Abstract

Human papillomavirus (HPV) can cause a number of anogenital cancers (i.e., cervical, penile, anal, vaginal, vulvar) and genital warts. A decade ago, the HPV vaccine was approved, and has been shown to be a public health achievement that can reduce the morbidity and mortality for HPV-associated diseases. Yet, the mistaken over-identification of HPV as a female-specific disease has resulted in the feminization of HPV and HPV vaccines. In this critical review, we trace the evolution of the intersection of science, politics, economics and gender norms during the original HPV vaccine approval, marketing era, and implementation. Given the focus on cervical cancer screening, women were identified as bearing the burden of HPV infection and its related illnesses, and the group responsible for prevention. We also describe the consequences of the feminization of HPV, which has resulted primarily in reduced protection from HPV-related illnesses for males. We propose a multilevel approach to normalizing HPV vaccines as an important aspect of overall health for both genders. This process must engage multiple stakeholders, including providers, parents, patients, professional organizations, public health agencies, policymakers, researchers, and community-based organizations.

Highlights

  • Vaccinations are one of the top public health achievements of the early twenty-first century, and the Human papillomavirus (HPV) vaccine has the potential to prevent morbidity and mortality from cervical and other HPV-related cancer and diseases [1]

  • The initial HPV vaccine was approved a decade ago for use in the United States, and it has been justifiably lauded as a scientific triumph for disease prevention, it has been a source of controversy for various reasons since its 2006 approval

  • We extend a longstanding tradition of critical and feminist scholarship that considers how health sciences can be used in ways to “discipline” and “regulate” women's bodies by including HPV in such conversations. [9,10] we review how the interplay of science and sexism has contributed to the feminization of HPV and fits within an existing cultural narrative of HPV being a woman's problem

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Summary

Introduction

Vaccinations are one of the top public health achievements of the early twenty-first century, and the HPV vaccine has the potential to prevent morbidity and mortality from cervical and other HPV-related cancer and diseases [1]. After years of global vaccine research and development, within the United States the Food and Drug Administration (FDA) reviewed the primary evidence of a quadrivalent HPV vaccine (4vHPV; meaning that four types of HPV - 6, 11, 16 and 18 - were targeted) [32]. This discussion focused on the efficacy of the vaccine among females 16-to years of age for cervical, vaginal, and vulvar cancers and their precursors, and whether immunogenicity data supported the extension to females 9-to-15 years of age. The success of these vaccines, 4vHPV, is demonstrated by a 64% decrease in HPV types 6, 11, 16, and 18 prevalence among 14-to-19 year old females 6 years after the vaccine's introduction [35]

Implications for male HPV vaccination
The evolution of the HPV vaccine to the present
Politics and policy of the HPV vaccine in the United States
The feminization of HPV: consequences for females
The feminization of HPV: consequences for males
Reversing the feminization of the HPV vaccine
Findings
Conclusion
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