RE: Recent Evidence confirms that Canada’s school-based human papillomavirus (HPV) vaccination are greatly impacted due to COVID-19 Pandemic: Opportunities to Increase HPV vaccine rates
References
Canadian Partnership Against Cancer. HPV Immunization For the Prevention of Cervical Cancer. 2021. [cited Access 2021; Available from: https://s22457.pcdn.co/wp-content/uploads/2021/04/HPV-immunization-prevention-cervical-cancer-EN.pdf.
Canadian Cancer Statistics Advisory Committee in collaboration with the Canadian Cancer Society Statistics Canada and the Public Health Agency of Canada. Canadian Cancer Statistics 2023. 2023. [cited Access 2023.
Public Health Agency of Canada. An Advisory Committee Statement (ACS) National Advisory Committee on Immunization (NACI): Updated Recommendations on Human Papillomavirus (HPV) Vaccines: 9-valent HPV vaccine 2-dose immunization schedule and the use of HPV
Canadian Partnership Against Cancer. HPV Vaccine Access in Canada, 2022. 2022; Available from: https://www.partnershipagainstcancer.ca/topics/hpv-vaccine-access-2022/.
Government of Canada. Vaccination Coverage Goals and Vaccine Preventable Disease Reduction Targets by 2025 – Canada. 6. ca. 2019 2022-08-16 [cited 2023 2023-11-28]; Available from: https://www.canada.ca/en/public-health/services/immunization-vaccine-prior
Each year, 3,800 new cancer cases in Canada are attributed to HPV; by 2042, this number is expected to double to 6,600 cases[1]. Cervical cancer is now the fastest increasing cancer (+3.7%/year since 2015) in Canada as of 2023, marking the first significant increase in cervical cancer incidence since 1984 [2]. The HPV vaccine is safe, effective, and can prevent over 90% of these cases. In Canada, the HPV vaccine is recommended in 2-3 doses, for males aged 9-26 and for females aged 9-45 by the National Advisory Committee of Immunization (NACI)[3]. All provinces and territories have implemented gender neutral school-based HPV immunization programs (Grade 4-7, program varies by province/territory) for over a decade[1].
Across all provinces, pre-pandemic rates for HPV vaccine completion in school-based programs ranged from 57 to 91% [4]. Publicly available data suggest that in the post pandemic COVID era, there has been an important decline in school-based HPV completion rates ranging from 15 – 81%. Canada is at high risk of not achieving the target to have 90% of 17-year-olds fully vaccinated with the HPV vaccine by 2025[5]. The importance of taking action to increase HPV vaccination is critical to mitigate HPV and its cancer consequences on future generations of Canadians. There is a clear missed opportunity of HPV vaccine confidence, which has not been realized adequately by vaccine providers and in turn, receivers.
With school rates declining, we must expand our efforts beyond publicly funded programs. HCPs are frequently cited as Canadians’ most trusted source of vaccination information, which makes a HCP recommendation the single most effective component impacting an individual’s decision to vaccinate. It is the collective role of all HCPs to initiate a discussion about HPV vaccination with their patients. This includes allied HCPs e.g., pharmacists, nurses, dentists who are well positioned to make an HPV vaccine recommendation.
We must also highly consider the expansion of the eligibility criteria so that all provinces include Individuals with known immunodeficiencies, individuals who are HIV-positive, and Males who have sex with Males (MSM), which will avoid confusion and create equity for all Canadians.
HPVGlobalAction.org, offers free downloadable educational resources e.g., pamphlets/posters, which are available in 19 different languages, and were created by scientists, sexual health educators and patients, to capitalize on the principles of “simple is best” and are continually updated and refined as the science evolved.
The word ‘eliminate’ has never been applied to cancer before, but Canada can eliminate cervical cancer and have a profound impact on 8 other HPV-related cancers, which would have a profound impact on health and well-being of all Canadians.