The Human papillomavirus (HPV) vaccine has over recent years, become a routine vaccine globally, with schools across nations encouraging students to receive the vaccine and even providing the vaccination to their students as part of the national school vaccination programme.
Singapore is no exception, especially as preventative health is becoming more of a concern in the nation as of recent years. The Ministry of Health (MOH) decided in 2017 to provide Cervarix, the licensed 2-strain HPV vaccine, for all 13-year-old girls enrolled in schools free-of-charge.
MOH has also been ramping up campaigns to increase visibility of cervical cancer and highlight its preventability – high-risk strains of HPV, which are often the ones that HPV vaccines aim to protect you from, are one of the most common causes of cervical cancer in women. So far, these efforts have largely been aimed at women in Singapore – and largely women between 9 and 26 years.
The above group is, of course, the group of individuals that is deemed most suitable to receive the HPV vaccination. However, there remain other groups who have not been traditionally identified as ideal recipients of the vaccine.
Men and the HPV vaccine
Can men contract HPV?
Not only can men develop HPV, but it is very important to note that they are often silent carriers of HPV. This means that they go their lifetimes without displaying any symptoms, which is why the virus is considered to be ‘harmless’ to men by many and vaccination is not deemed to be necessary for them.
However, these silent carriers are perfectly capable of passing on the virus to their sexual partners, who may be women who then have a higher risk of developing cervical cancer or any one of the numerous complications caused by the presence of HPV in the body. Some other complications include genital warts and oropharyngeal cancer (cancer of the mouth or throat)
Asymptomatism in men is all the more dangerous because of the potential for the disease risk to seen lesser in men, when it is not so. It also increases the possibility of asymptomatic men passing the viral load to women and the risk is amplified if these men have multiple sexual partners. It is therefore essential that boys are vaccinated at a young age against HPV much like girls are.
Can men infected with HPV develop symptoms?
Of course, not all men or boys are free of symptoms after being infected. Some men may go on to develop penile or anal cancer as a result of the HPV infection. The risk of this is not as high as the risk of women with HPV going on to develop cervical cancer, but it is present nonetheless. Genital warts are also a symptom that may develop in men with HPV. Men with compromised immune systems are more likely to develop cancers such as penile or oropharyngeal cancer or genital warts as a result of the infection.
Another group of men at risk are those who have sex with other men, – particularly, those who are on the receiving end of penetrative anal sex. These men have an increased risk of developing anal cancer if they are infected with anal HPV. It is important to note that this does not preclude men who have vaginal sex with women from infection – they are equally susceptible to getting the infection if their partner is carrying it.
Have efforts to vaccinate boys against HPV begun?
The UK is one of the first few countries in the world to offer the HPV vaccine to all 12 and 13 year olds as part of its school vaccination programme, regardless of gender. This means that boys in the school system develop early protection against the disease, likely before they become sexually active. They are this unlikely to become spreaders of HPV when they do go on to become sexually active and the risk of them passing the virus on to their sexual partners significantly decreases
The HPV vaccine for those above 26 years
Guidelines by the Ministry of Health in Singapore as well as the World Health Organisation point to the vaccine being most suitable for girls or women between the ages of 9 and 26. The reasoning behind this is that the vaccine is most effective if it is administered before the individual becomes sexually active and contracts any strain of HPV.
After all, the HPV vaccine can only offer protection against certain strains of HPV – it cannot treat HPV in those who already have been infected.
The Centres for Disease Control and Prevention (CDC) has found that vaccination of individuals prior to their becoming sexually active could potentially prevent 90% of HPV-related cancers from developing.
However, recently conducted studies have found that those above the age of 26 could also benefit greatly from the vaccine, even if they have already become sexually active. This is especially true if the HPV vaccine that is administered offers protection against a broader range of HPV strains.
This is because it ensures that those above 27 years who are likely already sexually active and even those who might already have been infected with a strain of HPV, will be protected against any more dangerous strains of HPV that they might be exposed to further down the line.
Has a HPV vaccine been approved for use in those above 26 years?
However, in 2018, the US Food and Drug Administration, a global leader in food and pharmaceutical product safety, approved the use of Gardasil 9, a nine-strain HPV vaccine, in both men and women between 27 and 45 years. Those below 27 can of course still receive Gardasil 9, but this move has allowed adults above 27 to also benefit from the vaccination, even if they are already sexually actively.
Gardasil 9 protects against the 9 most common strains of HPV – significantly more strains than Gardasil 4 or Cervarix protect against.
The Ministry of Health in Singapore has not officially changed its recommendations to include those above 27 years to receive Gardasil 9, but the move is highly anticipated and those 27 and above who are concerned and looking to protect their sexual health are already seeking out the vaccine independently.
Gardasil 9, much like Gardasil 4 and Cervarix, is scheduled for 3 doses (0, 2 and 6 months). FDA conducted a study of 3,200 women between the ages of 27 and 45 over a period of about three and a half years, which involved them receiving Gardasil 4. The study showed that Gardasil 4 was 88% effective in preventing onset of persistent infection, genital warts precancerous lesions in the vulva, vagina and cervix as well as cervical cancer.
Since Gardasil 4 and Gardasil 9 are produced by the same manufacturer and also cover the same 4 types of HPV, the results of the study also indicated the effectiveness of the use of Gardasil 9 in those above 27 years. Moreover, this clinical study as well as another which involved the administration of Gardasil 4 in men between 16 and 26 years also showed the effectiveness of the vaccine in men.
Gardasil 9, therefore, has been proven to be an effective method of protection against warts and cancers not only for girls between 9 and 26 years, but for boys, men and women between the ages of 9 and 45 years.
Protect yourself from cancer and warts – take action now and schedule an appointment with Clari Health CBD Travel Clinic for your dose of Gardasil 4 or 9 today. Ladies between the ages of 9 and 26 are eligible to have their vaccinations covered by Medisave.