Last fall, grade six boys in Prince Edward Island began rolling up their sleeves alongside their female classmates to be vaccinated against four strains of the human papillomavirus, or HPV. At the time, PEI was the only province to include boys as well as girls in its optional HPV-immunization program.
This week, the province of Alberta announced that their grade 5 and grade 9 boys will be offered the free shots, as well, beginning September 2014.
Until recently, school-based HPV-vaccination programs in Canada have only targeted girls. Including boys in the program is a move applauded by the Society of Obstetricians and Gynaecologists of Canada (SOGC), which has urged ministers of health in all provinces and territories to follow suit. The recommended age of vaccination is nine, for both boys and girls.
“HPV is a virus that can cause serious illness in both men and women,” says Jennifer Blake, an obstetrician- gynecologist in Ottawa, and CEO of the SOGC. The virus is associated not only with cervical cancer in women, but also anal and penile cancers and, increasingly, cancers of the mouth, nose and throat. HPV can also cause genital warts.
“We now know that the HPV vaccine is equally protective of boys as it is of girls,” says Blake. “And so it makes perfect sense to offer the same protection to both.”
Krista Cassell, a Charlottetown-based obstetrician- gynecologist – and the mother of two boys, ages seven and eight – has seen the effects of HPV all too often in her practice. “It’s a pretty traumatic, terrible thing for young women. If I can prevent that in my boys, or in their partners, that just makes sense.” Cassell plans on vaccinating both her sons once they reach grade six.
School-based vaccination programs – which allow parents to opt out – are designed to immunize kids when their immune systems are most robust, and before they become sexually active and risk exposure to HPV, says Blake. In her experience, most parents wholeheartedly support vaccinating their daughters and sons, but some have expressed concern that HPV vaccine unnecessarily “sexualizes” children.
Blake suggests that singling out girls and women for vaccination has actually highlighted the sexual aspect of what should be a routine health issue.
“By giving it to both boys and girls, we’re really focusing on the fact that this is the right thing to do for children.” And what about parental concerns that vaccinating may encourage kids to become sexually active earlier? “There’s lots of very good data that shows that in fact, no, the vaccine doesn’t change behaviours at all,” says Cassell.
Both doctors point to a strong body of evidence showing that the vaccine is safe and effective. In the “millions” of doses that have been administered worldwide, notes Blake, there have been no serious complications, whereas not being vaccinated poses serious risks.
Maria Lundin, a Toronto mother of two (Felix is 22 months and Simon is seven), says that choosing the HPV vaccine for her sons will be a no-brainer, if it becomes available to boys in Ontario. She’s well aware of the risks posed by the virus after she was diagnosed in her twenties, when a Pap test showed abnormal cell changes on her cervix. By the time Lundin was in her mid-30s and contemplating getting pregnant, her doctors discovered more severe, precancerous cervical cell changes that needed further treatment. She and her partner, Nancy, had to delay conception attempts for a couple of years. Lundin’s treatment also caused complications that made insemination difficult. Ultimately, Nancy ended up carrying both children. “It was a very physically and psychologically stressful time,” Lundin recalls. “It’s hard not to think that life could have been really different had I – or any of the partners I had been with – been vaccinated.”
A version of this article appears in our August 2013 issue, called "Boys and HPV," p.62.