What are HPV vaccines?

The HPV vaccines protect against infection from certain types of human papillomavirus (HPV) that cause cancers of the anus, cervix, mouth and throat, penis, vagina and vulva as well as genital warts. There are 2 HPV vaccines available in Canada: Cervarix^® (HPV2) and Gardasil^®9 (HPV9). The vaccines are approved by Health Canada, with HPV9 approved for use in both sexes, and HPV2 approved for use only in females.

Both vaccines protect against 2 types of HPV that cause about 70% of cases of cervical cancer and 80% of cases of anal cancer. The HPV9 vaccine protects against 5 additional types of HPV that cause 15% to 20% of cervical cancers and 11% of anal cancers in women and 4% in men. The HPV9 vaccine also protects against 2 types of HPV that cause about 90% of cases of genital warts.

Who should get the HPV vaccine?

The HPV9 vaccine is provided free to girls and boys in grade 6.

Boys (born in 2006 or later) and girls who did not get the vaccine in grade 6 remain eligible for free HPV vaccine if they start their vaccine series before their 19^th birthday and complete it before their 26^th birthday.

The HPV9 vaccine is also provided free to individuals 9 to 26 years of age who are:

• HIV positive
• Transgender
• Males who have sex with males, including those who may not yet be sexually active and are questioning their sexual orientation
• Males who are street-involved

Other males eligible for the HPV9 vaccine include those:

• 9 to 18 years of age in the care of the Ministry of Children and Family Development
• In youth custody services centres

Contact your health care provider to get immunized.

Unless mentioned above, the HPV9 vaccine is recommended, but not provided free, for the following individuals:

• Women 19-45 years of age
• Boys and men 9 to 26 years of age
• Men 27 years of age and older who have sex with men

The HPV2 vaccine is recommended, but not provided free, for girls and women 9 to 45 years of age.

The HPV vaccines are given as a series of either 2 or 3 doses over a 6 month period. Children who start a series when they are 9 to 14 years of age need 2 doses given at least 6 months apart. People who start a series when they are 15 years of age and older and those with a weakened immune system need 3 doses.

Those not eligible for free HPV vaccine can buy it at most pharmacies and travel clinics.

It is best to get immunized before becoming sexually active and coming in contact with HPV, because the vaccines prevent infection but do not clear it.

What are the benefits of the HPV vaccines?

In women who have never been infected with HPV, the vaccines prevent almost 100% of cases of cervical cancer caused by the HPV types covered by the vaccines.

The HPV9 vaccine also prevents about:

• 78% of cases of anal cancers in men caused by the two main types of HPV
• 90% to 100% of cases of genital warts in men and women caused by 2 other types of HPV

It is important for women to get regular Pap tests because the HPV vaccine protects against most but not all types of HPV that cause cervical cancer.

What are the possible reactions after the vaccines?

Common reactions to the vaccines may include soreness, redness and swelling where the vaccine was given. Fever, fatigue, headache, and muscle or joint ache may also occur.

It is important to stay in the clinic for 15 minutes after getting any vaccine because there is an extremely rare possibility, less than 1 in a million, of a life-threatening allergic reaction called anaphylaxis. This may include hives, difficulty breathing, or swelling of the throat, tongue or lips. If this reaction occurs, your health care provider is prepared to treat it. Emergency treatment includes administration of epinephrine (adrenaline) and transfer by ambulance to the nearest emergency department. If symptoms develop after you leave the clinic, call 9-1-1 or the local emergency number.

It is important to always report serious or unexpected reactions to your health care provider.

Who should not get the HPV vaccine?

Speak with your health care provider if you or your child has had a life-threatening reaction to a previous dose of HPV vaccine or to any part of the vaccine, including yeast. People who are pregnant should not get the vaccine.

There is no need to delay getting immunized because of a cold or other mild illness. However, if you have concerns speak with your health care provider.

What is HPV?

HPV is one of the most common sexually transmitted infections (STIs). Three out of 4 sexually active people who are unimmunized will get HPV at some point in their lives. Anyone who has any kind of sexual activity with another person involving oral, genital or anal contact can get HPV. Sexual intercourse is not necessary to get infected. The more sexual partners you have the higher the risk of being infected with HPV. Men who have sex with men are also at higher risk of HPV infection.

What happens when you are infected with HPV?

Most people infected with HPV do not show any signs or symptoms and can pass the virus on to others without even knowing it. Most often an HPV infection will clear on its own. For some people, HPV will not go away and cells infected with the virus can become pre-cancerous or cancerous over time.

Every year in B.C. approximately:

• 200 women will get cervical cancer and 50 will die from the disease
• 6,000 women will develop high risk changes to the cervix which are precancerous
• Over 450,000 women will undergo Pap tests and over 14,000 will need further follow-up. Follow-up may include more Pap tests and other procedures to stop cancer of the cervix from developing
• 110 people will get anal cancer and 20 will die from the disease
• 5,500 people will develop genital warts

Mature Minor Consent

It is recommended that parents or guardians and their children discuss consent for immunization. Children under the age of 19, who are able to understand the benefits and possible reactions for each vaccine and the risk of not getting immunized, can legally consent to or refuse immunizations. For more information on mature minor consent see HealthLinkBC File #119 The Infants Act, Mature Minor Consent and Immunization.

For More Information

For more information about HPV and genital warts, see HealthLinkBC File #101a Human Papillomavirus (HPV) Infection and Genital Warts.

For more information on immunizations, visit ImmunizeBC at https://immunizebc.ca.