Gardisil-Hpv

[monroe21]

Why is the gardisil vaccination not given to boys?

[Fernando Roque, MD]

Hi.  Most cases of HPV infection in males do not progress to genital warts and in fact do not have any symptoms at all.  These asymptomatic infections spontaneously resolve even without treatment.  The occurrence of genital warts implies a chronic HPV infection which needs to be treated.  HPV infection which resolves spontaneously does not leave any residual virus, so men whose infection resolves in this manner are not contagious.

[MartinLG]

Hello, Dr. Roque. Thanks for the response. What do you mean that most cases of HPV infection in males spontaneously resolve? Does this apply to genital warts? And if they "resolve" does this mean that the infection ceases or is suppressed? What effect does that have on contagiousness?

[Fernando Roque, MD]

Hi.  Yes, you have raised a good point.  Theoretically, Gardasil can prevent genital warts in men, by preventing infection from HPV.  At present, not enough men have been tested with this vaccine so there is no evidence that it will actually be effective for men.  But there are reports that Merck, the manufacturer of Gardasil, is "actively working on a similar vaccine" for use by males.  Again, there is a question of whether such a vaccine would be cost-effective, since most cases of HPV infection in men are asymptomatic and spontaneously resolve.

[MartinLG]

Of course men can not get cervical cancer, but Gardasil also prevents infection by HPV types 6 and 11, the two most common strains that cause genital warts. Wouldn't vaccination for these strains of HPV prevent genital warts?

[Fernando Roque, MD]

Hi.  Gardisil is meant to prevent infection from those subtypes of the human papilloma virus (HPV) which most commonly cause cervical cancer.  Boys are not vaccinated for obvious reasons - they have zero risk of developing cervical cancer.  Males do get infected with HPV, but the infection commonly does not cause any symptoms and is self-limiting.  So there is no need for men to get immunized from HPV.