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The case for HPV vaccines for Canadian gay men

Why isn’t the vaccine funded universally?

HPV is killing gay and bisexual men.

Over 60 percent of men who have sex with other men carry the sexually transmitted virus that can cause anal, throat and penile cancers in men, as well as genital warts. According to the Centers for Disease Control and Prevention (CDC), these men are also 17 times more likely to get anal cancer than straight men.

Yet, in all but three Canadian provinces — Alberta, PEI and Nova Scotia — HPV vaccinations are not government-funded for boys.

The explanation most often trotted out is that it is a matter of cost. The thinking goes that if enough women get immunized — more than half, according to CBC report — the entire population will be protected by herd immunity.

But according to Dr Natasha Crowcroft, the chief of applied immunization research at Public Health Ontario, that leaves out an entire segment of the population.

“What has been seen in other countries is that [the vaccine] is so effective that the virus almost disappears if you just give it to girls,” she says. “That doesn’t help gay men.”

And while offering HPV immunization universally would cost more, it likely wouldn’t require significantly more money than is used to immunize just girls now. In Alberta, where the program was expanded in 2013, it costs $11 million a year to offer the vaccine, including a catch-up program, according to the Globe and Mail.  

In Nova Scotia, immunizing Grade 7 boys added about $492,000 to the 2014 budget, compared to the $693,000 it costs to immunize girls, according to a CBC report.

And the long-term savings may outweigh any initial costs. A recent study published in Cancer recommended vaccinating boys, noting that the savings from not treating throat cancers caused by HPV could be upwards of $8 million, according to a Toronto Star report.

There is strong evidence to support vaccinating men — Crowcroft even points out that some people believe it would be more effective to only vaccinate men.

“If you want to protect gay men and women, if you just vaccinated boys you would probably do both,” she says, noting that the herd immunity would then extend to women.

“There’s quite an appeal to that, because, speaking as a woman, it’s always the women who have to have the vaccines.”

Ontario, along with many other provinces, continues to only immunize girls. Ministry of Health spokesperson David Jensen tells Daily Xtra that it is currently reviewing its HPV immunization program to determine if additional changes are required.

In England, where they too are debating who should be immunized, four doctors who recently spoke to Buzzfeed were more direct in their criticisms.

For instance, Dr Max Pemberton said that not giving boys the vaccine was “institutional homophobia.” Another, Dr Christian Jessen, called it discrimination — one born by those unwilling to confront illness so closely tied sexual activity.

HG Watson can be reached at hg.watson@dailyxtra.com or @hg_watson on Twitter.