Human Papillomavirus Vaccine (HPV) protects against:
Gardasil 9 covers HPV strains 6, 11, 16, 18, 31, 33, 45, 52, and 58 and is indicated to protect against:
● Cervical, vulvar, vaginal, and anal cancers caused by strains 16, 18, 31, 33, 45, 52, and 58.
● Genital warts caused by strains 6 and 11.
● Precancerous lesions caused by strains 6, 11, 16, 18, 31, 33, 45, 52, and 58
Who should get the vaccine:
In British Columbia, the HPV vaccine is provided to children as part of their grade 6 routine immunization program. The series starts between the ages of 9 and 14 years for all children. However, routine and catch-up vaccinations are recommended through age 26, for males and up to age 45 for females.
In addition to Grade 6 students, the vaccine is indicated and provided free in BC to the following individuals:
● Those who do NOT commence a series in grade 6 are eligible to initiate a series prior to age 19 (for males, born in 2006 or later), but not thereafter.
○ A series commenced prior to age 19 may be completed with publicly funded HPV vaccine prior to the 26th birthday.
● HIV positive individuals 9-26 years of age (inclusive) who have not received a completed series of HPV vaccine
● Males 9-26 years of age (inclusive) at the time of series commencement who are:
○ Men who have sex with men (including those who are not yet sextually active and are questioning their sexual orientation)
○ Street involved
● Males 9-18 years of age (inclusive) in the care of the Ministry of Children and Family Development
● Males in youth custody services centers
● Transgender individuals 9-26 years of age (inclusive)
The vaccine is also recommended but NOT provided free in BC for:
● Women 19-45 years of age
● Males 9-26 years of age (Who are not indicated above)
● Males 27 years of age and older who are men who have sex with men
Administration:
● Immunocompetent individuals 9-14 years of age (inclusive): 2 doses given as 0.5 mL intramuscularly, separated by at least 6 months
○ Those initiating immunization prior to their 15th birthday should be immunized using a 2-dose series
○ If the interval in a 2-dose schedule is less than 5 months (150 days), a 3rd dose should be given at least 24 weeks after the 1st dose and 12 weeks after the 2nd dose.
● Immunocompromised individuals 9-14 years of age (inclusive): 3 doses given as 0.5 mL intramuscularly at 0, 2, and 6 months
● Individuals 15 years of age and older: 3 doses given as 0.5 mL intramuscularly at 0, 2, and 6 months
HPV Vaccine Tolerability:
Most common adverse events are:
● Injection site pain (82% to 92%)
● Swelling (24% to 44%)
● Redness (24% to 48%)
More than 95% of reactions are mild to moderate and resolve within a few days. Fainting may happen and is more common among adolescents and younger adults.
Key Points to Remember:
● Since sexual touching can spread the virus, early vaccination at a young age is important to ensure immunity
● Avoid use during pregnancy, due to lack of data, and if a woman becomes pregnant during the vaccine series, delay future injections until after delivery
● Vaccination is most effective when given prior to becoming sexually active in males and females under the age of 26 years
○ In older women up to 45 years of age, vaccination may be about 47% effective for HPV infection, genital warts, and precancerous lesions regardless of prior HPV exposure or about 88% effective in those without prior HPV exposure
Not sure if you are eligible for publicly-funded Gardasil-9 or wondering if you are private insurance pay for it? Call us at 604-971-5163 and find out!
Reference: Communicable Disease Control Manual June 2019 Chapter 2: Immunization Part 4 - Biological Products