California sees first statewide teen male vaccination plan

Once Ontario health minister publicly funded boys’ vaccine for HPV, province will open the pandora’s box of what parents want from vaccines

Three weeks after Ontario announced it would begin making Cervarix, a vaccine for the human papillomavirus (HPV), available to boys as young as nine, Alberta Health is close to releasing its own version.

If Alberta provides universal coverage for the vaccine, as Ontario plans to do with the boys’ version, it will serve as a beacon for vaccination policy in the rapidly growing school vaccination segment, potentially seeing an aggressive rollout that could enable adolescent vaccination rates to begin meeting the United States and UK averages.

It’s not official yet, but Alberta’s vaccine is also expected to include vaccinating all boys between the ages of five and 11 against HPV, the same age bracket where Cervarix is covered, said Hugh Wirth, a senior scientist at Calgary’s Stollery Children’s Hospital and a scientist on vaccine safety and effectiveness at the University of Calgary.

Ontario became the first province in Canada to publicly fund the boys’ HPV vaccine, which protects against four HPV types that cause about one in 10 cases of genital warts and one in six cases of cervical cancer in females. Immunization rates are still extremely low in Canada, with only about one out of five teenage girls in Ontario inoculated, according to the Canadian Paediatric Society.

Opposition from parents remains strong to the male-only HPV vaccine, with some asserting that it is too confusing and unnecessary for their daughters. This also comes at a time when, according to Alberta’s public health agency, more than 12,700 boys in the province have been diagnosed with cases of HPV. Alberta is next in line to choose between Cervarix and Gardasil, the female HPV vaccine, although it has not indicated which option it will use.

“I would suspect it will be pretty similar to Ontario,” said Wirth, regarding Alberta’s choice of vaccination regimen. “There’s no evidence that there’s any difference in immunological profiles that make females more vulnerable or make males more susceptible to adverse side effects.”

Because of the clinical trials and evidence gathered for Cervarix, Alberta’s boys’ vaccine will be administered in a more streamlined and consistent way, Wirth explained. The girls’ vaccine has to be administered in three doses before puberty, which is more complicated for boys to adhere to, he said.

“If you’re already vaccinated with the girls’ HPV vaccine you’re supposed to be titrated [reduced] to a very, very small dose by the boys to prevent or to reduce likelihood of developing cervical cancer in a very short period of time,” Wirth explained.

Provincial public health agencies in Ontario and Alberta have become inundated with phone calls and e-mails from concerned parents, Wirth said. Some, like Jennifer Desres, registered nurse at the Mount Royal University Clinic in Calgary, are hearing from parents eager to learn more about Cervarix and express their unhappiness at their selection.

“I’ve had a lot of parents calling in saying ‘I’m really surprised to hear that they’re still allowing this as their insurance option in Ontario’,” Desres said. “They’re shocked that we’re continuing to go down this path … a lot of parents do want more information.”

Since Ontario announced that it would require all teenage girls to be vaccinated against HPV, Desres’ clinic has been inundated with inquiries from concerned parents about that same vaccine, asking questions such as why girls still haven’t been covered for the vaccine. She said parents are wondering why the “meat and potatoes” group – boys – should get protected when girls are neglected.

“You hear all the time about why girls aren’t getting their vaccine and why it’s such a problem,” Desres said. “They’re starting to wonder why there’s just such a disparity.”

At the moment, Ontario only gives free annual shots for girls. A plan is in the works for booster shots, to be administered every three years. Alberta’s plan, if launched successfully, could pave the way for Ontario to consider a one-dose booster, like Cervarix, Desres said.

“These plans are two steps further than I’ve seen anywhere else,” she

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