Direct Benefit of Vaccinating Boys Along with Girls Against Oncogenic Human Papillomavirus: Bayesian Evidence Synthesis

Below:  Burden of HPV associated cancers in men in the Netherlands in relation to vaccine coverage of girls, overall and separately for carcinomas of oropharynx, anus, and penis. White bars (posterior median plus 1 SD) denote QALYs lost to all HPV types, whereas coloured bars denote estimated burden from vaccine preventable HPV types 16 and 18

Results Before HPV vaccination, 14.9 (95% credible interval 12.2 to 18.1) QALYs per thousand men were lost to vaccine preventable cancers associated with HPV in the Netherlands. This burden would be reduced by 37% (28% to 48%) if the vaccine uptake among girls remains at the current level of 60%. To prevent one additional case of cancer among men, 795 boys (660 to 987) would need to be vaccinated; with tumour specific numbers for anal, penile, and oropharyngeal cancer of 2162, 3486, and 1975, respectively. The burden of HPV related cancer in men would be reduced by 66% (53% to 805) if vaccine uptake among girls increases to 90%. In that case, 1735 boys (1240 to 2900) would need to be vaccinated to prevent an additional case; with tumour specific numbers for anal, penile, and oropharyngeal cancer of 2593, 29107, and 6484, respectively.

Conclusions Men will benefit indirectly from vaccination of girls but remain at risk of cancers associated with HPV. The incremental benefit of vaccinating boys when vaccine uptake among girls is high is driven by the prevention of anal carcinomas, which underscores the relevance of HPV prevention efforts for men who have sex with men.

Via:  ht.ly/Q6mHX HT @VUmcAmsterdam