The HPV (Human Papillomavirus) vaccine for men is a crucial preventive measure against various health complications caused by HPV infections. HPV is a common sexually transmitted infection that can lead to genital warts, penile cancer, anal cancer, and oropharyngeal cancer in men. The vaccine works by stimulating the immune system to produce antibodies against HPV, thus preventing infection with certain strains of the virus.

Introduced primarily to protect against cervical cancer in women, the HPV vaccine has also been shown to be highly effective in preventing HPV-related diseases in men. By receiving the vaccine, men can significantly reduce their risk of contracting HPV and the associated health issues. It’s typically recommended for males starting from adolescence up to their mid-20s, although older age groups can also benefit from vaccination.

In addition to protecting individuals, HPV vaccination in men also contributes to herd immunity, reducing the overall prevalence of HPV in the population and indirectly protecting those who may not have received the vaccine themselves.

Overall, the HPV vaccine for men is a valuable tool in the prevention of HPV-related diseases and can significantly improve public health outcomes by reducing the burden of HPV infections and associated cancers. In this article, I will give current and general information about the HPV vaccine in men.

What is HPV vaccine?

The HPV (Human Papillomavirus) vaccine is a vaccine designed to prevent infection with certain strains of the HPV virus. HPV is a group of more than 200 related viruses, some of which are transmitted through sexual contact and can cause various health problems, including genital warts and several types of cancer.

The HPV vaccine works by triggering the immune system to produce antibodies against specific strains of HPV, thereby preventing infection. It’s typically administered through a series of injections over several months. The vaccine is most effective when given before exposure to HPV, which is why it’s recommended for preteens and teenagers, usually starting around age 11 or 12, although it can be given as early as age 9.

The HPV vaccine is primarily known for its role in preventing cervical cancer in women, as certain strains of HPV are strongly associated with this type of cancer. However, the vaccine also offers protection against other HPV-related cancers, including those of the anus, penis, vagina, vulva, and oropharynx (the back of the throat, including the base of the tongue and tonsils).

In many countries, the HPV vaccine is part of routine immunization schedules for adolescents, both males, and females. It’s considered a safe and effective way to prevent HPV infections and the health problems they can cause, including genital warts and various types of cancer.

Mechanisms of actions

The HPV (Human Papillomavirus) vaccine for men works primarily through stimulating the immune system to produce antibodies against specific strains of HPV. Here are the key mechanisms of action:

• Stimulating Antibody Production: The HPV vaccine contains viral antigens derived from the outer protein shell of the virus or virus-like particles (VLPs) that mimic the structure of the virus. When the vaccine is administered, these antigens prompt the immune system to recognize them as foreign invaders and mount an immune response. This response includes the production of antibodies specific to the HPV strains targeted by the vaccine.
• Neutralizing HPV Infection: The antibodies produced in response to the vaccine bind to the viral antigens on the surface of HPV particles, effectively neutralizing them. This prevents the virus from entering and infecting cells, thereby reducing the risk of HPV infection.
• Cellular Immune Response: In addition to antibody production, the HPV vaccine also activates cellular immune responses, including the activation of T-cells. These immune cells play a crucial role in recognizing and eliminating cells infected with HPV, further contributing to protection against HPV-related diseases.

• Preventing HPV Transmission: By reducing the prevalence of HPV infection in vaccinated individuals, the vaccine helps prevent the transmission of the virus to sexual partners. This not only protects vaccinated individuals but also contributes to reducing the overall burden of HPV-related diseases in the population

• Inducing Long-lasting Immunity: The immune response generated by the HPV vaccine is intended to provide long-lasting protection against HPV infection. While the duration of immunity provided by the vaccine may vary, studies have shown that vaccinated individuals maintain high levels of antibody protection for many years after vaccination.Formun Üstü

Is HPV vaccine effective for men?

Yes, there is an HPV vaccine for men, and it has been shown to be effective in preventing HPV-related diseases in males. The vaccine works by stimulating the immune system to produce antibodies against specific strains of HPV, thereby reducing the risk of HPV infection and related health complications.

While the HPV vaccine was initially introduced primarily to prevent cervical cancer in women, it has been found to offer significant benefits for men as well. HPV infections in men can lead to genital warts, penile cancer, anal cancer, and oropharyngeal cancer. By vaccinating males, it’s possible to prevent these conditions and reduce the overall burden of HPV-related diseases in both men and women.

Numerous studies have demonstrated the effectiveness of the HPV vaccine in preventing HPV infections and associated diseases in males. It’s typically recommended for boys and men starting from adolescence up to their mid-20s, although older age groups can also benefit from vaccination.

Overall, the HPV vaccine for men is considered a safe and effective way to prevent HPV infections and the health problems they can cause. It plays a crucial role in reducing the transmission of HPV and the incidence of HPV-related cancers in the population.

What is optimal age for HPV vaccine for men?

The optimal age for HPV vaccination in men is typically between 11 and 12 years old, according to recommendations from health authorities such as the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). However, vaccination can be administered as early as age 9. The rationale behind vaccinating boys at this age is to provide protection before they become sexually active and potentially exposed to HPV.

Here are some key points regarding the optimal age for HPV vaccination in men:

• Early Immunization: Vaccinating boys before they become sexually active ensures that they receive the vaccine when their immune response is likely to be the strongest. This helps maximize the effectiveness of the vaccine in preventing HPV infections and related health problems.
• Building Immunity: The HPV vaccine is administered as a series of doses over several months to build immunity against the virus. Starting the vaccination series at a younger age allows individuals to complete the full course of vaccination before potential exposure to HPV.
• Prevention of HPV-Related Diseases: HPV infections can lead to various health complications, including genital warts and several types of cancer. Vaccinating boys at a young age helps protect them against these diseases later in life.
• Herd Immunity: By vaccinating boys at an optimal age, public health efforts aim to establish herd immunity, which occurs when a high proportion of the population is immune to a disease, reducing the overall spread of the virus and protecting those who may not be vaccinated.

While the optimal age for HPV vaccination is typically during adolescence, individuals who have not been vaccinated during this time can still benefit from vaccination later in life. The HPV vaccine is recommended for men up to their mid-20s, and in some cases, even older age groups may benefit from vaccination based on individual risk factors and doctor recommendations.

Success of vaccination

The success rate of the HPV (Human Papillomavirus) vaccine for men can be evaluated in several ways, primarily in terms of its effectiveness in preventing HPV infections and related health outcomes. Here are some key points regarding the success rate of the HPV vaccine for men:

• Preventing HPV Infections: Clinical trials and real-world studies have demonstrated that the HPV vaccine is highly effective in preventing HPV infections caused by the specific strains targeted by the vaccine. These studies have shown a significant reduction in the incidence of vaccine-type HPV infections among vaccinated individuals compared to unvaccinated individuals.
• Reducing Genital Warts: The HPV vaccine has been shown to be highly effective in reducing the incidence of genital warts, which are caused by certain strains of HPV. Studies have demonstrated a significant decline in the prevalence of genital warts in populations with high HPV vaccination coverage.
• Preventing HPV-Related Cancers: The HPV vaccine has been shown to be effective in preventing HPV-related cancers in men, including penile, anal, and oropharyngeal cancers. While it may take longer to observe the impact of vaccination on cancer rates due to the time it takes for cancers to develop, studies have shown a reduction in the prevalence of precancerous lesions associated with HPV in vaccinated populations.
• Herd Immunity: Vaccinating men against HPV not only protects individual health but also contributes to herd immunity, which occurs when a high proportion of the population is immune to a disease, reducing the overall spread of the virus. By reducing the prevalence of HPV in the population, the vaccine helps protect unvaccinated individuals, including women and men who may not have received the vaccine themselves.

Protocol for HPV vaccine for men

The protocol for administering the HPV (Human Papillomavirus) vaccine for men typically follows a standard schedule recommended by healthcare authorities such as the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). Here is a general outline of the protocol:

• Vaccine Selection: The HPV vaccine currently available for men primarily targets the most common cancer-causing HPV strains, including types 16 and 18, as well as other high-risk strains. The specific vaccine formulation may vary depending on factors such as age, local vaccination recommendations, and vaccine availability.
• Vaccination Schedule: The HPV vaccine is typically administered as a series of injections over several months. The standard schedule involves two doses for individuals aged 9 through 14 years old, with the second dose given 6 to 12 months after the first dose. For individuals starting the vaccination series at age 15 or older, three doses are recommended, with the second dose given 1 to 2 months after the first dose and the third dose given 6 months after the first dose.
• Administration Route: The HPV vaccine is administered via intramuscular injection, typically into the deltoid muscle of the upper arm or the anterolateral thigh. Healthcare providers should follow standard vaccination practices, including proper preparation of the injection site and adherence to aseptic techniques.
• Vaccine Storage and Handling: Healthcare facilities administering the HPV vaccine must adhere to recommended storage and handling practices to maintain the vaccine’s potency and effectiveness. This includes storing the vaccine at the recommended temperature (usually between 2°C to 8°C or 36°F to 46°F), protecting it from light exposure, and ensuring proper handling to prevent contamination.
• Patient Counseling and Informed Consent: Before administering the HPV vaccine, healthcare providers should provide patients with information about the vaccine, including its benefits, potential side effects, and the recommended vaccination schedule. Informed consent should be obtained from the patient or their legal guardian before vaccination.
• Monitoring and Follow-up: After vaccination, patients should be monitored for any immediate adverse reactions, such as allergic reactions or fainting. Healthcare providers should also schedule follow-up appointments as needed to complete the vaccination series and address any questions or concerns the patient may have.

• Documentation and Reporting: Healthcare providers should maintain accurate records of HPV vaccine administration, including the vaccine type, dose, date of administration, and patient information. Adverse events following vaccination should be reported to the appropriate health authorities according to local regulations

Indications of HPV vaccine for men

The HPV (Human Papillomavirus) vaccine for men is indicated for several reasons:

• Prevention of HPV Infections: The primary indication for the HPV vaccine in men is to prevent infection with certain strains of HPV. This helps reduce the risk of developing HPV-related health problems such as genital warts and various cancers, including penile, anal, and oropharyngeal cancers.
• Protection of Sexual Partners: Vaccinating men against HPV also helps protect their sexual partners, including female partners. By reducing the prevalence of HPV in the population, the vaccine contributes to herd immunity, indirectly lowering the risk of HPV transmission and associated health issues in the community.
• Reduction of HPV-Related Cancers: HPV infections can lead to various cancers in men, including cancers of the penis, anus, and oropharynx. The HPV vaccine is indicated to help lower the incidence of these cancers by preventing HPV infections.
• Prevention of Genital Warts: HPV infections can cause genital warts in both men and women. Vaccination against HPV helps prevent the development of genital warts, which can be uncomfortable and may require medical treatment for removal.
• Adolescent Immunization: The vaccine is typically recommended for boys and young men starting from around age 11 or 12, although it can be administered as early as age 9. Vaccination during adolescence provides optimal protection before potential exposure to HPV through sexual activity.
• Individual and Public Health Benefits: Vaccinating men against HPV not only protects individual health but also has broader public health benefits. By reducing the overall prevalence of HPV infections and associated diseases, the vaccine contributes to improved population health outcomes.

Contraindications

The HPV (Human Papillomavirus) vaccine is generally safe and well-tolerated, but there are some contraindications to consider. Contraindications are conditions or situations where the vaccine should not be administered due to potential risks. Here are some contraindications to the HPV vaccine for men:

• Severe Allergic Reaction (Anaphylaxis): If an individual has had a severe allergic reaction to a previous dose of the HPV vaccine or any of its components (such as yeast, aluminum, or polysorbate 80), vaccination should not be given.
• Severe Allergy to Latex: Some HPV vaccine packaging may contain latex, so individuals with a severe allergy to latex should not receive the vaccine.
• Pregnancy: The HPV vaccine is not routinely recommended for pregnant individuals. While there’s no evidence of harm from the vaccine during pregnancy, it’s generally avoided as a precautionary measure. If a woman is found to be pregnant after starting the HPV vaccine series, vaccination should be delayed until after pregnancy.
• Moderate or Severe Acute Illness: If an individual is moderately or severely ill at the time of vaccination, it’s advisable to postpone vaccination until they have recovered. Minor illnesses, such as a mild cold, usually do not interfere with vaccination.
• Previous Severe Reaction to HPV Vaccine: If an individual has had a severe reaction to the HPV vaccine in the past, further doses should be avoided.
• Guillain-Barré Syndrome (GBS): If an individual has a history of Guillain-Barré Syndrome or develops GBS within six weeks of receiving a previous dose of the HPV vaccine, vaccination should be avoided.

Complications-Side effects

The HPV (Human Papillomavirus) vaccine is generally considered safe and well-tolerated. However, like all vaccines, it can cause side effects in some individuals. Most side effects are mild and temporary, resolving on their own within a few days. Serious complications from the HPV vaccine are rare. Here are some potential side effects and complications associated with the HPV vaccine in men:

• Pain, Redness, or Swelling at the Injection Site: This is the most common side effect of the HPV vaccine. Pain, redness, or swelling at the injection site may occur and usually resolves within a few days.
• Fever: Some individuals may experience a low-grade fever after receiving the HPV vaccine. Fever is typically mild and short-lived.
• Headache: Headaches are a common side effect of the HPV vaccine. They are usually mild and resolve without treatment.
• Fatigue: Feeling tired or fatigued is another common side effect of vaccination. Fatigue may occur for a day or two after receiving the vaccine.
• Muscle or Joint Pain: Some individuals may experience muscle or joint pain after vaccination. These symptoms are usually mild and temporary.
• Nausea or Vomiting: Nausea or vomiting may occur in some individuals after receiving the HPV vaccine. These symptoms are typically mild and short-lived.
• Dizziness: Some individuals may experience dizziness or lightheadedness after vaccination. This side effect is usually mild and resolves quickly.
• Syncope (Fainting): Fainting can occur after any vaccination, including the HPV vaccine. It’s more common in adolescents and young adults. Individuals are typically observed for a short period after vaccination to prevent injury from fainting.
• Allergic Reactions: Severe allergic reactions to the HPV vaccine are rare but possible. Symptoms of a severe allergic reaction may include difficulty breathing, swelling of the face or throat, hives, rapid heartbeat, and dizziness. Immediate medical attention is needed if a severe allergic reaction occurs.

Can men who have previously had HPV be vaccinated?

Yes, even if a man has had HPV before, the HPV vaccine may still be indicated for several reasons:

• Protection Against Other HPV Strains: The HPV vaccine protects against specific strains of the virus that the individual may not have been exposed to previously. There are multiple strains of HPV, and the vaccine typically targets the most common cancer-causing strains, such as HPV types 16 and 18. Therefore, even if someone has had one strain of HPV, they may still benefit from vaccination to protect against other strains to which they have not been exposed.
• Reducing Risk of Recurrence: Having had one HPV infection does not confer complete immunity against future infections with other HPV strains. Vaccination can help reduce the risk of recurrent or new HPV infections, including those that could lead to genital warts or HPV-related cancers.
• Protection for Sexual Partners: Vaccinating individuals who have had previous HPV infections can still provide protection for their current or future sexual partners. By reducing the risk of transmitting other HPV strains, vaccination contributes to the overall prevention of HPV-related diseases in the population.
• Enhanced Immune Response: Even if someone has been infected with HPV before, their immune system may not have mounted a sufficient response to provide long-lasting protection. The vaccine stimulates the immune system to produce a stronger and more durable response, potentially offering better protection against future HPV infections.
• Prevention of HPV-Related Cancers: HPV infections, even if they have occurred in the past, can increase the risk of developing HPV-related cancers later in life. Vaccination can help lower this risk by providing protection against additional HPV strains that could contribute to cancer development.

Can HPV vaccine be given to people who currently have active disease?

If a man has active HPV lesions, it is generally not recommended to administer the HPV vaccine. The vaccine is designed to prevent new HPV infections and does not effectively treat existing HPV infections or their associated lesions.

Here are some reasons why the HPV vaccine is not typically given to individuals with active HPV lesions:

• Limited Efficacy: The HPV vaccine works best when administered before exposure to the virus or infection. Once a person has already been infected with HPV and developed lesions, the vaccine may not be as effective in preventing further infection with the same or different HPV strains.
• Focus on Prevention: The primary goal of the HPV vaccine is to prevent HPV infections and related health problems, including genital warts and certain cancers. It is not intended as a treatment for existing HPV infections or lesions.
• Other Treatment Options: There are other treatment options available for managing active HPV lesions, such as genital warts. These treatments may include topical medications, cryotherapy (freezing), surgical removal, or other interventions recommended by healthcare providers.
• Safety Considerations: Administering the HPV vaccine to individuals with active HPV lesions may not provide additional benefit and could potentially lead to unnecessary vaccination-related side effects. It’s essential to prioritize the safety and well-being of individuals receiving the vaccine.

Instead of administering the HPV vaccine to individuals with active HPV lesions, doctors typically focus on appropriate management and treatment of the existing lesions. Once the lesions have been treated and resolved, individuals may still benefit from vaccination to prevent future HPV infections and related health problems

Summary

The HPV (Human Papillomavirus) vaccine in men is a crucial preventive measure against HPV infections and related health complications. Administered primarily to adolescents and young men, the vaccine stimulates the immune system to produce antibodies against specific strains of HPV, reducing the risk of genital warts, penile cancer, anal cancer, and oropharyngeal cancer. By vaccinating males, the spread of HPV is also curbed, contributing to herd immunity and protecting sexual partners. The vaccine’s efficacy in preventing HPV infections, reducing genital warts, and potentially lowering the incidence of HPV-related cancers highlights its importance in public health efforts.

Prof. Dr. Emin ÖZBEK

Urologist

Istanbul- TURKEY