An analysis has recommended expanding human papillomavirus (HPV) vaccination programs to include males in Canada because it will help protect them against HPV-related cancers.1

HPV is the most common sexually transmitted disease in Canada and is linked to various cancers (eg, the oral cavity, pharynx, penis, anus) in addition to causing anogenital warts and cervical cancer in women. Men who have sex with men are at high risk of HPV-related diseases.

Currently, only the provinces of Alberta, Nova Scotia, and Prince Edward Island offer the HPV vaccine to boys through school-based vaccination programs, while Manitoba and Quebec plan to extend their programs to boys this fall.

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“It is important for policy-makers to be cognizant that HPV infection causes cancer in males as well as females, that heterosexual males will not be consistently protected by herd immunity with current rates of HPV vaccination in females, and that [men having sex with men] will not be protected by female-only programs,” wrote Gilla Shapiro, a PhD student at McGill University and the Jewish General Hospital, Montréal, Quebec, with coauthors.

The authors explained that several barriers exist for adopting the HPV vaccine for boys. These include the misconception that HPV is only a women’s health issue, not receiving a recommendation from a doctor or health care provider, and concerns over costs. In provinces that do not provide the HPV vaccine for free, a single dose costs approximately $150, and multiple doses are required.

The authors recommend that HPV vaccination programs across all Canadian jurisdictions become gender neutral. To address finite health care resources, they suggest negotiating with pharmaceutical companies to decrease the cost of the HPV vaccine and changing the vaccination schedule from 3 to 2 doses, which is in line with international recommendations.


1. Shapiro GK, Perez S, Rosberger Z. Including males in Canadian human papillomavirus vaccination programs: a policy analysis [published online ahead of print April 25, 2016]. Can Med Assoc J. doi:10.1503/cmaj.150451.