Human Papillomavirus (HPV) and HPV Vaccine

The types of HPV virus are grouped according to their link with cancer. Infection with the "low risk" HPV viruses causes genital warts. "High-risk" types are associated with 70 per cent of cervical cancers. Most women who have been exposed to HPV do not develop cancer of the cervix, even if the HPV is a cancer-causing type. However, in some women the infection can remain and slowly lead to cancer if it is not found and treated. Cervical cancer affects about 1,400 Canadian women and causes 400 deaths each year. In Ontario about 500 women are diagnosed with cervical cancer each year, leading to 130 deaths annually.

Genital warts look like common skin warts. They usually appear as soft or hard, moist swellings, usually in the genital area. They often have a cauliflower-like appearance and may range in colour from pink, flesh-colour, white, brown or grey. They can be raised or flat, single or multiple, small or large. In women, they can appear on the vulva, in or around the vagina or anus, and on the cervix. Men may develop warts around the entrance to the urethra, on and under the foreskin, on the shaft of the penis, and around the anus.

Treatments used may vary depending on the number and location of the warts. Some common treatments available include:

• Cryotherapy, a procedure which 'freezes' the warts with liquid nitrogen
• Topical medications (e.g. podophyllin, trichloroacetic acid) applied directly to the warts
• Laser treatment or minor surgery are often used to treat the cervix or other internal warts

Over-the-counter wart treatments should never be used in the genital area.

• Abstinence is the best way to prevent HPV and other sexually transmitted infections (STIs).
• Condoms will significantly decrease the risk of getting most STIs and will help lower the chances of getting HPV infection.
• To prevent cervical cancer, make sure to have a regular Pap test.
• There are two HPV vaccines available, Gardasil® and Gardasil®9, that protect against common types of HPV infections.
• The vaccine(s) are publicly funded through The Ontario Ministry of Health and Long-term Care for all students beginning in grade 7 as well as certain high-risk groups. It can also be purchased privately with a prescription and may be covered through private insurance.
• Ottawa Public Health offers the HPV vaccine(s) beginning in grade 7 through a school-based clinic program.
  

• Being vaccinated will significantly lower the chances of getting both genital warts and cervical cancer. The vaccine is expected to provide long-term protection. If you have an infection with one of the HPV types in the vaccine, the vaccine will not prevent disease from that type, but will protect you against the other types of HPV covered by the vaccine.
• Sexually-active vaccinated women must continue to have regular Pap tests because the vaccine does not protect against all HPV types that cause cervical cancer.

• The vaccine is licensed in Canada for females aged 9 to 45 and males aged 9 to 26.
• The vaccine provides the best protection if given before becoming sexually active, although sexually-active women and men will still get good protection from being immunized.

• Girls and boys less than nine years of age.
• Women who are or may be pregnant.
• Anyone who is sick with a fever or has a moderate to severe illness should wait until they feel better to receive the vaccine.
• Anyone who has an allergic reaction to a previous dose of HPV vaccine or is allergic to aluminium or yeast.

• The most common reaction to Gardasil™ is redness, tenderness and swelling where the shot was given.
• Fever, nausea, dizziness and headache can also occur.
• Difficulty breathing has been reported very rarely.
• Allergic reactions such as hives, wheezing, or swelling of the face and mouth are very rare. If these symptoms occur, seek medical attention right away.