) vaccination in adolescent girls, the government has extended their immunization program to include boys, based on the conclusion of a five-year evidence review by scientists on the Joint Committee on Vaccination and Immunization (JCVI).
Initially developed to protect women against the two HPV strains associated with the highest risk of cervical cancer and the two strains that cause 90 percent of genital or oral warts, multiple studies have shown that immunizing females before or soon after they become sexually active can also prevent cancers of the mouth, anus, throat, and head and neck. The newest approved vaccine, which is administered in a series of two or three injections depending on the patient’s age, includes antigens for a total of nine high-risk and wart-associated strains.
“In the UK, the introduction of the HPV vaccine to girls in 2008 to prevent cervical cancer proved to be a major step forward in public health, significantly decreasing HPV infections in 16-21-year-old women by 86%,” Peter Openshaw, president of the British Society for Immunology, told the Science Media Centre in response to the announcement. “I’m pleased to see that boys will now also be able to reap the health benefits that this vaccine confers.”
“The Department of Health and Social Care now need to work with vaccine manufacturers to ensure that a national rollout of this vaccine to boys can begin as soon as possible. Alongside the rollout, it’s also crucial that we redouble efforts to actively communicate the important health benefits of this vaccine to parents and children.”
Currently, girls aged 12 to 13 are offered the HPV vaccine through their school’s health program, though all those aged up to 18 can get it for free through the NHS. The age at which boys will be eligible to receive the first of the vaccine doses is also between 12 and 13, according to Public Health Minister Steve Brine. For both sexes, vaccination prior to sexual maturity is key. Once one has had several partners, the likelihood that they have been exposed to HPV is significant. Between 2013 and 2014 in the US, around 45 and 40 percent of men and women, respectively, aged 18 to 59 were infected with at least one of the more than 40 types of HPV that can be spread through direct sexual contact, and 25 and 20 percent carried a high-risk strain. Estimates of HPV prevalence in England suggested rates were similar, at least for women, before standardized vaccinations began.
Men exposed to high-risk HPV infections are at similar risk for oral, genital, and head and neck cancers, and may also develop cancer of the penis.
“HPV vaccination protects all men against HPV cancers and warts irrespective of their sexual preferences,” stated Professor Margaret Stanley, a pathologist at the University of Cambridge. “Without vaccination men have very poor protection against infection with the cancer and wart causing HPVs since they make poor antibody responses to natural HPV infections but excellent responses to HPV vaccination. [Morevoer, immunizing] men (the other 50% of the population) gives additional protection to women – after all it takes two to tango.
Though the topic is muddled by issues of insurance coverage, the US Centers for Disease Control and Prevention has also officially endorsed HPV vaccines for girls since 2008. In late 2016, they expanded their immunization recommendation to include all children aged 11 to 12.