Immunization - HPV TESTING CENTRE

HPV Immunization: The Facts

Canadian guidelines regarding HPV vaccination are provided by the National Advisory Committee on Immunization (NACI). These guidelines aim to ensure the effective and safe use of HPV vaccines to prevent HPV infections and related diseases. Here are the key points:

Understanding HPV Infections

HPV Infections: Human Papillomavirus (HPV) infections are the most common sexually transmitted infections globally, affecting both men and women.
Symptoms and Resolution: Most HPV infections occur without symptoms and often resolve spontaneously within a couple of years without causing any health issues.
High-Risk HPV Types: Certain high-risk HPV types, including HPV 16, 18, 31, 33, 45, 52, and 58, are associated with an increased risk of developing cervical cancer, as well as other anogenital cancers such as those affecting the anus, vulva, vagina, penis, and the oral cavity.
Low-Risk HPV Types: Low-risk HPV types, such as HPV 6 and 11, are responsible for the development of genital warts, which are non-cancerous growths that appear on the genital or anal areas.
Vaccines: There are two HPV vaccines available:

CERVARIX® (HPV2): This vaccine targets HPV types 16 and 18, protecting against cervical cancer and its precursor lesions.
GARDASIL® 9 (HPV9): This vaccine offers protection against nine HPV types, including the high-risk types 16, 18, 31, 33, 45, 52, and 58, as well as the low-risk types 6 and 11. It provides additional protection against cervical cancer, other anogenital cancers, and genital warts.

Recommended Vaccination

Girls and Women

HPV2 or HPV9 vaccine is recommended for girls and women aged 9 to under 27. This includes individuals who have not been previously vaccinated or completed the vaccine series.
It is essential for those with previous Pap test abnormalities, a history of cervical cancer, or genital warts, as HPV vaccination can protect against future HPV-related complications.

Boys and Men

The HPV9 vaccine is recommended for boys and men aged 9 to under 27. Similar to girls and women, this recommendation applies to those who have not been previously vaccinated or completed the vaccine series.
The HPV9 vaccine offers protection against anogenital cancers (such as those affecting the anus, penis, and other genital areas) and genital warts.

Vaccination for Older Individuals

HPV2 or HPV9 vaccine may be administered to women and men aged 27 years and older who are at ongoing risk of exposure to HPV. This includes individuals who may have new sexual partners or are at risk due to their sexual behaviour.
While the immune response to the vaccine may not be as robust in older individuals, vaccination can still provide some level of protection against HPV-related diseases.

Vaccination Schedule

For immunocompetent adolescents aged 9 to less than 15 years:

2-Dose Schedule: HPV2 or HPV9 vaccine can be administered as two separate 0.5 mL doses at months 0 and 6. This schedule provides adolescents an effective and convenient option to complete their HPV vaccination series.
3-Dose Schedule: HPV2 (females only) should be administered in three separate 0.5 mL doses in months 0, 1, and 6. This schedule is specifically recommended for females and ensures optimal immune response to protect against HPV-related diseases, including cervical cancer.

Additional Considerations

Storage Requirements

Proper storage of vaccines is crucial to maintain their efficacy. Vaccines should be stored according to manufacturer recommendations, including temperature requirements and protection from light.

Safety and Adverse Events

Everyday adverse events associated with HPV vaccination include injection site pain, swelling, or redness. These symptoms are typically mild and resolve independently within a few days. Serious adverse events are rare.

Contraindications and Precautions

Vaccination should be avoided in individuals with severe allergies to vaccine ingredients or previous vaccine doses. It is essential to thoroughly review the patient's medical history and ensure they do not have any contraindications before administering the vaccine.

Other Populations

Pregnancy: While HPV vaccination is not routinely recommended during pregnancy, it may be considered in certain circumstances, such as when the individual is at high risk of HPV exposure or complications. However, the decision should be made in consultation with a healthcare provider.
Breastfeeding: HPV vaccination is considered safe during breastfeeding and poses no risk to the infant.
Immunocompromised Individuals: Immunocompromised individuals, including those with HIV infection, organ transplant recipients, or undergoing immunosuppressive therapy, are at increased risk of HPV-related complications. HPV vaccination is recommended for these individuals to help prevent HPV-related diseases. However, the immune response to the vaccine may be reduced in immunocompromised individuals.

NACI Updated Recommendations

The National Advisory Committee on Immunization (NACI) has updated recommendations on HPV vaccines, including the 9-valent HPV vaccine 2-dose immunization schedule and its use in immunocompromised populations. These recommendations provide valuable guidance for healthcare professionals in optimizing HPV vaccination strategies and ensuring comprehensive protection against HPV-related diseases. For detailed information, explore our guidance and advice.

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