Ask the Pharmacist

Q: I understand that the health care system is going to start giving the vaccine against the Human Papillomavirus (HPV) to boys in Grade 7 this fall. What are your thoughts on that?

A: We am all for it and not because it will be good for business. In fact, from a strictly dollars and cents point of view, when vaccines become part of the publicly-funded program (rather than a pay-if-you-want-it), that means a loss of revenue for the retail pharmacy industry.

That being said, we believe you will find very few pharmacists who think this is a bad idea going forward. Ontario has joined Alberta, Prince Edward Island and Manitoba as the only provinces to offer the HPV vaccine free to boys (all provinces provide this same vaccine free of charge to girls), although British Columbia does pay for the vaccine for those men or boys who self-identify as those who will have sex with men or are willing to admit they live on the streets.

All provinces offer the HPV vaccine free to girls in elementary school (this year it has been moved up to being administered in Grade 7) in order to protect them before they become sexually active.

The provincial government had been extensively lobbied by numerous groups, including the Canadian Cancer Society, the Canadian Medical Association and the Society of Obstetricians and Gynecologists, to extend coverage to boys with the underlying argument being that boys deserve the same protection that girls receive, and the facts seem to support this.

It is estimated that 75 per cent of all sexually-active Canadians will have an HPV infection at some point in time if not immunized. While many will have their immune system fight off this infection and be left with no lasting harm, others will not be so lucky. It is also very common for someone to be infected with HPV and have no symptoms but still be fully capable of passing it along to a partner who may not be so lucky.

HPV is well known to most people as being responsible for genital warts and cervical cancers but what is less well-advertised is that it is also responsible for numerous cases of penile, anal, throat and mouth cancers. That lack of awareness may change with the release of a recent report from the Canadian Cancer Society which found that over the past 20 years, HPV-related mouth and throat cancers rose by 56 per cent among men and 17 per cent among women.

The fear is that if these trends continue and males are not protected automatically, the number of new cases of HPV-related mouth and throat cancers in men will soon surpass cervical cancer cases in women. In fact, the cancer society claims that men are four times more likely to suffer from these oral cancers than women are. And while most cases of HPV infection are spread during sexual activity (including oral sex), it is not necessary to have intercourse to get HPV as the virus can be passed through intimate skin-to-skin contact (i.e. hand-to-genital or genital-to-genital) with an infected person.

So clearly, there is a need to protect boys just as much as there is to protect girls.

As well, cost to the taxpayers is not a valid reason not to offer this protection to boys as a recent study by Toronto-based researchers found that universal coverage could save the province between $8-million to $28-million over the course of its lifetime by preventing the very high treatment costs these cancers entail.

The other major argument in favour of coverage is that the HPV vaccine is both highly-effective and safe. It can prevent the infections that are associated with approximately 70 per cent of all cervical cancers, 92 per cent of anal cancers, 63 per cent of penile cancers, 89 per cent of the relevant types of throat cancers, and almost 90 per cent of genital warts. And its safety record is such that it is now used in more than 100 countries and more than 175-million doses have been distributed worldwide.

There are no common side effects but some recipients do experience arm pain or swelling and redness at the injection site and, rarely, some will experience nausea, dizziness, a headache or a fever lasting usually one to three days after receiving the dose.

The vaccine is administered in two doses, six months apart, although those who receive their first dose after age 14 or who have a compromised immune system, will require three shots over this same six-month time frame. Experts are unsure of just how long the protective effects will last but they are expected to be long-term.

For more information about this or any other health-related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination. Also check the website at www.gordon-pharmasave.com/ and the Facebook page at www.facebook.com/GordonPharmasave/?fref=ts