HPV Vaccination: Why Men and Queer People Should Get It Too

HPV vaccination has an image problem. It reads as a shot for girls and young women, even though it offers men real protection too. Anyone who looks into their own health quickly runs into numbers that should change that view.

HPV stands for human papillomavirus. It is one of the most common sexually transmitted infections, and most sexually active people catch it at some point in their lives. Often it clears on its own. If an infection with a high-risk type sticks around, it can lead to cancer years later. In men, that mainly affects the mouth and throat, the anal area and the penis.

The figures come from official sources. In Europe, about one in five male adolescents and men aged 15 and older is infected with at least one high-risk type that can cause cancer. In Germany, around 2,900 men are diagnosed with HPV-related cancer every year, mostly in the mouth and throat. In the United States and the United Kingdom, HPV-related throat cancer in men is now diagnosed more often than cervical cancer in women.

Papillomaviruses are a family name. There are more than 200 types, some harmless ones only cause warts, others raise the cancer risk. The vaccine targets the most dangerous of them. The widely used shot Gardasil 9 protects against the high-risk types 16 and 18 as well as 31, 33, 45, 52 and 58, plus types 6 and 11, which cause genital warts. The vaccine Cervarix focuses on types 16 and 18.

Health authorities agree on the recommendation. Germany's Standing Committee on Vaccination (STIKO) advises the shot for all children from age nine. Up to age 14, two doses are enough, from 15 on, three are needed. Catch-up vaccination is recommended up to age 17, and for adults over 18 the shot can still make sense in individual cases. The vaccines are approved from age nine with no upper age limit.

For men who have sex with men, the vaccine has a special meaning. Their risk for HPV-related precancerous lesions and anal cancer is higher, which is why international bodies like the US Advisory Committee on Immunization Practices (ACIP) explicitly recommend vaccination for them through age 26. The evidence behind this is solid: in a study of 602 men who have sex with men, the vaccine prevented about 75 percent of anal cancer precursor lesions and was nearly fully effective against genital warts.

Many adults wonder whether the shot still makes sense later in life. The answer is more nuanced than people expect. The vaccine works best before the first contact with the virus. The older the person at first vaccination, the lower the protection against precancerous lesions. Still: anyone who is not yet infected, or has only had contact with some of the types, can benefit from a later vaccination. A new sex partner counts as a risk factor for a new infection, regardless of age.

A common misunderstanding is that the vaccine is only for people without sexual contact. In fact, it works even after sexual experience. An infection with a vaccine type may already exist, but the body still builds protection against the remaining types. If you have weighed the decision for years, you are not too late just because the ideal moment has passed.

Costs differ from country to country. In Germany, statutory health insurance covers the STIKO-recommended vaccination for children and young people from 9 to 17. Many insurers reimburse the shot beyond that up to age 26, some up to 45, depending on the individual application. Private insurance depends on the plan. In other countries, the vaccine is often covered by national immunization programs, so it is worth checking local rules.

The side effects are well documented. Pain at the injection site, redness or tiredness appear shortly after the shot and usually fade on their own. Monitoring bodies have assessed the vaccines as safe for both women and men, based on the collected data. Serious adverse reactions are rare.

Anyone planning a vaccination should not hesitate long. A good place to start is a family doctor, a urologist or a public health clinic. For men who have sex with men and for people with a weakened immune system, the conversation about the vaccine can be a sensible part of regular health care. Alongside hepatitis A and B vaccinations and routine testing, the HPV shot belongs to a solid approach to your own sexual health.