Human Papillomavirus (HPV) vaccine
HPV immunization program
The Alberta government has taken action to prevent the majority of cervical cancers. Initiated in 2008, all girls entering Grade 5 are eligible to receive a vaccine that will prevent 70% of cervical cancers.
Human Papillomavirus (HPV) is a very common infection and is passed through sexual contact. It is estimated that over 70% of people will have at least one genital HPV infection in their lifetime. Certain types of HPV infection cause almost all cases of cervical cancer.
- For the first time with the licensing of the HPV vaccine, there is an effective way to prevent cervical cancer, an important health issue for women in Alberta.
The HPV vaccine is most effective when given to girls before they begin any sexual activity and risk exposure to HPV. Offering the vaccine as a school-based program ensures that all girls in the age groups can be protected.
The immunization is voluntary and as with all Alberta immunization programs, consent of a parent or guardian is required before the immunization occurs. The HPV vaccine is a major advancement in women’s health and another tool to prevent cervical cancer. Implementation of school-based programs for girls has been endorsed by medical experts in Canada including the National Advisory Committee on Immunization, the Canadian Paediatric Society, the Society of Obstetricians and Gynaecologists of Canada and the Canadian Cancer Society.
Common questions about HPV and HPV vaccine
What is human papillomavirus (HPV)?
HPV is a very common family of viruses with over one hundred different types that can cause skin warts, genital warts and certain kinds of cancer, most commonly cervical cancer. About 40 HPV types cause infections in the genital area.
- Many people infected with HPV do not know it and can pass the virus on to others. Most HPV infections cause no symptoms, and usually go away by themselves. Some infections may take one to two years to disappear by themselves while others may take a longer time to go away.
For approximately one in ten women infected with a cancer-causing HPV type, the infection does not go away by itself. These long-lasting infections may lead to changes in the cells of the lining of the cervix, cervical cancer and other more rare types of cancer.
There is no cure for HPV infection. However, treatment is available for the diseases caused by HPV infection, in particular, cervical cancer if it is identified early.
What is cervical cancer and how is it related to HPV?
Cervical cancer (cancer of the cervix) is a malignant disease of the cells lining the cervix. Every year in Canada approximately 1,350 women are diagnosed with cervical cancer and about 390 women die of the disease. In Alberta, approximately 180 women are diagnosed with cervical cancer and about 40 women with the disease die each year.
Studies over the past 15 years have shown that almost all cases of cervical cancer are linked to an infection with HPV. It can take 10 years or more for the infection to gradually progress to pre-cancerous and cancerous lesions of the cervix. Early detection of cervical cancer increases the likelihood of effective treatment, but prevention of the disease is best.
- Two types of HPV, 16 and 18, have been shown to cause about 70% of cervical cancers. The HPV vaccine protects against both of these types.
How is HPV spread?
HPV is a common virus passed easily through sexual activity. Infection occurs during sexual activity with an infected partner.
- The risk of HPV infection occurs when sexual activity begins.
- About 70% of individuals have at least one HPV infection in their lifetime.
Is HPV infection a new disease?
No. HPV infection has been known for a long time. However, more recently the relationship between HPV infection and cervical cancer has been established.
Can HPV infection be treated?
No. There are no treatments for HPV infections. However, treatments are available for the diseases caused by the virus. In particular, cervical cancer can be treated if identified early.
Can HPV infection be prevented?
Yes. HPV infection can be prevented through immunization.
- Condom use may reduce the risk but it does not provide full protection against HPV.
Given how common HPV infection is, even women who have minimal sexual activity are at risk. In addition, many women acquire HPV infection from their first sexual partner.
What is HPV vaccine?
GARDASIL®, HPV vaccine, was licensed in Canada in July 2006 for use in girls and women nine to 26 years of age. The vaccine provides protection from four types of HPV including types 16 and 18 which have been linked to about 70% of cervical cancer. The other two types, 6 and 11, cause of about 90% of genital warts.
The vaccine is given in a series of three doses over a six-month period. The immunization is most effective when given to all girls in the same age group before they become sexually active and are exposed to HPV. Girls, who have not yet been exposed to HPV, will get the full benefit of the vaccine with protection from all four HPV types included in the vaccine.
- The HPV vaccine has no treatment effect on existing HPV infection.
- The vaccine does not contain antibiotics or preservatives.
Is HPV vaccine safe?
Yes, the vaccine is safe. Vaccines are approved for use in Canada only after rigorous review and testing for quality, safety and effectiveness. After a vaccine is licensed, ongoing monitoring is conducted to ensure continued safety and efficacy.
- HPV vaccines have been in development for several years.
- Approximately 20 million girls and women around the world (North America, Latin America, Europe and Asian-Pacific regions) have received the vaccine.
- The vaccine cannot cause HPV infection because it is made from killed viruses.
Is the HPV vaccine effective?
The HPV vaccine is almost 100% effective in preventing long-lasting HPV infections for types 16 and 18 which are the cause of 70% of cervical cancer.
- Providing HPV vaccine to all girls in an age group (e.g. one grade in school) will dramatically reduce cervical cancer mortality for future generations of women.
What are the side effects of HPV vaccine?
The vaccine is generally well tolerated with minor to moderate side effects reported.
- The side effects are similar to those caused by other vaccines such as pain, redness, itchiness and swelling at the injection site.
- Less commonly, fever, nausea, dizziness, headache and vomiting have occurred.
- Fainting has occasionally occurred following HPV immunization.
- Fainting also occurs infrequently with other vaccines particularly when given to adolescents.
As with any immunization, unexpected, unusual or rare side effects can occur. For example, severe allergic reactions (anaphylaxis) are rare, occurring at an estimated annual rate of one per one million doses of vaccine distributed in Canada. In Alberta, vaccines are administered by public health nurses trained to identify and initiate treatment for anaphylaxis.
Has the vaccine been properly tested?
Yes. Before vaccines are licensed in Canada, they undergo rigorous scientific review and testing for quality, safety and effectiveness.
Once a vaccine is approved for use in Canada, every lot is tested for safety and quality. In addition, side effects are continuously monitored in Alberta and subsequently reported to the Public Health Agency of Canada.
Will booster shots be necessary?
Recent studies have indicated that the HPV vaccine provides good protection for at least five years after immunization.
- Studies are ongoing to determine if protection will be lifetime or if booster doses will be needed in the future for long-term protection.
Can HPV vaccine be given with other vaccines?
Yes. Studies have shown that GARDASIL® can be given safely at the same time as hepatitis B vaccine.
- GARDASIL® can also be given at the same time as other age-appropriate vaccines.
Multiple injections given at the same time help to keep children up-to-date and protected from diseases sooner. It is also practical – saving time, money and stress on the child.
Why is this vaccine offered as a school-based program to girls?
To achieve the maximum benefit from the vaccine in preventing cervical cancer, the vaccine needs to be available to girls before they begin any sexual activity. Therefore, offering the HPV vaccine to all girls in Grade 5 is the best time to get the vaccine, as they will be protected before there is any chance of infection with HPV. In addition, the vaccine was offered to girls in Grade 9 from September 2009 to June 2012 as a school catch-up program.
School-based immunization delivery systems generally result in higher numbers of students completing the immunization. It is also easier to access all the students in this grade through the school system making sure that all students have the chance to receive the vaccine. The school-based hepatitis B immunization program started in 1995 has been very successful in Alberta.
- HPV immunization for Grade 5 girls will be given at the same time as hepatitis B vaccine which is routinely offered to all students in Grade 5 in Alberta.
Does providing HPV vaccine to girls lead to earlier sexual activity?
There is no evidence to support that implementing an HPV immunization program would affect decision-making of young people about when they have their first sexual encounter. Research has shown that fear of getting a sexually transmitted infection does not affect onset of sexual activity. Therefore, the fear of HPV infection is unlikely to be a factor in the decision to become sexually active.
HPV immunization may provide an opening to talk to your daughter about sex. However, if you and your daughter are not yet ready to have this discussion, you may wish to tell her that the vaccine is to prevent cancer that may occur later in life.
How is the vaccine delivered?
The Alberta HPV Immunization Program is offered to all girls in Grade 5. When the program began, Grade 9 girls were eligible for three years, from September 2009 to June 2012.
- Immunization in Alberta is voluntary. When offered through school-based programs, consent is required from a parent or guardian of the student before the immunization occurs.
The vaccine will be given at the same time as hepatitis B vaccine in Grade 5 and, as with all the school-based immunization programs in Alberta, will be administered by public health nursing staff.
What about vaccine for older girls?
The publicly-funded Alberta HPV Immunization Program is for all girls in Grade 5, and began in the 2008/2009 school year. Any girls not eligible under this program can speak to their doctor or health care provider about purchasing the vaccine.
Will Pap tests continue to be recommended?
Pap tests for cervical cancer screening are recommended for women, including those who have received the HPV vaccine. Not all types of cervical cancer are caused by the HPV types represented in the vaccine. Routine cervical cancer screening will continue to be important in the early detection of pre-cancerous and cancerous changes to the cervix.
- For more information on cervical cancer screening, please talk to your family doctor.
- Visit the Alberta Health Services website
- National Advisory Committee on Immunization (2007). Statement on human papillomavirus vaccine. Canada Communicable Disease Report, 33 (ACS-2)
- Public Health Agency of Canada
- Canadian Cancer Society; Canadian Cancer Statistics 2011
- Canadian Paediatric Society (2007). Human papillomavirus vaccine for children and adolescents – position statement. Paediatric Child Health, 12(7)