British Medical Journal
02 August 2014(vol 349, issue 7969)
http://www.bmj.com/content/349/7969

Editorials
HPV vaccination – What about the boys?
Margaret Stanley, professor 1,
Colm O’Mahony, consultant in sexual health and HIV2, Simon Barton, clinical director HIV/genitourinary medicine and dermatology3
Author affiliations
BMJ 2014; 349 doi: http://dx.doi.org/10.1136/bmj.g4783 (Published 29 July 2014) Cite this as: BMJ 2014;349:g4783
Excerpt
A year ago an editorial in The BMJ highlighted the limitations of HPV vaccination in the UK1 and called for decisive action to maximise the public health benefits by thinking about vaccinating boys and some men. Similarly, a recent review by Stanley concluded, after consideration of cost effectiveness, that “failure to implement male vaccination looks like a missed public health opportunity.”2 We therefore share the disappointment expressed by the Royal College of Surgeons’ cancer services committee about the lack of response to its concerns about the inequity of vaccinating only girls against HPV in the UK.3
To summarise, the UK vaccination programme initially opted for Cervarix, a bivalent vaccine against HPV types 16 and 18, which are associated with cervical cancer. The programme switched to the quadrivalent Gardasil (which also protects against genital warts caused by HPV types 6 and 11) in September 2012 but still vaccinates only 12-13 year old girls. Interestingly, new data show that at that age the immune response to these vaccines is excellent and that only two doses of either vaccine is sufficient for long lasting immunity, rather than the three required at older ages…
…The only sensible answer to these dilemmas is a gender neutral vaccination strategy in schools that gives two doses of the vaccine to all 12-13 year old boys and girls. Anything else is discriminatory, inequitable, less effective, and difficult to explain. Can the UK afford to do it? If the price is right, we can’t afford not to.

Views and Reviews
Vaccinate boys as well as girls against HPV: it works, and it may be cost effective
BMJ 2014;349:g4834 (Published 29 July 2014)