The HPV Vaccination Strategy: Could Male Vaccination Have a Significant Impact?

Abstract

We investigate the potential success of the human papilloma virus (HPV) vaccine, taking into consideration possible waning immunity and the influence of behavioural parameters. We use a compartmental, population-level ordinary differential equation (ODE) model. We find the effective reproductive value for HPV, Re0, which measures the threshold for infection outbreak in a population that is not entirely susceptible, together with infection prevalence. We study the effects of different parameters on both of these quantities. Results show that waning immunity plays a large part in allowing infection to persist. The proportion of the population not sexually active when vaccination occurs affects Re0, as does the rate at which individuals become sexually active. In several cases, infection persists as a result of an infection reservoir in the male cohort. To explore this further, we introduce male vaccination and find the conditions for which vaccination of males could be considered appropriate.

Sex-Specific Immunization for Sexually Transmitted Infections Such as Human Papillomavirus: Insights from Mathematical Models

“…Also note that low or waning vaccine efficacy may cause even complete coverage of a single sex to be insufficient for elimination. We refer to others for an analysis of conditions in which vaccination of both sexes may be needed to achieve R v <1 [35],[36].…”

Human Papillomavirus Vaccination in Males: The State of the Science

“…The precise benefit of herd immunity depends on the prevalence of vaccination among females in the population, and is inversely proportional to the percentage of vaccinated females. Mathematical modeling has predicted that susceptible males could serve as a potential reservoir for HPV, decreasing the threshold for infection outbreak among susceptible females [43]. Models also predict further decreases in genital warts, cervical intraepithelial neoplasia, and cervical cancer deaths through widespread vaccination of men [44].…”

Aspects of Prophylactic Vaccination against Cervical Cancer and Other Human Papillomavirus-Related Cancers in Developing Countries

“…Overall, the highly infectious nature (high transmission probability) of HPV supports the idea of vaccinating both sexes. It is also possible that vaccinating the same number of males and females as in the female-only vaccination strategy would decrease the prevalence of hrHPV infections slightly in a steady state of hrHPV epidemics [85] and in dynamic state of the hrHPV epidemics (as is the case in many countries), and it is likely that the impact of male vaccination would be higher.…”