Boys de­serve ac­cess to HPV vac­cine

Of­fer­ing cancer-pre­vent­ing im­mu­niza­tion is part of clos­ing re­gional health gaps


The hu­man pa­pil­lo­mavirus (HPV) vac­cine should be avail­able to all Cana­dian chil­dren. How­ever, the chil­dren in the North still don’t have univer­sal ac­cess to this life­sav­ing vac­cine.

Now that New­found­land and Labrador has an­nounced funding for the HPV vac­cine for boys, all chil­dren in Canada’s 10 prov­inces have ac­cess to the vac­cine that helps pre­vent cancer. This is great news. But un­for­tu­nately for chil­dren in the North, the gov­ern­ments of the North­west Ter­ri­to­ries, Nu­navut and Yukon have not yet made this dis­ease-pre­vent­ing and life­sav­ing de­ci­sion.

That no Cana­dian ter­ri­tory of­fers the HPV vac­cine to boys is un­just for at least five rea­sons:

Boys need the HPV vac­cine. The Cana­dian Cancer So­ci­ety re­ports that the ma­jor­ity of head and neck cancer pa­tients are male and the num­bers are ris­ing more quickly in males than fe­males.

Boys have a spe­cial need for HPV preven­tion. Whereas fe­males have Pap tests to de­tect early cer­vi­cal cancer, there is no sim­i­lar pro­gram for males to de­tect head and neck can­cers. Con­se­quently, the Cana­dian Med­i­cal As­so­ci­a­tion, Cana­dian Pae­di­atric So­ci­ety and Cana­dian Cancer So­ci­ety, among other med­i­cal or­ga­ni­za­tions, rec­om­mend males be vac­ci­nated against HPV.

Chil­dren in the North don’t have the same pop­u­la­tion with HPV im­mu­nity as in the South. Ter­ri­to­rial gov­ern­ment re­ports and parental sur­veys re­veal that their girls are the least likely of all Cana­dian girls to be vac­ci­nated against HPV. Ter­ri­to­rial low fe­male vac­cine cov­er­age rates re­duce the like­li­hood that boys will be pro­tected through herd im­mu­nity — the pro­tec­tion of­fered to non-vac­ci­nated peo­ple by those who are vac­ci­nated.

The ter­ri­to­ries’ peo­ple have a greater need for HPV preven­tion. Re­search demon­strates that in­dige­nous peo­ple have a higher preva­lence of HPV in­fec­tion and dis­ease than non-in­dige­nous peo­ples. Although data is lim­ited and dif­fer­ences among First Na­tions, Métis and Inuit pop­u­la­tions are rarely iden­ti­fied, it ap­pears that the larger HPV dis­ease bur­den in in­dige­nous peo­ples re­sults from un­equal ac­cess to preven­tion and screen­ing ser­vice.

Cancer preven­tion is es­pe­cially im­por­tant where there are great dis­tances be­tween peo­ple and ter­tiary cancer care, as ex­ist in the North.

Pro­vin­cial and ter­ri­to­rial gov­ern­ments usu­ally make vac­cine funding de­ci­sions. The ter­ri­to­ries’ rel­a­tively small pop­u­la­tions and vast land mass present unique funding chal­lenges, not least be­cause the ter­ri­to­ries have the low­est gross do­mes­tic prod­uct per capita. The fed­eral gov­ern­ment could help ad­vance eq­uity in health out­comes across Canada by funding HPV vac­ci­na­tion for boys.

The Truth and Rec­on­cil­i­a­tion Commission’s re­port called on Par­lia­ment to close the health gaps be­tween in­dige­nous and non-in­dige­nous com­mu­ni­ties in a num­ber of ar­eas, in­clud­ing chronic dis­ease, life ex­pectancy and the avail­abil­ity of ap­pro­pri­ate health ser­vices. The fed­eral gov­ern­ment can help re­duce chronic dis­ease and in­crease life ex­pectancy by mak­ing avail­able to all chil­dren an ap­pro­pri­ate pre­ven­tive health mea­sure. Such a de­ci­sion would re­duce the need for peo­ple to seek med­i­cal care, re­duc­ing health spend­ing.

The dis­par­ity in HPV cancer preven­tion and care is un­ac­cept­able. Canada can do bet­ter. If Canada were to vac­ci­nate all boys and girls against HPV, it would join Aus­tralia, Aus­tria, Is­rael, Italy and Switzer­land in tak­ing such mea­sures to pre­vent HPV-re­lated can­cers in a gen­er­a­tion of chil­dren.

Former NDP leader and medi­care’s found­ing fa­ther Tommy Dou­glas said, “My dream is for peo­ple around the world to look up and to see Canada like a lit­tle jewel sit­ting at the top of the con­ti­nent.” It’s time for the fed­eral gov­ern­ment to help all Cana­dian chil­dren avoid the suf­fer­ing of HPV-re­lated dis­ease by funding vac­ci­na­tion for North­west Ter­ri­to­ries, Nu­navut and Yukon boys.

Gilla Shapiro is a doc­toral can­di­date at McGill Univer­sity and a Vanier Canada Grad­u­ate Scholar. Juliet Guichon is an as­sis­tant pro­fes­sor in the Cumming School of Medicine at the Univer­sity of Cal­gary. Zeev Rosberger is an as­so­ci­ate pro­fes­sor in the de­part­ment of psy­chol­ogy and fac­ulty of medicine at McGill Univer­sity and Jewish Gen­eral Hospi­tal. Dis­trib­uted by Troy Me­dia

… the ma­jor­ity of head and neck cancer pa­tients are male and the num­bers are ris­ing more quickly in males than fe­males.


The HPV vac­cine. Boys in Canada’s North should also be im­mu­nized, the au­thors ar­gue.

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