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

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.