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Human papillomavirus (HPV) infection is very common in Canada. Without vaccination, about 75 per cent of Canadians will get an HPV infection in their lifetime. Globally and in Canada, HPV-associated diseases are a significant public health problem.
The human papillomavirus 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.
Gardasil® 9 (HPV9)
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 birth parent to baby before and during birth. Newborns with HPV can develop a condition called respiratory papillomatosis. Pregnant individuals are at higher risk of a more serious HPV infection compared to those who are not pregnant. In pregnancy, HPV can lead to serious complications like miscarriage and pre-term birth. The HPV vaccine can be safely given during pregnancy to reduce these risks. Studies show that getting the vaccine while pregnant does not increase the risk of pregnancy complications.
The HPV vaccine can protect against nine strains of HPV infection. These nine strains cause over 70 per cent of cervical cancer, and are the main cause for head and neck and other genital cancers (vaginal, vulvar, anal) and 90 per cent of genital warts. Vaccination works best when it is given before an HPV infection.
HPV vaccines will not protect against an existing HPV infection or HPV strains not included in the vaccine. Even if you have an HPV infection, getting vaccinated will protect you against other strains in the vaccine. Individuals should continue regular cervical screenings after receiving the HPV vaccine.
Free (publicly funded) HPV vaccine is available by appointment at Toronto Public Health community vaccine clinics for:
Toronto Public Health also offers the HPV vaccine in schools to students in grade 7, and catch-up opportunities for students in grade 8, through the School Immunization Program.
If you are not eligible for the free vaccine, check with your private health coverage. The cost of the HPV9 vaccine is about $215 per dose.
Ontario’s publicly funded immunization schedule recommends two doses of HPV vaccine, given six months or more apart.
Individuals who are 15 years and older when the first dose was given should get a third dose if the second dose was given less than six months after the first dose. A third dose is not needed if it’s been more than six months between the two doses.
Certain individuals nine years of age and older with a weakened immune system, taking medications that can weaken the immune system, or with specific health conditions should get three doses.
In July 2024, NACI recommended one dose of HPV vaccine for anyone nine to 20 years old. A two dose schedule may be considered on an individual basis in consultation with a health care provider. Individuals 21 to 26 years old should receive two 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 health care provider.
Ontario still allows, recommends and publicly funds two doses of HPV vaccine for students in grades 7 to 12 (aged 12 to 18). A third dose is publicly funded for anyone who needs it.
The HPV vaccine is very safe and effective.
HPV vaccines have continued to be monitored for safety, even over 15 years after being licensed in Canada. Many global health organizations, including the World Health Organization (WHO) Global Advisory Committee on Vaccine Safety, have thoroughly reviewed the safety of the HPV vaccine. Hundreds of millions of doses of HPV vaccine have been given across the world.
Data continues 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 per cent.
To date, there has been no evidence that the HPV vaccines cause new-onset autoimmune disease including Guillain-Barré Syndrome, multiple sclerosis, chronic fatigue syndrome (CFS), complex regional pain syndrome (CRPS), postural orthostatic tachycardia syndrome (POTS), primary ovarian insufficiency (POI), or infertility.
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, or swelling in the throat and face may occur. Allergic reactions can be treated and are usually temporary. People are monitored for 15 minutes after vaccination for any reactions. There are no long-term side effects or chronic medical conditions associated with this 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.
Talk to a health care provider or call 811 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.