Vaccinating boys against human papillomavirus not cost-effective

BOSTON — Persistent infection with high-risk types of human papillomavirus, a sexually transmitted virus, is known to be a cause of cervical cancer.

Current guidelines prioritize HPV vaccination of pre-adolescent girls, which has been shown to be cost-effective in previous studies, but the value of vaccinating boys in the United States has been unclear.

In a new study, Harvard School of Public Health researchers found that if vaccine coverage and efficacy are high in girls, a universal recommendation to vaccinate young boys is unlikely to provide comparatively good value for resources, compared with vaccinating girls only.

The study was published in The British Medical Journal.

The Food and Drug Administration approved the use of Gardasil to prevent genital warts caused by HPV in boys on Oct. 16.

"Policymakers will need to decide whether or not to recommend vaccinating boys," said Jane Kim, assistant professor of health decision science and lead author of the study. "To inform these deliberations, both the incremental health benefits that would accrue with vaccination of boys and girls and the economic costs of the program should be compared to those associated with vaccination of girls alone."

The authors emphasize, "this analysis does not address decision-making at the individual level; indeed, families who are considering HPV vaccination for an individual boy may consider the vaccine benefits worthwhile in terms of reducing the future risk of genital warts and possibly other health conditions."

While the authors conclude that routine vaccination of boys is unlikely to provide comparative value to other public health interventions vying for resources, they emphasize that the study was conducted from a public health perspective and with the objective of informing general policy recommendations at the population-level.

This study was funded by grants from the National Cancer Institute, the Centers for Disease Control and Prevention, and the American Cancer Society.