Updated April 2025

Human Papillomavirus Infection

There are more than 100 strains of human papillomavirus (HPV). Human papillomavirus infection can spread through intimate skin to skin contact. Most infections do not show symptoms and may clear on their own. However, high-risk HPV strains can cause cervical cancer, cancers of the genitals (penis, anus, vulva, vagina) and cancers of the mouth and throat. Low-risk strains can cause warts.

The virus can also be passed from the birth parent to baby before and during birth. Newborns with HPV can develop respiratory papillomatosis. Pregnant individuals are at increased risk of a more serious HPV infection compared to those who are not pregnant. In pregnancy, an HPV infection can lead to serious complications such as miscarriage and pre-term birth. HPV vaccine can be given during pregnancy to reduce these risks. Current data indicate no increased risk of adverse pregnancy outcomes with getting the HPV vaccine during pregnancy.

Prevent Cancer

Vaccination can protect against nine strains of HPV infection. These nine strains cause over 70% of cervical cancer, and are the main cause for head and neck and other genital cancers (vaginal, vulvar, anal) and 90% of genital warts. Vaccination works best when it is given prior to infection with HPV.

HPV vaccines will not protect against existing HPV infections or HPV strains not included in the vaccine. Even if someone had an HPV infection, getting vaccinated will prevent against the other strains in the vaccine. Individuals should continue with regular cervical screening, even after receiving the HPV vaccine.

Vaccine Benefits

The vaccine can prevent high-risk precancerous cervical lesions, head and neck cancers and anal/genital cancers caused by the strains that are present in the vaccine. HPV9 vaccine also can prevent 90 per cent of genital warts.

Human papillomavirus (HPV) infection is very common in Canada. Without vaccination, it is estimated that 75% of people in Canada will acquire an HPV infection in their lifetime. Globally and in Canada, HPV-associated diseases are a significant public health problem.

Vaccine Given at Toronto Public Health Clinics

Gardasil® 9 (HPV9)

Eligibility / Cost

Free HPV vaccine is being offered at public health immunization clinics to:

  • Students in grades 7 to 12
  • Males up to 26 years of age who identify as gay, bisexual, or trans or as having sex with men

The cost of HPV9 vaccine is approximately $215 per dose. If you are not eligible for the free vaccine, check with your private health coverage.

Vaccine Schedule

In Ontario’s publicly funded immunization schedule:

  • 9 to 14 years of age (when first dose given): two-doses of publicly funded HPV vaccine, six months or more apart
  • 15 years and older (when first dose given): two doses, six months apart will provide protection. If the second dose was given less than 6 months after the first dose, a third dose is needed. If it’s been more than 6 months between the two doses, a third dose is not needed.
  • 9 years and older with a weakened immune system, taking medications that can weaken the immune system or specific health conditions: three-doses

Update Recommendations from the National Advisory Committee on Immunization (NACI)

  • In July 2024, NACI recommended one dose of HPV vaccine for anyone 9 to 20 years of age. A 2-dose schedule may be considered on an individual basis in consultation with their health care provider. Individuals 21 to 26 years of age should receive 2 doses of HPV vaccine. Individuals 27 years of age and older who are at ongoing risk of exposure to HPV may receive HPV9 vaccine in consultation with their healthcare provider.

Ontario still allows, recommends and publicly funds two doses of HPV vaccine for students in grade 7 to 12 (aged 12 to 18). A third dose is publicly funded for anyone who needs it.

Vaccine Safety and Effectiveness

The HPV vaccine is very safe and effective.

HPV vaccines continue to be monitored for safety, even over 15 years after being licensed in Canada. Hundreds of millions of doses of HPV vaccine have been given across the world. The data continue to show that the HPV vaccines are safe and well tolerated. Clinical trials have shown that even a single dose can generate a strong immune response. The vaccine is highly effective in preventing persistent HPV infections and related diseases, including cervical cancer and genital warts. In young women, the vaccine’s efficacy against various HPV types is nearly 100%.

Many global health organizations, including the World Health Organization (WHO) Global Advisory Committee on Vaccine Safety and the Institute of Medicine (IOM) of the National Academy of Sciences of the United States, have thoroughly reviewed the safety of the HPV vaccine. Ongoing vaccine safety monitoring systems in countries like Canada also support the safety. To date, there has been no evidence that the HPV vaccines cause new-onset autoimmune disease including Guillain-Barre Syndrome, multiple sclerosis, chronic fatigue syndrome (CFS), complex regional pain syndrome (CRPS), postural orthostatic tachycardia syndrome (POTS), primary ovarian insufficiency (POI), or infertility.

People Who Should Not Get the Vaccine

Anyone who is allergic to vaccine ingredients such as yeast or alum should not receive the vaccine. As a precaution, if you have a fever, delay getting the vaccine until you are feeling better.

Possible Side Effects and Risks

The vaccine is safe, effective and well tolerated. Reactions are usually mild. Common side effects include pain, swelling and redness where the vaccine was given, headache, fever, dizziness, nausea, vomiting or feeling faint shortly after receiving the vaccine. Teenagers in particular can feel dizzy and faint after vaccination, often due to stress or anxiety about the vaccination.

In rare cases, serious allergic reactions such as trouble breathing, rash, swelling in the throat and face may occur. The allergic reactions can be treated and are usually temporary. Please stay at the clinic for 15 minutes after vaccination so staff can monitor for any reactions. There are no long-term side-effects or chronic medical conditions associated with this vaccine.

More Information

Call a health care provider, or Health811 to connect to a registered nurse day or night for free, secure and confidential health advice. You can also call Toronto Public Health at 416-336-7600.