Early oral HPV vaccine expected in Canada

Image copyright Getty Images Image caption A new Gardasil vaccine protects against the four strains of HPV responsible for genital warts and other infections

Canada’s Chief Medical Officer of Health says she expects oral Gardasil vaccinations to be available within weeks for young children.

Nearly all teenagers in Canada now get a shot against the human papillomavirus (HPV), a common sexually transmitted infection that causes cervical cancer, genital warts and several other cancers.

But officials say the vaccine is not recommended for children less than 10 years old.

Leading companies are expected to offer the oral vaccine for children under five.

Experts say this is better than older vaccines, such as those used to prevent cervical cancer, because vaccines to protect against HPV infection normally don’t have to be taken immediately after sex.

There are older vaccines used to prevent other HPV infections but this will be the first oral vaccine to protect against the four types of the virus that cause most cervical cancers.

Image copyright Getty Images Image caption A new HPV vaccine protects against the four strains of the virus responsible for genital warts and other infections

In the UK, there are hopes that the “morning after” form of Gardasil – another of the main HPV vaccines on the market – will also be available soon.

Cancer Research UK’s Dr Tor Ekelund said many of the Gardasil vaccine’s side effects were due to immune-suppression, rather than the actual vaccine itself.

“There are side effects when vaccination is administered for other vaccines such as hepatitis B and diphtheria that people can’t see. There can be increased blood pressure or muscle stiffness or tenderness in the injection site.

“It’s a question of recognizing what the risks are and getting them recognised.”

Why not give it earlier?

Health care professionals say they are conflicted over whether it is right to give young children the Gardasil vaccine before they are old enough to have sex.

“Obviously we can’t give the oral vaccine to young children but we would rather give them the vaccine than not be able to protect them,” said Dr Ekelund.

But Dr Elissa Eiserman, chief executive officer of the Immunotherapy Alliance in Toronto, said she thinks it is not a good idea to encourage young children to have sex.

“It isn’t recommended, but I don’t think I would offer it because I think its important for a lot of children to not start having sex until they are old enough to manage it themselves.”

She said it is important the vaccine is given to 10- to 18-year-olds, not just children.

There are two separate body parts – the cervix and the vagina – that are susceptible to HPV infection and two virus types – HPV 16 and HPV 18 – that cause the majority of infections.

Dr Eiserman said the HPV vaccines don’t prevent sexual infection and that the shots may add an additional component to “preventative care”.

Although it’s far too early to tell how well the oral vaccine will protect kids against cancer, Dr Eiserman said it was “a step in the right direction”.

Dr Seena Fazel, a GP at University College London, said he’s surprised the oral vaccine hasn’t been marketed earlier.

Image copyright Getty Images Image caption Study after study have found the GPDV vaccine is extremely effective at protecting children against HPV infections

“For young children, it’s not 100% [effective] but it’s at least one, maybe two, effective types of HPV.”

Dr Fazel said he plans to keep offering the oral vaccine because he wants parents to know they can protect their children.

“Even if it isn’t 100% effective, it’s worth trying to protect them. Most people would say that and that’s my point.”

Image copyright AFP Image caption Some young people fear HPV vaccination can undermine virginity.

Dr Eiserman doesn’t think it will “negatively impact” the sexual behaviour of children but she has concerns it may make them “more susceptible to sexual exploitation, particularly if the girls have had no other form of protection for HPV”.

She added: “Because this is a new vaccine, we don’t know what side effects there might be, there could be things like peripheral inflammation but we would be naive to assume they are completely harmless.”

Vaccine concerns

Most parents are more likely to question whether an oral vaccine – without the obvious side effects of the injection – will be more acceptable.

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