The Evolution of HPV Vaccination in Canada

Vaccination is the most effective intervention known to prevent HPV-related infections and associated diseases. 6 Although HPV vaccination does not offer absolute protection from the virus, it can significantly reduce the prevalence of genotypes that are responsible for the majority of anogenital and oropharyngeal cancers. 6 A Danish cohort study demonstrated an 86% reduction in cervical cancer incidence amongst females vaccinated prior to the age of 17, 12 while a randomized control trial reported between 97 and 99% seroconversion for vaccine-targeted HPV genotypes in males, further supporting the vaccine’s efficacy in preventing incident and persistent infections amongst both, males and females. 13

Currently, two vaccines are licensed for use in Canada: the bivalent (2vHPV) vaccine, which is available for females aged 9 to 45 years, and the nonavalent vaccine (9vHPV), which is licensed for both females and males within the same age demographic. 6 In 2007/08, Canada was one of the first countries to implement publicly-funded school-based HPV vaccination programs, initially targeting girls due to early evidence suggesting cervical cancer prevention. 14 Over time, gender-neutral vaccination programs were introduced between 2013/14 and 2018/19 (provincially and territorially dependent) to mitigate the burden of HPV-related infections and associated diseases more equitably. 14 The National Advisory Committee on Immunization (NACI) now recommends HPV vaccination for all individuals between nine and 26 years, with safe administration for adults until the age of 45. 6 Beyond school-based gender-neutral vaccination programs, most Canadian jurisdictions offer publicly-funded catch-up vaccination for high-risk populations, including transgender peoples, MSM and immunocompromised individuals (e.g., those living with the Human Immunodeficiency Virus).14,15