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Expand HPV vaccination programs in Canada to include males

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Expanding human papillomavirus (HPV) vaccination programs to include males in Canada will help protect them against HPV-related cancers, according to an analysis published in CMAJ (Canadian Medical Association Journal) (pre-embargo link only) http://www.cmaj.ca/site/press/cmaj.150451.pdf.

HPV is the most common sexually transmitted disease in Canada and is linked to cancers of the oral cavity, pharynx, penis, anus and others, in addition to causing cervical cancer and anogenital warts. Men who have sex with men are at high risk of HPV-related diseases.

However, only three provinces — Alberta, Nova Scotia and Prince Edward Island — offer the HPV vaccine to boys through school-based vaccination programs. Manitoba and Quebec have pledged to extend their programs to boys in fall 2016.

"It is important for policy-makers to be cognizant that HPV infection causes cancer in males as well as females, that heterosexual males will not be consistently protected by herd immunity with current rates of HPV vaccination in females, and that [men having sex with men] will not be protected by female-only programs," writes Gilla Shapiro, McGill University and the Jewish General Hospital, Montréal, Quebec, with coauthors.

Evidence indicates that the HPV vaccine is safe and effective.

The authors cite barriers to adoption of the HPV vaccine in boys that include the misconception that HPV is only a women's health issue, not receiving a recommendation from a doctor or health care provider, and concerns over costs; in provinces where the HPV vaccine is not provided free, the cost of one dose is about $150, and multiple doses are required.

The authors recommend that HPV vaccination programs across all Canadian jurisdictions become gender neutral. To address finite health care resources, they suggest negotiating with pharmaceutical companies to decrease the cost of the HPV vaccine and changing the vaccination schedule from 3 to 2 doses, which is in line with international recommendations.

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Kim Barnhardt
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@CMAJ

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