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Note that the total benefit of male vaccination is still underestimated because our model does not allow for quantification of herd immunity in non vaccinated men who have sex with men resulting from a reduced homosexual transmission.ResultsBurden of HPV associated cancers in men before vaccinationWe estimate that 16.8 (95% credible interval 13.7 to 20.3) QALYs per thousand men were lost to HPV related cancers before HPV vaccination in the Netherlands. Vaccine preventable types that is, HPV 16 and 18 accounted for 89% (86% to 92%) of the total burden of HPV related cancer among men. The projected loss due to vaccine preventable cancers was 14.9 (12.2 to 18.1) QALYs per thousand men, of which 8.4 (6.0 to 11.3) QALYs per thousand men were lost to oropharyngeal squamous cell carcinomas, 5.2 (4.5 to 6.0) to anal carcinomas, and 1.1 (0.7 to 2.4) to penile cancer.

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