HPV Vaccine Coverage

July 2011

ACT supports expanding access to the HPV vaccine, regardless of sex or gender, to reduce transmission of the cancer-causing virus and to save long-term health care costs. Allowing males to access the vaccine for free would allow men and women to take equal responsibility for preventing HPV, and also provide protection for gay men.

This could be implemented through a combination of the following strategies:

    • Expanding Ontario’s school-based HPV vaccination program to allow all students to participate, regardless of sex or gender.
    • Providing the HPV vaccine for free to males, females and trans people up to the age of 26, via public health units, sexual health clinics, HIV clinics and primary care physicians.

Background:

In July 2006, Health Canada approved a new vaccine to provide protection against four types of human papillomavirus (HPV), which can cause cancer and genital warts. Due to the limited research studies available at the time, Health Canada only licensed the vaccine for use in females aged 9 to 26 years. In 2007, the Government of Ontario rolled out a free province-wide school-based vaccination program for female students.

After studies demonstrated the effectiveness of the vaccine in preventing pre-cancerous anal lesions and genital warts in men, Health Canada approved its use on males aged 9 to 26 years in February 2010. However, Ontario’s school-based HPV vaccination program has not yet been extended to male students.

HPV is of particular concern to gay, bisexual, and other men who have sex with men, who are 17 times more likely to develop anal cancer than heterosexual men. Among HIV-positive gay men, the likelihood is even higher. The HPV vaccine prevents 77.5% of pre-cursor lesions to anal cancer in gay and bisexual men. Yet gay men do not benefit from the current vaccination program, and they must pay for the vaccine out of pocket, costing each individual hundreds of dollars.

Limiting the HPV vaccine to females also limits the effectiveness of the program in a heterosexual context, by reducing the number of eligible participants. Providing the vaccine for free to all eligible males would allow everyone – regardless of their sex or gender – to share responsibility for preventing HPV.

HPV vaccination not only benefits the health of the individual and our communities, but also reduces long-term costs in the health care system by preventing illnesses. In one modeling study by the Harvard School of Public Health (The Lancet Infectious Diseases. 10(12):845-52, 2010 Dec.), vaccination of gay, bisexual and other men who have sex with men would provide a cost effectiveness ratio of up to $15,290. The study found that vaccination was cost effective for this population even up to the age of 26, pointing to the benefit of expanding free access beyond school-based programs.

The health and economic benefits of HPV vaccination demonstrate the need to eliminate barriers by expanding coverage beyond the existing school-based vaccination program.