Impact of a Gender-Neutral HPV Vaccination Program in Men Who Have Sex with Men (MSM)

Abstract

A major challenge in human papillomavirus (HPV) vaccine programs is the universal gender-neutral recommendation, as well as estimation of its long-term effect. The objective of this study is to predict the added benefit of male vaccination, especially in men who have sex with men (MSM), and to analyze the impact of the program on society. We propose a mathematical model of the HPV infection based on a network paradigm. Data from Spain allowed constructing the sexual network. HPV force of infection was taken from literature. Different scenarios using variable vaccine coverage in both males and females were studied. Strong herd immunity is shown in the heterosexual population, with an important decrease of HPV 6/11 infections both in men and in unvaccinated women with an only-women vaccination at 14 years of age. No impact of this program occurred in the infection incidence in MSM. This group would only benefit from a vaccination program that includes males. However, the impact at short term would be lower than in heterosexual men. The protection of MSM can only be achieved by direct vaccination of males. This may have important consequences for public health.

Factors influencing HPV vaccination willingness among men who have sex with men in China: a structural equation modeling analysis

“…Therefore, MSM who do not receive indirect protection from vaccination can only be protected by being vaccinated. 19 , 20 The HPV vaccine is effective even after the first sexual encounter. 21 , 22 Increasing vaccination coverage in the MSM population will ultimately have an important impact on reducing HPV infection in MSM.…”

A two-sex model of human papillomavirus infection: Vaccination strategies and a case study

“…Waning immunity was also considered to be important, especially when studying persistent HPV infection and its associated cancer incidence [31,34]. The impact of HPV vaccination was also evaluated in the population of MSM [27,[44][45][46]. Díez-Domingo et al showed that MSM would not benefit by the herd immunity effect of vaccinating females [46].…”

Update on the Epidemiological Features and Clinical Implications of Human Papillomavirus Infection (HPV) and Human Immunodeficiency Virus (HIV) Coinfection

“…Universal vaccination of women led to a decline in the incidence of cervical disease years later [ 150 , 151 ], as well as lower HPV (HPV-6, HPV-11, HPV-16, and HPV-18) infection rates in MSW, owing to herd protection from female-only vaccination schedules [ 152 ]. However, most MSM do not benefit from this herd protection, and therefore, specific vaccination schedules have focused on this population [ 153 ]. Indeed, universal vaccination of men, regardless of their sexual behaviors, has been implemented in some countries (including the USA, France, Germany, New Zealand, and Australia) and has led to a substantial reduction in the incidence of genital warts [ 154 ].…”