HPV & Vaccination — Revisited

Marek Sikorski

HPV & Vaccination — Revisited

Wydawnictwo Naukowe Semper, Warszawa 2025

ISBN 978‑83‑7507‑336‑2

Format A5, p. 84, hardcover

#HPV, #vaccination, #vaccine, #infection, #prevalence, #seroprevalence, #fertility, #MSM

The attitude towards HPV vaccines is changing, taking different shapes depending on current global or local epidemiological situation, not necessarily directly related to the diseases the given vaccine is aimed to protect. The eruption of huge and sudden fear of COVID infection was somehow accompanied by a great suspicion about the anti‑COVID vaccines, which were delivered in a very short time, thus lacking the proper population‑based post‑vaccine observation. Surely, the situation necessitated the haste, although loads of misbeliefs emerged.

The concern about risk compensation following HPV vaccination should be considered as a myth other than a true entity. Most important areas of fear – earlier sexual debut, promiscuity, non‑use of contraceptives, engaging in risky behavior or STD acquisition – turned out not to be real. Data deliver convincing conclusions suggesting higher consciousness of vaccinated subjects, which translates into more responsible sexual life.

It is well established that HPV vaccinations are safe and well tolerated, and there is no apparent reason to radically change the recommendations. However, further research should probably be focused on the less obvious and less precisely clinically defined adverse events, like somatophorms of neural and/or vascular complications, which considerably decrease the quality of life of vaccinees.

Vaccination against HPV before pregnancy can possibly bring considerable health benefits for pregnant women, and the reduction of preterm deliveries is supposedly of major importance. There is not sufficient body of evidence to consider vaccination of pregnant women as safe and reasonable. However, postpartum counseling and administration of first (or missing) dose of HPV vaccine seems plausible.

HPV infection is a significant factor contributing to the couple infertility and unfavorable pregnancy course. There is a growing body of evidence that sperm infection with HPV may be substantial cause of conception failure. There is no sound proof documenting adverse influence on fertility, particularly preterm ovarian insufficiency, though careful population‑wide surveillance is mandatory. It seems to be reasonable to offer HPV vaccination to males as a prophylactic measure in order to preserve their fertility, which is an important new indication. The administration of HPV vaccine with the therapeutic intention in cases of HPV sperm infection seems plausible.

HPV infections of anogenital area in males are extremely common, and are easily spreading via sexual route. Natural immunity usually is not protective against the acquisition of new infections. Disease burden related to HPV in males encompasses very common benign genital warts but also most cases of anal canal cancers and significant proportion of penile cancers as well as head and neck cancers. Vaccination of males against HPV has been proven to be safe and effective in significant reduction of persistent HPV infections and in reduction of HPV‑driven diseases. However, its efficacy is lowered in catch‑up populations of males in higher age groups due to preexisting HPV infections. It is of value however to offer the vaccination particularly to high‑risk groups, like MSM or/and HIV infected. Extending population based, refunded vaccinations to males up to 26 years of age seems economically unfounded.

Table of content

- Attitudes
- Sex
- Safety
- Pregnancy
- Fertility
- Males
- Literature