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HPV Vaccine Uptake Among Canadian Youth and The Role of the Nurse Practitioner

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Abstract

The human papillomavirus (HPV) infects approximately 550,000 Canadians annually. Cancers of the cervix, mouth, anus, throat and neck are caused by various strains of the virus. The virus also causes genital warts. The disease and economic burden of HPV is high. Primary prevention through vaccine administration prior to onset of sexual activity is evidenced as best practice. Two vaccines are available, Gardasil and Cervarix. Consistent with global practices in developed countries, these vaccines are currently publicly funded for females and provided in school-based clinics in all provinces and territories in Canada. Despite well-documented efficacy with minimal adverse effects, the uptake of these vaccines remains low in all countries, including Canada. Although HPV immunization rates have increased, they remain significantly below the rates of other vaccine-preventable diseases. This is puzzling since school-based clinics and public funding presumably increase vaccine access. Barriers explicated include family lack of knowledge about the vaccine, and attitudes that are not informed by science and epidemiology. There is evidence that a health provider’s recommendation is the single biggest influence on uptake. However, not all providers are cognizant about emerging issues in this area, including controversies about universal coverage for boys as well as girls, new vaccines and more. Nurse practitioners are in a position to collaborate with public health agencies to expand knowledge and coverage across Canada.

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References

  1. National Advisory Committee on Immunization. (2012). Update of Human Papillomavirus (HPV) Vaccines. http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/12vol38/acs-dcc-1/index-eng.php.

  2. Society of Obstetricians and Gynecologists of Canada. (2007). Canadian consensus guidelines on human papillomavirus. http://sogc.org/guidelines/canadian-consensus-guidelines-on-human-papillomavirus/.

  3. Public Health Agency of Canada. (2015a). Canadian immunization guide. http://www.phac-aspc.gc.ca/publicat/cig-gci/p04-hpv-vph-eng.php.

  4. Isaranuwatchi, W., Graham, D., Siu, L., & Hoch, J. (2014). Could the human papillomavirus vaccination be cost-effective in males for the prevention of oropharyngeal cancer? Expert Review of Pharmacoeconomics and Outcomes Research, 14(6), 763–765.

    Article  Google Scholar 

  5. Public Health Agency of Canada. (2015b). Immunization coverage in Canada (2002–2012). http://www.phac-aspc.gc.ca/im/nics-enva/icc-cvc-eng.php.

  6. Ogilvie, G. S., Cook, D. A., Taylor, D. L., et al. (2013). Population-based evaluation of type-specific HPV prevalence among women in British Columbia, Canada. Vaccine, 31(7), 1129–1133.

    Article  PubMed  CAS  Google Scholar 

  7. Ogilvie, G. S., Taylor, D. L., Achen, M., Cook, D. A., & Krajden, M. (2009). Self-collection of genital human papillomavirus specimens in heterosexual men. Sexually Transmitted Infections, 85(3), 221–225.

    Article  PubMed  CAS  Google Scholar 

  8. Dawar, M., Dobson, S., & Deeks, S. (2007). Literature review on HPV 6, 11, 16 and 18: disease and vaccine characteristics. http://www.phac-aspc.gc.ca/naci-ccni/lr-sl_2-eng.php.

  9. Kaplan-Myrth, N., & Dollin, J. (2007). Cervical cancer awareness and HPV prevention in Canada. Canadian Family Physician, 53, 693–697.

    PubMed  PubMed Central  Google Scholar 

  10. Smith, A., Stewart, D., Poon, C., Peled, M., Saewyc, E., & McCreary Centre Society (2014). From Hastings Street to Haida Gwaii: Provincial results of the 2013 BC Adolescent Health Survey. Vancouver, BC: McCreary Centre Society. http://www.mcs.bc.ca/pdf/From_Hastings_Street_To_Haida_Gwaii.pdf.

  11. Statistics Canada. (2013). Sexual behavior and condom use of 15-to-24-year olds in 2003 and 2009/2010. http://www.statcan.gc.ca/pub/82-003-x/2012001/article/11632-eng.htm.

  12. Morris, S., & Nguyen, C. (2008). The human papillomavirus in Canada. Canadian Journal of Public Health, 99(2), 114–116.

    PubMed  Google Scholar 

  13. Okoronkwo, C., Sieswerda, L. E., Cooper, R., Binette, D., & Todd, M. (2012). Parental consent to HPV vaccination for their daughters: The effects of knowledge and attitudes. Canadian Journal of Human Sexuality, 21, 117–126.

    Google Scholar 

  14. Society of Obstetricians and Gynaecologists of Canada. (2015). Gardasil 9 HPV vaccine now available in Canada. http://sogc.org/news_items/gardasil-9-hpv-vaccine-now-available-in-canada-2/.

  15. Ogilvie, G., Anderson, M., Marra, F., et al. (2010). A population-based evaluation of a publicly funded, school-based HPV vaccine program in British Columbia, Canada: Parental factors associated with HPV vaccine receipt. PLoS Medicine, 7(5), 1–11.

    Article  Google Scholar 

  16. Smith, L. M., Brassard, P., Kwong, J. C., Deeks, S. L., Ellis, A. K., & Lévesque, L. E. (2011). Factors associated with initiation and completion of the quadrivalent human papillomavirus vaccine series in an Ontario cohort of grade 8 girls. BMC Public Health, 11(1), 2–11.

    Article  Google Scholar 

  17. Canadian Immunization Committee. (2007). Recommendations on a human papillomavirus immunization program. http://www.phac-aspc.gc.ca/publicat/2008/papillomavirus-papillome/pdf/CICHPV_Recommendations_Final.pdf.

  18. Sauvageau, C., Duval, B., Gilca, V., Lavoie, F., & Ouakki, M. (2007). Human papillomavirus vaccine and cervical cancer screening acceptability among adults in Quebec, Canada. BMC Public Health, 7(304), 1–6.

    Google Scholar 

  19. Ogilvie, G. S., Remple, V. P., Marra, F., et al. (2007). Parental intention to have daughters receive the human papillomavirus vaccine. CMAJ: Canadian Medical Association Journal, 177(12), 1506–1512.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Wilson, S., Harris, T., Sethi, P., Fediurek, J., Macdonald, L., & Deeks, S. (2013). Coverage from Ontario, Canada’s school-based HPV vaccine program: The first three years. Vaccine, 13, 757–762.

    Article  Google Scholar 

  21. Naus, M., & Ogilvie, G. (2010). Human papillomavirus vaccine program in BC: A good start with room for improvement. BC Medical Journal, 52(2), 95–99.

    Google Scholar 

  22. Public Health Agency of Canada. (2014). Recommendations for human papillomavirus immunization program. http://publications.gc.ca/collections/collection_2014/aspc-phac/HP40-107-2014-eng.pdf.

  23. Kessels, S. J., Marshall, H. S., Watson, M., Braunack-Mayer, A. J., Reuzel, R., & Tooher, R. L. (2012). Factors associated with HPV vaccine uptake in teenage girls: A systematic review. Vaccine, 30(24), 3546–3556.

    Article  PubMed  Google Scholar 

  24. Future I/II Study Group. (2010). Four year efficacy of prophylactic human papillomavirus quadrivalent vaccine against low grade cervical, vulvar, and vaginal intraepithelial neoplasia and anogenital warts: Randomised controlled trial. BMJ: British Medical Journal, 341(7766), 239–248.

    Google Scholar 

  25. Gainforth, H., Cao, W., & Latimer-Cheung, A. (2012). Determinants of human papillomavirus (HPV) vaccination intent among three Canadian target groups. Journal of Cancer Education, 27, 717–724.

    Article  PubMed  Google Scholar 

  26. Holman, D., Bernard, V., Roland, K., Watson, M., Liddon, N., & Stokley, S. (2014). Barriers to human papillomavirus vaccination among US adolescents. A systematic review of the literature. JAMA Pediatrics, 168(1), 76–82.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Poland, G., & Jacobson, R. (2012). The clinician’s guide to the anti-vaccinationists’ galaxy. Human Immunology, 73, 859–866.

    Article  PubMed  Google Scholar 

  28. Ritvo, P., Irvine, J., Klar, N., et al. (2003). A Canadian national survey of attitudes and knowledge regarding preventive vaccines. Journal of Immune Based Therapies and Vaccines, 1(3), 1–9.

    Google Scholar 

  29. Duval, B., Gilca, V., McNeil, S., et al. (2007). Vaccination against human papillomavirus: A baseline survey of Canadian clinicians’ knowledge, attitudes and beliefs. Vaccine, 25(45), 7841–7847.

    Article  PubMed  Google Scholar 

  30. Dobson, S., McNeil, S., Dionne, M., et al. (2013). Immunogenicity of 2 doses of HPV vaccine in younger adolescents vs 3 doses in young women: A randomized clinical trial. The Journal of the American Medical Association, 309(17), 1793–1802.

    Article  PubMed  CAS  Google Scholar 

  31. BC Center for Disease Control. (2014). Human papillomavirus (HPV) 2 dose schedule Q & A document. http://www.bccdc.ca/NR/rdonlyres/8599987C-3B80-41A1-8557-F3AF83A2E71D/0/2Dose_HPV_Program_QA_Oct15_2015.pdf.

  32. National Advisory Committee on Immunization. (2015). Update on the recommended human papillomavirus vaccine immunization schedule. http://www.phac-aspc.gc.ca/naci-ccni/acs-dcc/2015/hpv-vph_0215-eng.php.

  33. Quebec. (2015). HPV vaccination program. http://www.msss.gouv.qc.ca/sujets/santepub/vaccination/index.php?aid=193.

  34. Government of Saskatchewan. (2015). Saskatchewan immunization manual. Chapter 10: Biological products. http://www.ehealthsask.ca/services/manuals/Documents/sim-chapter10.pdf.

  35. QUEST Study. (2015). Quadrivalent HPV vaccine evaluation study. http://questhpvstudy.ca/.

  36. Statistics Canada. (2014). Same-sex couples and sexual orientation… by the numbers. http://www.statcan.gc.ca/dai-quo/smr08/2014/smr08_189_2014-eng.htm.

  37. Public Health Agency of Canada. (2013). Canadian guidelines on sexually transmitted infections: Section 6: Specific populations. http://www.phac-aspc.gc.ca/std-mts/sti-its/cgsti-ldcits/section-6-3-eng.php.

  38. Canadian Immunization Committee. (2014). Summary of Canadian Immunization Committee (CIC) recommendations for human papillomavirus immunization programs. Canadian Communicable Disease Report 2014, 40(8), 152–153.

  39. Alberta Health. (2014). Immunization. http://www.health.alberta.ca/health-info/immunization.html.

  40. Prince Edward Island. (2014). Immunization. http://www.gov.pe.ca/health/immunizationschedule.

  41. Government of Nova Scotia. (2015). Budget highlights for fiscal year 2015–2016. http://novascotia.ca/news/release/?id=20150409002.

  42. Quinn, S., & Goldman, R. (2015). Human papillomavirus for boys. Canadian Family Physician, 61, 43–46.

    PubMed  PubMed Central  Google Scholar 

  43. Canadian Nurses Association. (2010). Canadian nurse practitioner core competency framework. https://www.cna-aiic.ca/~/media/cna/files/en/competency_framework_2010_e.pdf.

  44. Lenehan, J. G., Leonard, K. C., Nandra, S., Isaacs, C. R., Mathew, A., & Fisher, W. A. (2008). Women’s knowledge, attitudes, and intentions concerning human papillomavirus vaccination: Findings of a waiting room survey of obstetrics-gynaecology outpatients. Journal of Obstetrics and Gynaecology Canada, 30, 489–499.

    PubMed  Google Scholar 

  45. Rosenthal, S. L., Weiss, T. W., Zimet, G. D., Ma, L., Good, M. B., & Vichnin, M. D. (2011). Predictors of HPV vaccine uptake among women aged 19–26: Importance of a physician’s recommendation. Vaccine, 29(5), 890–895.

    Article  PubMed  CAS  Google Scholar 

  46. Ogilvie, G. S., Remple, V. P., Marra, F., et al. (2008). Intention of parents to have male children vaccinated with the human papillomavirus vaccine. Sexually Transmitted Infections, 84(4), 318–323.

    Article  PubMed  CAS  Google Scholar 

  47. Government of New Brunswick. (2015). FAQ–HPV and HPV vaccine. http://www2.gnb.ca/content/gnb/en/departments/health/NewBrunswickCancerNetwork/content/FrequentlyAskedQuestionsForNewBrunswickScreeningPrograms/FAQ-HPV.html.

  48. Daley, A. (2011). Providing adolescent-friendly HPV education. The Nurse Practitioner, 36(11), 35–40.

    Article  PubMed  Google Scholar 

  49. BC Center for Disease Control. (2009). HPV Q & A #3. http://www.bccdc.ca/NR/rdonlyres/5C8F3267-18DF-4F1A-94BB-403907566CA5/0/Imms_GF_HPV_Q_A_3_September3_09.pdf.

  50. Singh, A., Wong, T., & Howlett, R. (2008). Human papillomavirus vaccines: Why the time is right to implement immunization and surveillance programs in Canada. The Canadian Journal of Infectious Diseases and Medical Microbiology, 19(4), 294–296.

    PubMed  PubMed Central  Google Scholar 

  51. College of Physicians and Surgeons of Ontario. (2015). Consent to treatment: policy statement #3–15. http://www.cpso.on.ca/CPSO/media/documents/Policies/Policy-Items/Consent-To-Treatment.pdf?ext=.pdf.

  52. Graham, D., Isaranuwatchai, W., Habbous, S., et al. (2015). A cost-effectiveness analysis of human papillomavirus vaccination of boys for the prevention of oropharyngeal cancer. Cancer, 121(11), 1785–1792.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Faculty of Nursing, University of New Brunswick, 33 Dineen Drive, Fredericton, NB, E3B 5A3, Canada

    Katlyn Scott & Mary Lou Batty

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  1. Katlyn Scott
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Correspondence to Katlyn Scott.

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Scott, K., Batty, M.L. HPV Vaccine Uptake Among Canadian Youth and The Role of the Nurse Practitioner. J Community Health 41, 197–205 (2016). https://doi.org/10.1007/s10900-015-0069-2

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