Everyone deserves HPV vaccinations free of charge

Are you a male who’s sexually active, straight, HIV negative, and not “street involved”? If you are, tough luck, because you aren’t eligible to receive the human papillomavirus (HPV) vaccine for free.

Under the current BC policy, you can get its cost covered if you are a female aged 12 to 22, or if you are a nine- to 26-year-old male at “increased risk” of HPV — for instance, if you “have sex with men [. . .] are street involved, [or] are HIV positive.” If you don’t fall into those categories though, you’re going to have to pay $300–450 to get the vaccine.

It makes sense when you consider that cervical cancer, which is most often caused by HPV, was “the second largest cause of cancer deaths in women” back in 2006, according to U.S.-based research conducted by the National Center for Biotechnology Information, when the free vaccination program started. Now, with HPV-caused cancers on the rise in males, it’s time to consider broadening our attention.

The Public Health Agency of Canada estimates that over 70 percent of “sexually active Canadian men and women” contract HPV eventually. While HPV is often harmless, every year sees cases of it leading to genital warts, lesions, and fatal cancers. Health organizations throughout Canada are recommending the HPV vaccine for people of all genders.

Why, then, are we not vaccinating everybody for free? The BC Centre for Disease Control’s official response seems to be that it is not cost-effective. However, the study they cite has its flaws.

The study was conducted in the United States, using data solely gathered from US research; while our countries share many similarities, that doesn’t necessarily make our populations interchangeable for research purposes. It was performed using simulated models rather than in any kind of real-life setting. Furthermore, it was based on vaccine prices from 2006, while the study itself was from 2009.

We live in a rapidly changing world, and the prices have undoubtedly changed within the last 10 years. So why isn’t there more Canadian research into the cost-effectiveness of the vaccine for men?

Perhaps because there isn’t even enough research on how many men actually have HPV. As acknowledged by the Public Health Agency of Canada, while female occurrence of HPV is well-studied, there’s “limited data on the natural history, epidemiology, and burden” of HPV occurrence in men.

The Public Health Agency of Canada cites a meta-analysis of over 40 different HPV studies that found estimates of HPV occurrence in men ranging from 1.3 percent to 72.9 percent. That’s a large gap, and before we can truly determine if it would be cost-effective to freely provide the vaccine to men, we need more concrete numbers as to how many men in BC are actually suffering from HPV.

It’s often said that by immunizing females, men will indirectly be protected from HPV. Yet, there was a study published just this year, looking at anogenital warts (AGW) as an indicator of HPV. The study showed that while the implementation of the HPV vaccination program for females in Ontario in 2007 has resulted in lower AGW rates in females, the incidence of AGW in males has actually increased since then.

Anyone can be a victim of HPV and its related cancers, and we should be prepared to service anyone whose quality of life could be affected by such a disease. If we’re going to recommend that everyone be vaccinated against HPV, we should likewise find solutions to provide proactive vaccination to everyone — not just certain parts of the population.