SynthesisJournal of translational medicine2025
Should routine HPV vaccination programs include males 25-29 years? A systematic review and global meta-analysis.
Synthesis in Journal of translational medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
8 authors.
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Abstract
backgroundMales aged 25-29 years represent the peak transmission group for human papillomavirus (HPV). However, they are often excluded from routine vaccination programs due to concerns regarding cost-effectiveness and limited efficacy data. This study synthesized evidence on vaccine efficacy and herd effects to support the potential expansion of HPV vaccination to this demographic.
methodsThis systematic review and meta-analysis searched PubMed, Embase, and the Cochrane Library from January 1, 2007, to February 1, 2025. We included randomized controlled trials and observational studies that reported on the efficacy of the 4vHPV vaccine against incident HPV infections (4vHPV-type [6/11/16/18] or any HPV) in males, as well as herd effects on anogenital warts (AGW) in unvaccinated males aged 25-29 years following female vaccination. Exclusions comprised pediatric, HIV, and female-only cohorts, non-4vHPV vaccines, and immunogenicity-only reports. Two reviewers independently extracted summary-level data, and discrepancies were resolved by a third reviewer. The primary outcomes were pooled relative risks (RRs) for HPV infection and AGW incidence, calculated using DerSimonian-Laird random-effects models. (PROSPERO: CRD420251104471)
resultsFrom 3,024 screened records, 28 studies (2 RCTs, 26 observational; n = 68,113,157 participants) were analyzed. Direct vaccination significantly reduced 4vHPV-type infections among males aged 13-26 years (RR = 0.35, 95% CI: 0.18-0.65; I
conclusionsThis study demonstrates that extending HPV vaccination to males aged 25-29 years provides both individual and population-level benefits, particularly in settings with suboptimal female coverage. These findings support the inclusion of this demographic in vaccination programs and suggest that revising current age-restrictive policies could contribute to global efforts to eliminate HPV-related diseases. Future research should focus on real-world data to further strengthen the evidence base.
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