HPV is a very common virus that is usually spread during sexual activity through skin-to-skin contact with an infected person. There are many different types of HPV. Some types of HPV can cause cancer of the cervix in women, and other types can lead to genital warts. Fortunately, most HPV infections and cervical cancers can be prevented with the HPV vaccine.

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 (the area around the opening of the vagina). Other types of HPV can cause warts in the genital areas of men and women. Genital warts are not a life-threatening disease. But they can cause emotional stress, and getting them treated can be very uncomfortable.

The most efficient way to monitor for the HPV virus, for both males and females, is to visit your primary healthcare provider (for example, your doctor) on a regular basis. Women should continue to receive routine cervical screening (PAP tests).

For most people who get an HPV infection, the infection will go away over time through the body's natural immune system. However, some types of HPV may develop into cervical cancer or other types of cancers.

An estimated 75% of sexually active individuals in North America will have at least one HPV infection in their lifetime. Most HPV infections will cause no signs or symptoms and clear up by themselves. However, some HPV infections can lead to genital warts, cancer of the cervix or other types of cancer.

The HPV virus is spread through skin-to-skin contact with the penis, scrotum, vagina, vulva or anus of a person who has an HPV infection. Kissing or touching that person's sex organs with your mouth (oral sex) can spread HPV. It is not necessary to have intercourse to get HPV.

Yes, males can be infected with HPV. Males are at risk of developing HPV-related genital warts and some types of cancers (e.g., anal cancer). Males can also be carriers of HPV without experiencing visible symptoms, and they can pass the HPV virus unknowingly to their partners.

Cervical cancer occurs when normal cells in the cervix change into cancer cells. The main risk factor for developing cervical cancer is infection of the cervix with the human papillomavirus (HPV). Routine cervical screening (PAP tests) is the most effective way to identify potentially precancerous changes. The early identification and treatment of cervical cell changes can prevent the development of cancer. The best protection against cervical cancer is routine screening and getting the HPV vaccine.

Every year in Ontario, approximately 500 females are diagnosed with cervical cancer and 140 die from the disease. Half of all women diagnosed with cervical cancer are younger than 47 — much younger than with many other cancers. The best protection against cervical cancer is routine screening and getting the HPV vaccine.

Regular cervical screening and HPV immunization are the most effective ways to prevent cervical cancer. Regular PAP tests and follow-up screening can prevent most, but not all, cases of cervical cancer at an early, curable stage. The HPV immunization protects against the types of HPV virus that cause 70% of all cervical cancers.

The HPV vaccine helps to strengthen a person's immune system against the HPV virus. The publicly funded HPV vaccine used in Ontario protects against four types of the HPV virus and these four cause 70% of all cervical cancers and 90% of all genital warts. Three doses of the vaccine are required for complete protection. HPV immunization, along with regular PAP tests, can reduce the risk of cervical cancer in women.

The vaccine is almost 100% effective against the four HPV types that the vaccine protects against. The HPV vaccine is most effective at preventing disease in females if they get immunized before they become sexually active. Receiving the vaccine at a young age is an investment in long-term health, and the HPV vaccine will provide protection against cervical cancer and other related diseases as young females grow into adulthood.

To date, there have been no found links between ovarian cysts and the HPV vaccine.

Researchers predict that HPV vaccine protection will last at least 15 years. Researchers base this prediction on ongoing clinical trials that are monitoring people who have been vaccinated and the immune response that has been seen with the vaccine. Follow-up studies are being done to see if there will be a need for a booster dose in the future. The HPV vaccine will protect girls now. It's far better to give the vaccine and then give a booster in the future, if needed, than not to give the vaccine at all.

The HPV vaccine is most effective if given to girls before they may be exposed to the HPV virus. At this age their immune system is robust and will have a great response to immunization. Receiving the vaccine at a young age is an investment in long-term health, and the HPV vaccine will provide protection against cervical cancer and other related diseases as girls grow into adulthood.

The HPV vaccine is approved for females aged 9 to 45. It is recommended that females get the vaccine before becoming sexually active and before possibly being exposed to HPV. Females who are sexually active may also benefit from vaccination, but they may get less benefit. This is because they may have already been exposed to one or more of the HPV types targeted by the vaccine.

Research shows that there are many factors that influence a young person's decisions about early sexual activity. These include peer pressure, self-image, sex education and the impact of the media. The HPV vaccine will provide protection against cervical cancer and other related diseases as young women grow into adulthood.

Each year, girls in Grade 8 are offered HPV immunization at school at no cost. Girls who do not receive or complete their three doses of HPV vaccine in Grade 8 may catch up until the end of Grade 12 at no cost. The HPV vaccine is approved for females aged 9 to 45. Females not covered by the school-based program can purchase the HPV vaccine with a prescription. Call your local Public Health Unit to find out more about your options.

HPV immunization is voluntary. Each year, girls in Grade 8 are offered HPV immunization at school at no cost. This program is run by qualified registered nurses from local Public Health Units. The vaccine is given in three doses. The first dose is usually given at the start of the school year, the second dose is given two months after the first dose, and the third dose is given six months after that, before the end of the school year. It is important to get all three doses for full protection.

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 -- types 6, 11, 16 and 18. HPV types 16 and 18 are considered to be of high risk for cervical cancer. HPV types 6 and 11 are associated with genital warts.

In 2006, the vaccine was approved for administration to females between the ages of 9 and 45. In 2011, the vaccine was approved for administration to males between the ages of 9 and 26. It is encouraging that the HPV vaccine has been approved for wider use. Before considering the expansion of any of Ontario's vaccine programs, an analysis and an evaluation of the current program will need to be completed.

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 and school trips. These clinics can be scheduled in the morning or afternoon, during regular school hours. The schools will distribute consent forms provided by the Public Health Unit. These consent forms also include information about the vaccine that will be administered in the schools by the Public Health Unit. 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 to ensure the vaccinations are provided within an environment where there is enough space to administer vaccines safely.

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.

All three doses of the HPV vaccine are recommended for maximum protection. Females who do not receive or complete their three doses of HPV vaccine in Grade 8 may catch up on missed doses until the end of Grade 12 at no cost. Contact your local Public Health Unit to find out more.

It's 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, an analysis and an evaluation of the current program would need to be completed.

Yes, the vaccine is safe. It has been approved by Health Canada and recommended for use by the National Advisory Committee on Immunization. Before obtaining approval for use in Canada, the vaccine went through rigorous testing and evaluation. HPV vaccine is approved for use in over 100 countries, and over 40 million doses have been given worldwide. After a vaccine is approved for use, ongoing monitoring is conducted to ensure continued safety.

You cannot become infected with HPV from the vaccine.

The HPV vaccine does not contain any preservatives, antibiotics, thimerosal or mercury.

The HPV vaccine has side effects similar to what has been seen with most other available vaccines. These side effects include redness, tenderness and swelling at the injection site and, less commonly, nausea, dizziness, headache and fever. As with any vaccine or drug, on rare occasions, severe allergic reactions may occur with symptoms such as difficulty breathing, swelling of the face or mouth, wheezing and hives or rashes.

The risk of getting infected with HPV is high. Three in four adults will contract an HPV infection at some point in their lifetime, usually without even realizing it. The HPV vaccine is a breakthrough in cancer prevention because it offers almost complete protection against the two types of HPV that are responsible for 70% of cervical cancers.

The HPV vaccine has side effects similar to those seen with most other available vaccines. These side effects include redness, tenderness and swelling at the injection site and, less commonly, nausea, dizziness, headache and fever. As with any vaccine or drug, on rare occasions severe allergic reactions may occur with symptoms such as difficulty breathing, swelling of the face or mouth, wheezing and hives or rashes. Public health nurses administer the vaccine and are present at school clinics at all times. They are trained and prepared to handle any reaction.

The HPV vaccine should not be given to anyone who:

• has already been fully vaccinated with the HPV vaccine;
• has had a serious reaction to a previous dose of the HPV vaccine;
• is sick with a fever or infection worse than a cold on the day the needle is to be given;
• has an allergy to any component of the vaccine; (i.e. yeast, amorphous aluminium hydroxyphosphate sulfate, sodium chloride, L-histidine, polysorbate 80, and sodium borate); or
• is pregnant.

The HPV vaccine does not contain any preservatives, antibiotics, thimerosal or mercury. The HPV vaccine Gardasil contains aluminum salts, a common substance added to vaccine to enhance the immune response. Called an adjuvant, this substance makes it possible to reduce the amount of antigens (parts of weak or dead viruses or bacteria) in a vaccine needed to achieve immunity. Aluminum salts have been shown to be safe over seven decades of use and are also found in other vaccines, such as the tetanus, diphtheria and hepatitis B immunizations. After oxygen and silicon, aluminum is the third-most abundant element in the environment, and daily exposure occurs primarily through food. Aluminum is found in infant formula in similar amounts as in the HPV vaccine. Both exposures are considered to be within the limits of safety.

Since 2007, in Ontario, the HPV vaccine has been available free of charge to all females in Grade 8 through the school-based HPV immunization program. 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. The HPV vaccine is approved for use in over 100 countries, and over 40 million doses have been given worldwide.