We got experts to answer your questions about the HPV vaccination program. Check out what they said!
Q. How serious is the Human Papillomavirus (HPV)? |
| A: HPV is a common sexually transmitted infection. There are over 100 types of HPV. Some types of HPV are considered higher risk than others and can develop into cervical cancer. |
Answered by:
Nina Arron - RN, MHA |
Q: What are the symptoms of HPV? |
| A: Most people never get symptoms and may not know they have been infected with HPV but they still carry the virus and can infect others. However, depending on the type of HPV infection, they may develop cervical abnormalities, cervical cancer and other cancers like cancers of the anus, vagina and vulva (area around the opening of the vagina). Other types of HPV can cause warts in the genital areas of men and women, called genital warts. Genital warts are not a life-threatening disease. But they can cause emotional stress and their treatment can be very uncomfortable. |
Answered by:
Dr. Vivien Brown - MDCM, CCFP, FCFP, NCMP |
Q: What is cervical cancer? |
| A: Cervical cancer occurs when normal cells in the cervix change into cancer cells. This can happen because you have been infected with a virus (such as HPV), or because of other human factors, such as genetics. Routine cervical screening (pap smears), is the most effective way to identify potentially precancerous changes. The early treatment of high-grade cervical cell changes can prevent the development of cancer. The best protection against cervical cancer is routine screening and getting the HPV vaccine. |
Answered by:
Dr. Vivien Brown - MDCM, CCFP, FCFP, NCMP |
Q: How big a problem is cervical cancer? |
| A: In Ontario, there are approximately 500 females diagnosed with cervical cancer and 140 deaths each year. |
Answered by:
Nina Arron - RN, MHA |
Q: How effective is HPV vaccine? |
| A: The vaccine is almost 100% effective against the four HPV types that the vaccine protects against. There is no risk of getting an HPV infection from the vaccine, since the vaccine does not contain live virus. |
Answered by:
Dr. Vivien Brown - MDCM, CCFP, FCFP, NCMP |
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Q: What is the name of the vaccine that the government is using for Grade 8 girls? |
| A: The Ministry of Health and Long Term Care currently offers the HPV vaccine at no charge to all grade 8 girls. The vaccine is called Gardasil, manufactured by Merck Frosst. It provides protection against four types of HPV, two of which are associated with cervical cancer. This vaccine will protect against HPV types 6, 11, 16 and 18. HPV types 16 and 18 are considered high risk for cervical cancer. HPV types 6 and 11 are considered low risk and are associated with genital warts. This vaccine is currently licensed for use in females aged 9 to 26 years. |
Answered by:
Dr. Vivien Brown - MDCM, CCFP, FCFP, NCMP |
Q: Are physicians involved in providing the vaccine through this program? |
| A: The HPV vaccine is administered primarily in schools by public health unit staff. There may be situations in which it would be appropriate for a physician to obtain the publicly funded vaccine from the health unit; the need for this would be addressed on a case-by-case basis. |
Answered by:
Nina Arron - RN, MHA |
Q: There have been concerns about the safety of this vaccine. What assurances are there that this is a safe vaccination? |
| A: The Biologics and Genetic Therapies Directorate (BGTD) of Health Canada has approved the use of the HPV vaccine for females and males ages 9 to 26 years. The BGTD is the regulatory authority responsible for establishing the safety, efficacy and quality of all biologics, including vaccines, for human use in Canada. Before introducing a new vaccine to Ontario’s publicly funded immunization program, the province considers the needs of Ontarians, the advice of several immunization expert groups and the safety, efficacy, cost and appropriateness of the specific vaccine for possible administration through Ontario’s publicly funded programs.
Completed clinical trials for this vaccine have shown it to be safe and effective. The reported reactions to this vaccine are typical reactions seen with all vaccines. These typical reactions include soreness at the injection site or a low grade fever. No deaths have been reported that have been specifically linked to the HPV vaccine. |
Answered by:
Nina Arron - RN, MHA |
Q: What are the risks of getting the HPV vaccine? |
| A: Like with most other vaccines, there may be mild side effects in some people. Side effects of the HPV vaccine may include redness, tenderness and swelling of the injection site, and less commonly, fever, nausea, dizziness and headaches. These are not considered to be severe adverse reactions as they are expected with routine vaccinations. |
Answered by:
Dr. Vivien Brown - MDCM, CCFP, FCFP, NCMP |
Q: What are the side effects for the HPV vaccine? |
| A: The HPV vaccine is safe and approved for use in Canada for females and males aged 9 to 26 years. The HPV vaccine has similar side effects to most other available vaccines. These side effects include redness, tenderness and swelling of the injection site and, less commonly, fever, nausea, dizziness and headache. Rare reactions that occur within 15 days of the vaccination should be reported to your doctor or local health unit. These reactions include trouble with breathing, swelling of the face or mouth, a fever over 39°C, hives or rashes. Public health nurses administer the vaccine and are present at school clinics at all times. They are trained and are prepared to handle any reaction. | Answered by:
Dr. Vivien Brown - MDCM, CCFP, FCFP, NCMP |
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Q: Is the HPV vaccine mandatory for Grade 8 females? |
| A: The vaccination is voluntary. |
Answered by:
Nina Arron - RN, MHA |
Q: When will the vaccination program start? |
| A: The HPV vaccine will be offered to all female students in Grade 8 beginning in the fall. Three doses of the vaccine are recommended. |
Answered by:
Nina Arron - RN, MHA |
Q: Why is it necessary to vaccinate grade 8 girls? What if the teenager is not sexually active and is careful about their sexual partners? |
| A: Grade 8 was chosen because the vaccine is most effective if given to girls before they are potentially exposed to the HPV virus and at a time when their immune system is robust and will have a great response to immunization. At the same time, females in Grade 8 are aware of sexually transmitted infections and will be better able to understand the benefits of the vaccine than females of a younger age. |
Answered by:
Dr. Vivien Brown - MDCM, CCFP, FCFP, NCMP |
Q: Do boys get HPV too? |
| A: Yes, males can be infected with HPV, but they are not at risk of cervical cancer as they do not have a cervix. Males can also be carriers of other HPV types that may be transmitted to their partners during sexual activity. Without experiencing visible symptoms, they can pass the HPV virus unknowingly to their partner. |
Answered by:
Dr. Vivien Brown - MDCM, CCFP, FCFP, NCMP |
Q: Why is this program only targeted to females when males can also get HPV? |
| A:In 2006, the vaccine was approved for administration to females between the ages of 9 to 26 years. This year, the vaccine was approved for administration to males between the ages of 9 to 26 years. It is encouraging that the HPV vaccine has been approved for wider use. Before considering the expansion of any of Ontario's vaccine programs, a feasibility analysis as well as an evaluation of the current program will need to be completed |
Answered by:
Nina Arron - RN, MHA |
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Q: Who is eligible to get the publicly funded HPV vaccine? |
| A: The program is for the female Grade 8 cohort in Ontario. |
Answered by:
Nina Arron - RN, MHA |
Q: If one is symptom free how can they find out if they do in fact carry the virus? |
| A: The most efficient way to monitor for the HPV virus is to visit your family health care provider on a regular basis and continue to receive routine cervical screening (pap smears). |
Answered by:
Dr. Vivien Brown - MDCM, CCFP, FCFP, NCMP |
Q: How many years has the HPV vaccination been given to adolescent girls? |
| A: The HPV vaccine was approved for use in Canada in July of 2006 for females between the ages of nine and 26 years. The vaccine was thoroughly tested to meet Health Canada’s standards for safety and efficacy. It has been endorsed by the National Advisory Committee on Immunization, and other leading Canadian health organizations. |
Answered by:
Dr. Vivien Brown - MDCM, CCFP, FCFP, NCMP |
Q: How is the current immunization program administered in schools? |
| A: Public health units plan and organize school-based immunization clinics throughout the school year. The clinic schedule within the schools is organized between the public health unit and the school to ensure that the vaccination clinic does not conflict or disrupt other important school activities such as exams, school trips, etc. These clinics can be scheduled in the morning or afternoon, during regular school hours. The schools will distribute consent forms that are provided by public health. These consent forms also include information about the vaccine that will be administered in the schools by public health. The actual clinics are usually held within the school in an area that is safe and appropriate, such as the school gymnasium. The clinics are not held within the classroom in order to ensure the vaccinations are provided within an environment where there is enough space to administer vaccines safely. |
Answered by:
Nina Arron - RN, MHA |
Q: Why not vaccinate boys and older teens who are sexually active? |
| A: It is recommended that the vaccine is administered prior to becoming sexually active and possibly exposed to HPV, because the effectiveness of the vaccine is unknown when administered to someone who is exposed and/or infected with HPV. |
Answered by:
Nina Arron - RN, MHA |
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Q: How will females in private schools get the vaccine? What about females who are wards of the Crown or in group homes? |
| A: We work closely at both the provincial and local levels to ensure that the vaccine is made available and accessible to all females in Grade 8. This means ensuring that the vaccine is available to females in private schools, to those who are home schooled and to those who are wards of the Crown and in group homes. |
Answered by:
Nina Arron - RN, MHA |
Q: Will the HPV vaccine be provided to First Nations communities? |
| A: Yes. The HPV vaccination program is implemented within First Nations communities in a manner consistent with the other publicly funded school-based vaccination programs that currently exist in Ontario, such as Hepatitis B and Meningococcal vaccines. All females in the Grade 8 cohort will be offered the HPV vaccine. |
Answered by:
Nina Arron - RN, MHA |
Q: What happens if I decide not to sign the consent form? |
| A: You can have your child vaccinated whenever you feel the time is right. However, if you decide to decline the Grade 8 program this fall and decide to have your Grade 8 daughter vaccinated later, you will have to incur the expense of the vaccination (about $400). |
Answered by:
Nina Arron - RN, MHA |
Q: Can you die from the vaccine? |
| A: To date, there have been no serious adverse events or deaths reported in Ontario in relation to the HPV vaccine. Most of the adverse events were either reports of hives, rashes and primarily soreness at the injection site, a typical reaction to most vaccines. The Ministry continues to review any adverse events reported in relation to all vaccines administered in Ontario.
Completed clinical trials for this vaccine have shown it to be safe and effective.The Biologics and Genetic Therapies Directorate (BGTD) of Health Canada have approved this vaccine for use for females and males ages 9 to 26 years. The BGTD is the regulatory authority responsible for establishing the safety, efficacy and quality of all biologics, including vaccines, for human use. Before introducing a new vaccine to Ontario’s publicly funded immunization program, the province considers the needs of Ontarians, the advice of several immunization expert groups and the safety, efficacy, cost and appropriateness of the specific vaccine for possible administration through Ontario’s publicly funded programs. |
Answered by:
Nina Arron - RN, MHA |
Q: Does the HPV vaccine stop ovarian cysts? |
| A: To date there have been no found links between ovarian cysts and the HPV vaccine. |
Answered by:
Dr. Vivien Brown - MDCM, CCFP, FCFP NCMP |
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Q: Can you get HPV without having sex? |
| A: Possibly. HPV is most commonly spread though any unprotected sexual activity that involves skin-to-skin contact with an infected area. This includes kissing and oral sex. |
Answered by:
Dr. Vivien Brown - MDCM, CCFP, FCFP NCMP |
Q: In cases of a low risk HPV type, how common is it for the virus to go away on its own? |
| A: Most people who get an HPV infection will be able to clear the infection on their own over time through their body’s natural immune system. There is greater concern for high risk types of HPV as they may develop into cervical or other types of cancers. |
Answered by:
Dr. Vivien Brown - MDCM, CCFP, FCFP NCMP |
Q: What if my daughter misses one of the vaccinations? |
| A: All three doses of the HPV vaccine are recommended for protection. If your Grade 8 daughter missed the one of the three HPV vaccination doses, please contact your local Public Health Unit. |
Answered by:
Nina Arron - RN, MHA |
Q: How many years does the vaccine last for? |
| A: We do not yet know how long the HPV vaccination will protect women after they have received the three recommended doses. Follow-up of females who have completed the three dose HPV vaccine series continues to show they have good protection against the high risk HPV types that the vaccine protects against. The follow-up completed thus far showed that the levels of antibodies in their systems remained very high, demonstrating that their protection against HPV remains quite strong. |
Answered by:
Dr. Vivien Brown - MDCM, CCFP, FCFP NCMP |
Q: How many adults will get HPV in their lifetime? |
| A: An estimated 75 per cent of sexually active individuals in North America will have at least one HPV infection in their lifetime. Although most women will clear the infection, there are some that will have persistent HPV infections that puts them at risk of developing genital warts or cancer of the cervix. |
Answered by:
Dr. Vivien Brown - MDCM, CCFP, FCFP NCMP |
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Q: What are the Lifetime risks/rates of cervical cancer and genital warts among Ontario women? Also, what are the rates of severe reaction to the HPV vaccine? |
| A: HPV types 16 and 18 are considered high risk for cervical cancer and cause 70 per cent of cervical cancer in women. HPV types 6 and 11 are considered lower risk and cause about 90 per cent of genital warts in men and women. In Ontario, there are 500 women diagnosed with cervical cancer and 140 deaths each year. Therefore, this vaccine that is now available is an important tool in the prevention of cervical cancer in women.
In clinical trials for the HPV vaccine, headache, fever, diarrhea, and injection site reactions were reported as the most common side effects from the HPV vaccine. In Ontario, no fatal adverse reactions have been reported in relation to the HPV vaccine. The majority of the reports related to adverse events following immunization have been urticaria (hives) and rash - and these are considered common reactions after routine immunizations. |
Answered by:
Dr. Vivien Brown - MDCM, CCFP, FCFP NCMP |
Q: Has MOHLTC done anything to increase/improve overall screening of cervical cancer? |
| A: Maintaining and strengthening Ontario’s cervical cancer screening program continues to be a priority. The HPV vaccination program is in no way an indication of any intention to relax cervical cancer screening in Ontario. We will continue to work with partners such as Cancer Care Ontario to ensure that women and their health care providers understand the importance of regular cervical cancer screening such as Pap smears. We know that these continuing efforts are particularly important for hard-to-reach groups that are historically under-screened. |
Answered by:
Nina Arron - RN, MHA |
Q: Are there other ways to prevent cervical cancer? |
| A: HPV vaccination and regular cervical screening is the most effective way to prevent cervical cancer. Regular Pap tests and follow-up can prevent most, but not all, cases of cervical cancer. Pap tests can detect cell changes in the cervix before they turn into cancer. Pap tests can also detect most, but not all, cervical cancers at an early, curable stage. |
Answered by:
Nina Arron - RN, MHA |
Q: Now that Cervarix has been approved will the government be only using Gardasil? |
| A: It is encouraging that there is another HPV vaccine that has been approved for use in Canada. Before considering any expansions or changes to any of Ontario's vaccine programs, a feasibility analysis as well as an evaluation of the current program would need to be completed |
Answered by:
Nina Arron - RN, MHA |
