Should young men who have sex with men be targeted for HPV vaccinations?

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Vaccinating men who have sex with men (MSM) against the human papillomavirus is a cost-effective method for preventing anal cancer and gential warts, a new analysis published in Lancet Infectious Diseases has found. Last year the FDA approved the use of Merck’s HPV vaccine Gardasil to prevent genital warts for boys and men ages 9 to 26, but the CDC didn’t make it a routine vaccination because cost-effectiveness data were lacking. Study author Jane J. Kim, Ph.D., of the Harvard School of Public Health found that a universal vaccination for young boys might not be necessary to protect MSM from future development of anal cancer and genital warts. Instead, she recommended targeting men who have sex with men for vaccination.

Dr. Ross asks the obvious question: “How do you decide which 12- and 14-year-olds are going to grow up to be men who have sex with men?”

In her analysis, Dr. Kim writes that while ideally vaccines would be given to gay boys that young (before “sexual debut”), “HPV vaccination of MSM need not occur at the earliest ages to be good value for money.” Even vaccinating 26-year-old men who have sex with men makes economic sense, she says.

Dr. Whelan notes: “Unfortunately, by that age, most of the target group will likely have already acquired HPV infection, thereby reducing the efficacy of the vaccine. Earlier vaccination would also likely be protective against other HPV-related cancers, such as oral cancer.”