HPV Vaccination Rates On the Rise Among US Males

A new study led by researchers from Johns Hopkins University School of Medicine recently found that the rate of human papillomavirus (HPV) vaccination among boys and men in the United States is on the rise.

HPV infections are common in the United States, where about 1 in 4 individuals — or about 80 million – currently have the virus. According to the Centers for Disease Control and Prevention (CDC), an estimated 14 million individuals in the United States become infected with HPV every year. While 9 out of 10 HPV infections clear on their own within 2 years, certain cases persist and can go on to cause certain forms of cancer, including cancer of the cervix, vagina, or vulva in women and in cancer of the penis for men. In both men and women, HPV can also cause cancer of the anus and back of the throat. The CDC estimates that 30,700 cancer cases in the United States each year occur due to HPV infections and that 28,000 of those cases can be prevented with the HPV vaccine.

The first HPV vaccine became licensed in 2006 as a quadrivalent vaccine recommended for females starting at age 11 years; in 2009, the vaccine became licensed for use in males as well. In 2009, a bivalent vaccine was licensed for use in females to prevent HPV types 16 and 18, which cause about 66% of all cervical cancer cases in the United States and most other HPV-caused cancers. Since 2014 a 9-valent HPV vaccine licensed for use in both males and females starting at age 11 has been available to prevent 9 types of the virus. While HPV vaccination efforts initially targeted young women with the goal of cervical cancer prevention, a study recently published in in the Journal of Infectious Diseases shows that vaccination rates have been rising among boys and men.

In 2011 the US Advisory Committee on Immunization Practices (ACIP) began recommending HPV vaccination with the quadrivalent vaccine for all boys starting at age 11, to prevent genital warts and an estimated 7,000 cancer cases each year from HPV 16 and 18. At the time, coverage with at least 1 dose of the vaccine among males aged 13 through 17 years was less than 2%. Using annual vaccination data from the National Health and Nutrition Examination Survey from 2011 through 2016, the new study found that HPV vaccination for US males ages 9 to 26 increased from 7.8% to 27.4%. The changes, according to the authors, were observed among every stratum of age, race/ethnicity, health insurance status, poverty level, and immigration status. During the same period, vaccination rates among girls and women rose from 37.7% to 45.7% overall, but those gains all occurred in women between the ages of 18 and 26 while the rates did not rise among girls between the ages of 9 and 17.

“The rising prevalence of HPV vaccination among males in the United States between 2011-2016 is likely due to the introduction of gender neutral-recommendations for HPV vaccination in 2011 by the Advisory Committee on Immunization Practices,” explained study author Eshan U. Patel, MPH in an interview with Contagion^®. Despite these gains, Mr. Patel says the United States needs to see a bigger increase in HPV vaccination coverage to meet the Healthy People 2020 goal of 80% HPV vaccination coverage in males and females ages 13 to 15.

“We need to be doing more to increase HPV vaccination rates among males and females in the U.S. Barriers to HPV vaccination exist in the healthcare system, provider, and parental level,” he added, noting that parents of unvaccinated teenagers too often don’t see a high need for the vaccine and have misguided fears about its safety.

“There are still many misperceptions about HPV infection and the role of the HPV vaccine in protecting men and women’s health,” said Mr. Patel. “HPV is an equal opportunity infection that causes both cervical and noncervical cancers. We need to do better in defeminizing the HPV vaccine. The increases in HPV vaccination observed among males in this study could be used to convey to the public that HPV vaccination among males is moving towards the norm.”