HPV Vaccine for Men: It's About Time

November 14, 2008 05:41 PM ET | Bernadine Healy M.D. | Permanent Link | Print

Finally, two years after it was approved for use in young women, a vaccine against the sexually transmitted human papillomavirus (HPV) has now been shown to be safe and effective in protecting young men as well. Merck's vaccine Gardasil cut infections caused by the four most dangerous strains of this virus by 45 percent and reduced the occurrence of HPV-induced warts by 90 percent, according to a new study involving more than 4,000 male volunteers age 16 to 26. The next step is for the Food and Drug Administration to give its blessing.

The delay in studying the vaccine in men has puzzled me. Men are, after all, carriers of this virus known to infect the female cervix, leading to a virtual epidemic of abnormal Pap smears in sexually active young women. Although in most women the virus is cleared by their immune system, when it's not it continues to percolate for years and each year accounts for the almost 11,000 cancers of the cervix—a cancer that robs women of their fertility if not their life. Ignoring the role of men in promulgating this illness is at odds with how we approach most other forms of STDs, where doctors treat both partners. Leaving men out also subverts the core tenet of vaccination: creating so-called herd immunity.

But men infected with HPV put more than women's health in jeopardy. They can develop genital warts from certain strains of the infection, as well as genital cancer. HPV-derived cancers of the penis and anus are considerably less common than is invasive cervical cancer in women, but to the thousands of men who are so afflicted, the cancer is every bit as disabling and life-threatening.

What's less appreciated by most people and even many doctors is that HPV is also linked to head and neck cancers, once thought to be almost exclusively the result of a lifetime of drinking and smoking. Not so anymore. We are now seeing a rise in HPV-related cancers of the tonsils and back of the tongue in a generally younger group of people, and here men seem more vulnerable to this devastating cancer than women do.

The explanation is that HPV is transmitted during oral sex—a practice that's become epidemic among our kids, one in which "safe sex" involving condoms is almost unheard of. There's an important lesson here for young men. Just because they can't get pregnant does not mean they can't get infected—and with dire consequences. And, though it's better late than never that young men will have access to the HPV vaccine, it should be accompanied with a heavy dose of sex health education as well. HPV is not the only STD that goes for the throat.

Bernadine Healy, M.D., U.S.News & World Report's health editor and author of the magazine’s On Health column, is the former head of the National Institutes of Health, the American Red Cross, and the College of Medicine and Public Health at Ohio State University. A cardiologist and author of two books, she spent more than 25 years practicing medicine. In this blog, she covers matters close to her heart, including cardiovascular disease and other important aspects of personal health and health policy.