ARCHIVED - Recommendations on a Human Papillomavirus Immunization Program

To decrease the morbidity and mortality associated with cervical cancer, its precursors and other HPV-related cancers in women in Canada, the CIC recommends school-based HPV vaccination of one female cohort to be implemented in all Canadian provinces and territories.

1. To immunize 80% of school-aged girls in either grade 4, 5, 6, 7 or 8 with the required doses of the HPV vaccine within 2 years of program introduction.
2. To immunize 90% of school-aged girls in either grade 4, 5, 6, 7 or 8 with the required doses of the HPV vaccine within 5 years of program introduction.

Particular efforts should be undertaken to achieve high vaccine coverage for routine programs in hard-to-reach and high-risk populations. Catch-up strategies could be extended to these populations.

For jurisdictions that wish to and are able to consider catch-up programs could proceed with the inclusion of additional female cohorts. Particular efforts should be undertaken to achieve high vaccine coverage for routine programs in hard-to-reach and high-risk populations. Catch-up strategies could also be extended to these populations.

Following the manufacturers' indications for the quadrivalent HPV vaccine, NACI recommends a three-dose schedule (0, 2 and 6 months),(2).

The introduction of vaccination is expected to have a major impact ultimately on screening recommendations, and the two activities must now be planned simultaneously. An immunization program should constitute part of a comprehensive cervical cancer prevention program.

To develop a detailed evaluation plan that would include:

• Vaccination coverage;
• Incidence and prevalence of HPV-associated diseases and cervical cancer;
• Efficacy and duration of protection by the vaccine;
• Psychosocial impact of vaccination; and
• Optimal cervical cancer screening approaches.