"The human papillomavirus HPV vaccine can help stave off genital warts https in boys and men according to a new study in the Feb.  issue of the New England Journal of Medicine. Of  boys and men aged  to  from  countries vaccination with an HPV vaccine https that targets four types of HPV https infection  HPV HPV HPV and HPV  protects against infection with these types of HPV and potentially the development of related external genital warts https or lesions. HPV a sexually transmitted disease https can be transmitted through vaginal anal and oral sex https and has been linked to genital warts as well as cervical vaginal vulvar oral penile and anal cancers. Two HPV vaccines https are now approved by the FDA Cervarix and Gardasil https Both of these vaccines https are recommended to prevent cervical cancers. These vaccines are now on the CDCs routine childhood vaccine schedule for girls starting at age .  The Gardasil vaccine has also received FDA approval for prevention of genital warts https The vaccine is recommended for optional use in boys and men. The vaccine is used in girls and boys and young adults ages  to  for prevention of genital warts caused by HPV types  and . The most salient message is that the Gardasil vaccine can prevent HPV infection on the external genital region which means that we can now prevent most cases of genital warts if the boy is vaccinated at a sufficiently early age says study researcher Joel Palefsky MD a professor of medicine at the University of California San Francisco. HPV Vaccine for Males The new study does not address cancer https risk in boys and men he says. These data provide evidence that the vaccine can be efficacious in males and adds to the list of reasons to consider vaccinating boys and men he says. In theory this could cut down on cancers but it hasnt yet been proven. The big debate now is whether or not universal vaccination of young men should be encouraged he says. HPV is a sexually transmitted infection and the burden of vaccination should not fall solely on girls and women. HPV causes disease in men too he says. In addition men who have sex https with men are at increased risk for genital warts and anal cancer https and likely would not benefit from female vaccination he says.  Casting a wide net that vaccinates all boys aged  would cover such highrisk groups he says. So why not do it  The main disadvantage is cost because thus far the vaccine appears to be safe he says. Its less costeffective because most of the serious diseases such as cervical cancer https occur in women not men. Theoretically if you vaccinated all women you wouldnt need to vaccinate men except for men who have sex with other men he says. Not every female who is eligible for the vaccine has received it and many females  and their current or future sexual partners  remain unprotected. Jane J Kim PhD an assistant professor of health decision science in the department of health policy and management at the Harvard School of Public Health in Boston wrote an editorial that accompanied the new study. Its telling us something quite promising. The Gardasil shot has strong potential to reduce genital wart cases in boys with high effectiveness she writes. More recent data that has resulted in the FDA expanding the use for prevention of anal lesions in women and men has resurfaced the debate about routine vaccination for everyone she writes. Its going to be hard to target the boy who will grow up to be highest risk for anal cancer of anyone in the country  men who have sex with men she says. Our ability to target these males when they are really young and the vaccine is most beneficial is a hard sell and not feasible as people dont necessarily become aware of their sexual orientation https that early. With universal vaccination this issue goes away she says. You wouldnt have to think about it and you prevent HPV in everyone. Vaccines Boys vs. Girls But there is more to this discussion. The most costeffective use of vaccine as we know it today is to vaccinate young girls before they get exposed to HPV she says. Men who have sex with men would also benefit greatly and the rest of the population of men would benefit in terms of reducing genital warts possible anal lesions as well as anal and penile cancer https but they are at low risk for those cancers. There is benefit but are we willing to spend that much money on a vaccine to get that amount of benefit she says. Most of the evidence suggests that it would not be a good use of health dollars to vaccinate all boys. This could all change if the vaccine cost comes down or if the uptake in young females remains low she says. It is trending upward but if it remains low and we can cover boys instead that may be a good costeffective strategy."