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The human papillomavirus (HPV) can cause a range of cancers as well as genital warts and recurrent respiratory papillomatosis in men and women. Most cases can be prevented by vaccination in adolescence. Many countries vaccinate girls and an increasing number, although still a minority, vaccinate both boys and girls. The case for vaccinating boys is based on arguments of public health, equity, ethics and cost-effectiveness. The selective vaccination of females does not protect males sufficiently and provides no protection at all for men who have sex with men. In the United Kingdom (UK), the government’s vaccination advisory committee (Joint Committee on Vaccination and Immunisation [JCVI]) began to consider whether boys should be vaccinated as well as girls in 2013 and made clear in draft statements that it considered this not to be cost-effective. A campaign group, HPV Action, was established to advocate gender-neutral vaccination. This group became a coalition of over 50 organisations and used evidence-based arguments, political advocacy and media campaigning to make its case. One of its members initiated legal action against the government on the grounds of sex discrimination. In July 2018, the government agreed that boys in the UK should be vaccinated. The lessons for other campaigns in the men’s and public health fields include: be prepared for the long haul, focus on clear and specific goals, build alliances, align the objectives with existing policies, make a financial case for a change of policy, and use all legitimate means to exert pressure.

Worldwide cancer incidence is increasing, with viral infections including human papillomavirus (HPV) responsible for a significantly higher number of cancer deaths in low- and middle-income countries (LMICs) when compared to high income countries. Globally, in 2015, there were 72 national HPV vaccination programmes, and 39 demonstration or pilot programmes. Despite HPV’s impact on both sexes, for examples in malignancies such as oropharyngeal cancer (whose incidence is increasing across the world) few countries have a gender-neutral vaccination policy. Herd protection and cost-effectiveness are important considerations in potential extension of vaccination to males and while there is some suggestion that a targeted vaccination programmes for “high risk” groups, such as men-who-have-sex-with-men (MSM) may be preferable, a universal vaccination approach is the best solution to protect both men and women from HPV-related cancer and sexually transmitted disease. Higher incidence of certain HPV-related male cancers, lack of effective treatment, high prevalence of HIV, attitudes to MSM and sexual orientation, all support a universal vaccination strategy for LMICs. Thus, policy-makers and healthcare providers in LMICs need to take timely decisions to “prevent the preventable” by providing vaccination for both girls and boys.