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. 2021 Feb 22;28(1):991-1007.
doi: 10.3390/curroncol28010097.

Evolution of Public Health Human Papillomavirus Immunization Programs in Canada

Alexandra Goyette  1 , Glorian P Yen  2 , Voica Racovitan  1 , Parambir Bhangu  1 , Smita Kothari  2 , Eduardo L Franco  3
Affiliations

Evolution of Public Health Human Papillomavirus Immunization Programs in Canada

Alexandra Goyette et al. Curr Oncol. .

Abstract

Background: Since 2007, all Canadian provinces and territories have had a publicly funded program for vaccination against human papillomavirus (HPV) infection. The objective of this study was to describe the evolution of these vaccination programs. Methods: This was a targeted literature review of public HPV vaccination programs and vaccination coverage rates, based on information provided by jurisdictional public health authorities. Results: HPV vaccination of schoolgirls began in school years 2007/08 to 2010/11 with three doses of the quadrivalent HPV vaccine in all provinces except Quebec, which started with two doses. By 2018/19, all jurisdictions were vaccinating with two doses of the nonavalent vaccine in both girls and boys, except Quebec, which used a mixed vaccination schedule with one dose of the nonavalent and one dose of the bivalent vaccines. Public HPV vaccination programs in most provinces include after-school catch-up vaccination. Immunocompromised or other high-risk individuals are eligible for the HPV public vaccination program in most provinces, but policies vary by jurisdiction. In 2017/18, vaccination coverage rates in provincial HPV school-based programs varied from 62% in Ontario to 86% in Prince Edward Island in girls and from 58% in Ontario to 86% in Prince Edward Island in boys. Conclusions: Since their introduction, Canadian school-based HPV public vaccination programs have evolved from a three-dose to a two-dose schedule, from a quadrivalent to a nonavalent vaccine, and from a girls-only to a gender-neutral policy. Vaccination coverage rates have varied markedly and only Prince Edward Island and Newfoundland/Labrador have maintained rates exceeding 80%.

Keywords: Canada; human papillomavirus; public health programs; school health services; vaccination; vaccine policy.

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Conflict of interest statement

We have read and understood Current Oncology’s policy on disclosing conflicts of interest and declare the following interests: AG, VR, and PB are employees of Merck Canada Inc., Kirkland, QC, Canada. GPY and SK are employees of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc. Kenilworth, NJ, USA and may own stock in Merck & Co., Inc., Kenilworth, NJ, USA. ELF has served as occasional advisor to companies involved with HPV vaccination (Merck & Co., Inc. and GlaxoSmithKline) and HPV diagnostics (Roche and Becton Dickinson). His institution has received unconditional grants from Merck & Co., Inc. and Roche in support of research that he initiated at McGill University.

Figures

Figure 1
Figure 1
Map of Canada with provinces and territories.
Figure 2
Figure 2
Time trends in HPV vaccination coverage rates in schoolgirls in school years 2007/08 to 2018/19 in the 10 provinces with data. Vaccination coverage rates are reported for full course of treatment at the time of the vaccination. Vaccination coverage rates may not be comparable across provinces as each province used its own methodology. Source: Canadian Partnership Against Cancer System Performance and provincial health authorities [10,12,13,15,17,19,20,21,31,37,38,39].
Figure 3
Figure 3
Most recent HPV vaccination coverage rates in schoolgirls and schoolboys, by province. Shown are the most recent data only for provinces with vaccination of both girls and boys. Data are for 2016/17 for Nova Scotia. Data are for 2017/18 for Alberta and Ontario. Data are for 2018/19 for British Columbia, Quebec, New Brunswick, and Prince Edward Island. Source: Canadian Partnership Against Cancer System Performance and provincial health authorities [10,11,12,13,14,15,16,17,18,19,20,23,36,37,39].
See this image and copyright information in PMC

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