In January, the National Advisory Committee on Immunization released a report recommending that Health Canada begin vaccinating boys against human papillomavirus (HPV). This same vaccine has been available to women in Canada since 2008 to protect against cervical cancer. Why has it taken so long for the vaccine to be made available to boys, when we know that HPV causes cancer in men, too? The answer lies not in sound science, but in the politics of sex.
HPV vaccination has been a polarizing issue since clinical trials were initiated in the 1980s, and the debate has centered on the initiation of sexual activity in girls. HPV is a sexually transmitted infection. Over 75 per cent of the Canadian population will be infected with HPV at some point in their lives. In order to offer the best protection against acquiring HPV, vaccination needs to begin before the initiation of sexual contact, not just sexual intercourse.
A clinical trial published in the New England Journal of Medicine demonstrated the efficacy of the vaccine in women aged 15 to 26, many of whom were already sexually active. In this study, as in many others, the average age at first intercourse ranged from 14 to 18. One can assume that the age at first sexual contact – kissing, touching, or petting – precedes intercourse by a few years. Hence, when the vaccine was first made available in 2007 in the United States, it was approved for administration to girls and women aged nine to 26. At that time, however, the vaccine was not approved for boys (of any age).
The Christian right and pro-family lobby groups in the U.S. were enraged by the implication that girls as young as nine years old are sexually active, and even went so far as to argue that by vaccinating girls this young, the medical establishment was promoting promiscuity. As a result, many girls eligible for the vaccine were denied the opportunity to be immunized.
On the other hand, by limiting vaccination to women under the age of 26, the implication was that no woman over 26 could be sexually naïve, and/or that the vaccine isn’t effective in women already exposed to HPV. While both statements are false, the age restriction that spurred them nevertheless eliminated another segment of the population that could have benefitted from this vaccine.
The entire debate over the appropriate age for vaccination misses the point. The vaccine is an effective preventative measure for many HPV-related cancers. It has the ability to prevent 270,000 deaths annually caused by cervical cancer in women worldwide, and many additional deaths from oropharyngeal, penile, anal, and vulvar cancers. When in history have we overlooked a cancer fighting opportunity like this? When have we vaccinated children based on gender? The virus doesn’t discriminate: This is not just a women’s issue. HPV can infect anyone. We need to get rid of the stigma attached to the vaccine by making it available as part of the routine childhood vaccination schedule for girls and boys alike.
Photo courtesy of Reuters.
There are no comments yet