By Karin Yeske

Sask. considering HPV vaccine for boys

Jan 29, 2014 | 10:03 AM

By this fall, boys in Alberta and Prince Edward Island will be getting free HPV immunizations but Saskatchewan is not ready to do the same.

“HPV is quite an expensive vaccine so there is significant cost considerations. As we look at our overall vaccine budget, the HPV vaccine is one of the more expensive vaccines that we provide. Obviously adding or doubling the amount of vaccine that we have to provide would actually be quite a cost. We have to look at the cost-benefit. We have to look at public demand and acceptability … before we make that decision,” Dr. Saqib Shahab, chief medical health officer for Saskatchewan, said.

Grade 6 girls have been getting the vaccine in the province since 2008. When it was first licensed, it was approved for women aged nine to 26. That has increased to include women up to the age of 45.

“Most provinces had to consider first of all, are they going to start this immunization program and if so, at which age group?” he said.

“It is quite cost prohibitive to give it to everyone in that age group so it was initiated only for women who were entering Grade 6 at that point.”

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Girls born in 1996 or later in Saskatchewan are eligible to receive the free HPV vaccine but if for some reason, if a woman didn’t get the vaccine in Grade 6, she can get it later through the catch up program.

It wasn’t until 2012 that the National Advisory Committee on Immunizations (NACI) recommended that boys should also be immunized.

“Currently, there are two HPV vaccines available on the market. One is actually licenced for both women aged nine to 45 now and for men aged nine to 26,” Shahab said.

“The recommendation is that even young men should receive the HPV vaccine but unfortunately in Saskatchewan as in most provinces, it is not currently part of the publicly funded program.”

The HPV immunization is quite expensive and would retail around $500 to $600 for the three scheduled doses. The cost of immunizing girls in a year is an estimated $2 million and including boys would double it. While the vaccine is free, the uptake for girls is around 60 per cent.

Cervarix is licensed for use in Canada, which protects women against the two main strains that cause about 70 per cent of all cervical cancers.

Gardasil, which Saskatchewan uses, is licensed for girls and boys. It protects against four strains, two of which cause about 75 per cent of cervical cancers and two more types that cause about 90 per cent of genital warts. In boys, it helps protect approximately 90 per cent of genital warts and in girls aged nine to 26, it helps protect against about 70 per cent of vaginal cancer cases and up to 50 per cent of vulvar cancer cases.

In 2013, Prince Edward Island was the first province to offer the HPV immunization to boys. This fall, Alberta will also offer the vaccine to boys.

“Certainly I think there is movement happening towards adding boys in two provinces so far out 13 provinces and jurisdictions. Certainly we are interested in exploring the potential for adding boys. We think there would be tremendous benefit in terms of reducing the burden of not just cervical cancer but penile cancer,” Shahab said.

“This is an increasing area of concern and interest so we are actively looking at if and when we can include HPV vaccines for boys as well. Even if we did, that would be restricted to a certain age.”

All men aged nine to 26 should be aware that NACI recommended boys be immunized, Shahab said. He understands the out-of-pocket cost is significant but he encourages it.

“As a physician, my advice would be you should strongly consider immunizing both boys and girls with the HPV vaccine,” he said.  

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