Boys should also get HPV protection

B.C. I Boys as well as girls should be offered the free HPV vaccine to stop the spread of the cervical cancer-causing disease, former deputy health minister Dr. Penny Ballem says.

The vaccine, which will be offered by the provincial government to girls entering Grade 6 and 9 on a voluntary basis next year and women up to age 26, is not even licensed for use on males in Canada.

But Ballem insists that should change if the province is intent on controlling the spread of the human papillomavirus, which can lead to cervical cancer in women and genital warts and other cancers in both sexes.
“If you really want to wipe out a scourge, you have to go after the people who carry the virus and pass it on,” Ballem said. “There needs to be more of a burden on men in our society in protecting women.”
The virus is among the most common sexually transmitted infections in Canada. The vaccine, Gardisil, targets the two strains of the infection responsible for 70 per cent of cervical cancer.

Boys and men can only access the vaccine “off label” from their doctors if they want it but will have to pay the full cost, which is about $300 to $400 for treatment, said provincial health officer Dr. Perry Kendall.
Kendall said although there are calls to offer the vaccine to men, he doubts doctors are recommending it to males because of the high cost. Nor does he think it will be offered to the male population in the next year because it hasn’t been tested or licenced for use on males in Canada.

If it was to spend $100 million, he said, the government would likely to find other areas where the money could be better spent.

He noted it would about $8 million to vaccinate the Grade 6 girls, but said if you calculated over a lifetime how many deaths the vaccine would prevent and the quality of life for survivors, it works out to “$25,000 per quality of life adjusted year.”

For males, it would be about $35,000.

“The question is the return worth the investment?” he said.
“If the price comes down substantially it might be something you offered to both sexes.”
Kendall noted that while HPV can cause genital warts and a few hundred cases of penile and other cancers in males, it carries a higher risk for women, who can get cervical cancer and be possibly rendered sterile if they require invasive surgery to their cervix.

Cervical cancer is the second most common cancer for Canadian women aged 20 to 44, with 150 women contracting the disease each year, he said. Of those about 50 die annually.
“Far fewer boys die from cancer associated with HPV and no one dies from genital warts,” Kendall said. “We’re doing it for cancer.”

But Ballem said she doesn’t believe the decision to offer the vaccine to only girls and women was well thought out, noting there are “gaps in the coverage.”

The vaccination, which requires three shots over six months, will not prevent all cervical cancers, meaning women will still have to have annual pap smears, she said.
She added girls may even get false sense of security that sex is safer than it is because they’ve had the vaccine.
Apart from passing on the disease, she maintains that by vaccinating boys it would help boost immunity across the sexually active population.

She added women are more vulnerable to disease because they have more mucus membranes exposed to bodily fluids than men.

“The focus was never on where do they get the virus from? They get it from men,” Ballem said. “Frankly, maybe we should go after the source of HPV and the people who are spreading it around.”

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