By Gilla Shapiro,
and Zeev Rosberger
The human papillomavirus (HPV) vaccine should be available to all Canadian children. However, the children of the North still don’t have universal access to this life-saving vaccine.
Now that Newfoundland and Labrador has announced funding for the HPV vaccine for boys, all children in Canada’s 10 provinces have access to the vaccine that helps prevent cancer. This is great news. But unfortunately for children in the North, the governments of Northwest Territories, Nunavut and Yukon have not yet made this disease-preventing and life-saving decision.
That no Canadian territory offers the HPV vaccine to boys is unjust for at least five reasons:
- Boys need the HPV vaccine. The Canadian Cancer Society reports that the majority of head and neck cancer patients are male and the numbers are rising more quickly in males than females.
- Boys have a special need for HPV prevention. Whereas females have Pap tests to detect early cervical cancer, there is no similar program for males to detect head and neck cancers. Consequently, the Canadian Medical Association, Canadian Paediatric Society and Canadian Cancer Society, among other medical organizations, recommend males be vaccinated against HPV.
- Children in the North don’t have the same population with HPV immunity as in the south. Territorial government reports and parental surveys reveal that their girls are the least likely of all Canadian girls to be vaccinated against HPV. Territorial low female vaccine coverage rates reduce the likelihood that boys will be protected through herd immunity – the protection offered to non-vaccinated people by those who are vaccinated.
- The territories’ people have a greater need for HPV prevention. Research demonstrates that aboriginal people have a higher prevalence of HPV infection and disease than non-aboriginal peoples. Although data is limited and differences among First Nations, Métis and Inuit populations are rarely identified, it appears that the larger HPV disease burden in aboriginal peoples results from unequal access to prevention and screening services.
- Cancer prevention is especially important where there are great distances between people and tertiary cancer care, as exist in the North.
Provincial and territorial governments usually make vaccine funding decisions. The territories’ relatively small populations and vast land mass present unique funding challenges, not least because the territories have the lowest gross domestic product per capita. The federal government could help advance equity in health outcomes across Canada by funding HPV vaccination for boys.
The Truth and Reconciliation Commission’s report called on Parliament to close the health gaps between aboriginal and non-aboriginal communities in a number of areas, including chronic disease, life expectancy and the availability of appropriate health services. The federal government can help reduce chronic disease and increase life expectancy by making available to all children an appropriate preventive health measure. Such a decision would reduce the need for people to seek medical care, reducing health spending.
The disparity in HPV cancer prevention and care is unacceptable. Canada can do better. If Canada were to vaccinate all boys and girls against HPV, it would join Australia, Austria, Israel, Italy and Switzerland in taking such measures to prevent HPV-related cancers in a generation of children.
Former NDP leader and medicare’s founding father Tommy Douglas said, “My dream is for people around the world to look up and to see Canada like a little jewel sitting at the top of the continent.” It’s time for the federal government to help all Canadian children avoid the suffering of HPV-related disease by funding vaccination for Northwest Territories, Nunavut and Yukon boys.
Gilla Shapiro is a doctoral candidate at McGill University and a Vanier Canada Graduate Scholar. Juliet Guichon is assistant professor, Cumming School of Medicine, University of Calgary. Zeev Rosberger is an associate professor, department of psychology and faculty of medicine, McGill University and Jewish General Hospital.
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