Human papilloma virus (HPV) is the most common sexually transmitted infection (STI) in the world – for more information about  HPV, check out our other factsheet on it! You may have heard that there is a vaccine that can help prevent some strains of HPV. How do they work? Should you get one? Are they safe? Here is some information about HPV and the vaccines to help you decide if an HPV vaccine is right for you.

What is HPV?

• It is a virus transmitted through skin-to-skin contact, particularly genital skin-to-skin contact, with someone who already has HPV.
• There are over 100 strains (kinds) of HPV, around 40 of which affect the genital and anal (butt) area.
• The majority of people with HPV do not show any symptoms of HPV and most people don’t even know they have it.
• HPV spreads easily, and it is estimated that 75% of Canadians will get at least one type of HPV at some point in their lives.
• HPV infections are usually cleared up by the immune system on their own over time. However, when the virus is not cleared, it remains in the body and can cause health problems.
• Low-risk HPV can cause genital warts, which are little bumps that can grow on the penis*, anus (butthole) or on the outside and inside of the vagina* (see the HPV factsheet for more information).
• High-risk HPV can cause changes to cells in the cervix (the opening to the uterus), which can lead to cervical cancer. It can also lead to anal, penile, vulvar (the genital area outside the vagina) and mouth/throat cancers.

*We know that these aren’t the words everyone uses for their bodies (e.g. trans folks), and support you using the language that feels best for you.

What are the vaccines?

• There is currently one HPV vaccine available in Canada:

• • Gardasil 9: This vaccine offers over 98% protection against the 9 most common strains of HPV: 2 low-risk strains (that can cause genital warts) and 7 high-risk strains (that can lead to cervical and other cancers).
  • There were other types of HPV vaccines once offered in Canada before 2016 that protected against fewer strains of HPV (between 2-4, depending on which vaccine you got). Talk to your healthcare provider if you believe you got these vaccines to discuss if additional vaccination is required.
• The vaccine trigger your immune system’s response to the virus. There is no way you can get HPV from getting an HPV vaccine.
• The vaccine is given by injection, usually in the upper arm.
• Depending on your age and the vaccine you choose, you may need 2 or 3 doses over a 6 month period. Your health care provider can clarify what’s recommended.
• While all the doses of the same vaccine are needed for it to be effective, if you miss/are late for a dose, talk to your clinician. If it is within a year, you can usually get the remaining doses without having to start over.
• Current studies show that the vaccines provide protection for at least 6 years
• The most common side effects of getting an HPV vaccine are pain at the time of injection, a sore arm, and redness or swelling at the site of injection for a few days after which then goes away.
• Less common side effects are fever, nausea, stomach upset and fainting shortly after the injection. The likelihood of having side effects is lower than with most other vaccines.
• No serious or life-threatening side effects of the vaccines have been documented.
• The vaccines do not treat any HPV you may already have (i.e., any existing genital warts or abnormal cervical cells).
• The base (adjuvant) of the Gardasil vaccine is aluminum hydroxyphosphate. Research has found that the quantities of the bases used in the vaccines are not harmful to people.
• The Gardasil 9 vaccine is made using yeast – if you have allergies to yeast, please let your clinician know.

Who can get an HPV vaccine?

• In Canada, Gardasil 9 is approved for people 9–45 years old.
• If you are interested in a vaccine but you don’t fit these categories, talk to your clinician.
• In Ontario, the Gardasil 9 vaccine is offered free of charge to people in Grade 7 in schools only (the cost is covered by OHIP), and can be ordered by your healthcare provider for free if you missed those vaccines in school and are now in grade 9-12.
• Toronto Public Health (TPH) has offered coverage for men up to 26 years of age who self identify as having sex with men (self-identify as gay, bisexual, or trans).
• For everyone else, Gardasil 9 is about $215 per dose. There may be more dispensing fees or taxes when bought at a pharmacy. You can only buy one dose at a time.
• The vaccines are covered by many insurance plans. You can ask your insurance provider if they are covered by your plan using the DIN (drug identification number). The DIN for Gardasil 9 is 02437058.

Should I get an HPV vaccine?

• It is important that you make an informed decision according to your own values.
• It’s suggested to get vaccinated before you become sexually active. However, the vaccines are still useful for people who are already sexually active. The likelihood that someone who is sexually active has already had all of the strains of HPV that the vaccine prevents is very low.
• If you are or may be pregnant, talk to your health care provider.

Where can I get an HPV vaccine?

• You need a prescription to get an HPV vaccine, which you can get from most sexual health clinics and family doctors. You would take the prescription to a pharmacy, buy the vaccine, and bring it back to your clinician to get the injection. You do this for each dose of the vaccine.
• If you qualify for free vaccines, your healthcare provider will order them from Public Health and store them for you, and you will return to your clinician to get the vaccine instead.
• If you are not going directly from the pharmacy to get the vaccine injected, talk to the pharmacist about storing the vaccine properly. Some clinics stock the vaccine onsite and some pharmacies can inject the vaccine at the pharmacy, but may charge an injection fee. Check with yours to find out.

How can you get tested for HPV?

• A nurse practitioner or doctor can tell if you have low-risk HPV (warts) by looking at any bumps you may have in and around your genitals and anus.
• A Pap test involves a small brush that sweeps the cervix to collect a sample of cells. The cells are then examined to see if there are any abnormalities caused by high-risk HPV. This does not test for HPV directly.
• Direct HPV testing for some strains of high-risk HPV is available with the same type of test as a pap smear (cervical smear), but is not covered by OHIP and costs $95. This test is recommended only in specific cases – discuss this with your clinician if interested.
• If you’re interested in testing for changes to the cells in your anus caused by high-risk HPV, check with your health care provider.
• There is currently no routine testing that detects changes in the cells caused by HPV inside the penis, mouth, or throat.

More to Consider

• HPV vaccines do not take the place of regular Pap testing.
• The vaccine does not protect you from other STIs or the strains of HPV not covered by the vaccine.