Abstract
The important goal of immunization programs in many countries is the reduction of the incidence of cervical cancer using either the quadrivalent (Silgard/Gardasil) or the bivalent (Cervarix) HPV (human papillomavirus) vaccine. Nevertheless, HPV infection is associated with the development of cancers of anus, vagina, vulva and penis, and cancers of the head and neck and genital warts, too.
Large trials for both vaccines find efficacy against HPV-related infection and different HPV associated diseases. Infection with HPV and diseases caused by HPV are common in boys and men, too.
Approximately 5.2 % of all cancers are HPV associated and the burden of HPV associated disease in men is now comparable to that in women in economically developed countries. Randomized control trials demonstrate robust antibody responses and high efficacy also in men.
Several countries recommend gender-neutral vaccination. Detailed cost effective modeling has preceded these decisions showing that when the burden of disease in men is included in the models then, depending upon vaccine price, coverage of a vaccinated population, and other factors male vaccination can become cost effective.
Vaccine price had a decisive impact on results. However, increasing coverage in girls is substantially more effective and cost-effective than expanding vaccination coverage to boys and should be considered a priority.
Since 2012, vaccination of girls at the age of 13-14 years has been covered from the health insurance in the Czech Republic.