England is launching a gonorrhea vaccine. Is Canada next?

England will soon begin administering a vaccine to high-risk individuals that may reduce their chances of contracting gonorrhea, but a similar program is not yet in the cards for Canada.

According to studies cited by England's National Health Service, the 4CMenB vaccine, which is presently used in Canada for immunization against meningitis B, has an effectiveness of 32.7 to 42 per cent against gonorrhea.

To combat rising infection rates, the health service said last month it will begin administering the vaccine free of charge in August for those deemed to be at high risk of contracting gonorrhea, including gay and bisexual men who have a history of sexually transmitted infection or multiple sex partners.

But the vaccine has not been authorized for this use in Canada, even as cases of gonorrhea continue to rise across the country.

According to the most recent national statistics, rates of the sexually transmitted infection more than tripled in Canada from 2010 to 2022, going from 11,381 in 2010 to 35,956 in 2022.

Gonorrhea, often referred to as "the clap," is passed on through oral, anal or genital sex.

People who've been infected, especially women, often show no symptoms at all. If left untreated, it can have serious health risks.

In an interview with CBC News on Monday, Calgary physician Caley Shukalek, the chief medical officer for Freddie, an online service that focuses on 2SLGBTQ+ health care, said it's still too soon to know how effective the 4CMenB vaccine will be at preventing new gonorrhea infections.

Early research hasn't been conclusive either, Shukalek said, citing another study conducted by researchers in France that suggested the vaccine may not have any statistical effect on gonorrhea rates.

"I think in the medical community, there's still a bit of skepticism," he said, noting that more research needs to be done before the true impact is known. 

The potential upside is promising enough, however, that Shukalek said he has begun prescribing the vaccine to some people who are willing to pay for it out of pocket or through private health insurance.

"Its safety is very well established, so for those at high risk of STIs, I think this is a very worthwhile thing and something that could be considered," he said.

"But because it's kind of what we call off-label, it absolutely is something that needs to be a discussion between a prescriber and a patient to make sure that it's the right decision based on their individual risk."

The vaccine is typically administered in two phases, he said, with the second dose coming at least four weeks after the first.

Regular testing key for preventing spread 

Chris Aucoin is the executive director of the Health Equity Alliance of Nova Scotia, a group that advocates for those living with HIV and members of the 2SLGBTQ+ community.

He's aware of the latest research on the use of the 4CMenB vaccine to help prevent the spread of gonorrhea, but notes that even if it's approved, it would only be one part of a potential prevention strategy.

Aucoin said the best thing people can do now and in the future to prevent the spread of gonorrhea is to get tested regularly.

"If people are concerned about gonorrhea rates, which are too high … the biggest factor in that for me is the fact that people don't test regularly enough."

He said the recent launch of Nova Scotia's STI Care Now program, which mails out free at-home testing kits for chlamydia, gonorrhea and HIV to anyone interested across the province, is a positive step toward making this easier.

"We now have a tool that's accessible to them in a way that's never been the case in Nova Scotia," he said.

In a statement, the Public Health Agency of Canada said the National Advisory Committee on Immunization is monitoring the latest research on the 4CMenB vaccine.

In a 2023 report, the advisory committee noted that although the vaccine is not currently authorized for this purpose, it may "offer some level of cross-protection against gonococcal infection."

The agency said it expects the committee to further assess this possibility as more evidence becomes available. 

Nova Scotia's Department of Health and Wellness echoed this statement, noting that it takes its cues on immunization from the committee

Those looking to pay out of pocket for the vaccine in the private market would be looking at around $200 per dose, the department said. 

In 2024, there were 368 new cases of gonorrhea reported in Nova Scotia.

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