HPV is one of the most common sexually transmitted infections in Canada and worldwide. It is estimated that as many as 75% of sexually active men and women will have at least one anogenital HPV infection in their lifetime, but most people with healthy immune systems will eventually clear the infection from their bodies. HPV is a leading cause of the ongoing increase in incidence in head and neck cancers.
Vertical transmission between mother and child is also a recognized mode of acquisition, particularly for respiratory papillomatosis.
HPV vaccination has shown a decrease of 88% in persistent oral HPV infections. As experts in oral health, the HPV Vaccine is within a dentist’s scope of practice as both head and neck cancers and oral papillomas are often identified by dentists and can be caused by the human papilloma virus (HPV). By taking a role in HPV vaccination dentists are leaders to all health professions and make a significant impact on public health.
Guidelines & Standards
Members are encouraged to order, prescribe, and administer the HPV vaccine while ensuring they follow guidelines and standards set in place by Alberta Health Services and legislation set out by the Government of Alberta.
Alberta Immunization Regulation
Alberta Public Health Act
Provincially funded HPV vaccinations (Under Age 26) are available to patients through certain public health clinics in Alberta. Privately funded vaccinations to persons outside this age range or persons choosing to receive their vaccinations outside a public health clinic may be administered by dentists, physicians, pharmacists. An intramuscular injection USC&LS code would be appropriate for use until dedicated vaccination codes are released in the 2023 USC&LS.
Health Canada has authorized three vaccines to prevent infections from the most common types of HPV: Gardasil®, Gardasil®9 (for females and males) and Cervarix® (for females only).
Previous guidance created confusion on who is eligible for HPV Vaccination, and as a result a large majority of Canadians remain unvaccinated against HPV. There is no upper age limit for receiving the HPV Vaccine. The HPV Vaccine is for everyone. A patient may still receive HPV vaccination even if there is a previous history of HPV infection.
To administer the HPV Vaccine in Your Practice
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Register for the Immunization Direct Submission Mechanism (IDSM)
- It is a mandatory requirement that all vaccines administered be submitted and recorded. This is done through the IDSM, a standalone web application which facilitates electronic submission of immunization and adverse event information to the provincial immunization repository (Imm/ARI)
- Access to the IDSM requires a remote token granted by the eHealth Support Services Team
- Users may apply for a remote token and a login for the Immunization Direct Submission Mechanism (IDSM)
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- Within the IDSM you must chart the type of vaccine, lot number, dose amount, route of administration, manufacturer, reason for immunization, and location
- Access to IDSM can help you understand past immunizations of the patient. (Example: HPV 9 was given in the USA and patient needs it on AB healthcare, so that it indicates dose #3 and series completion, you are able to input historical/patient reported vaccine, with date and type of vaccine)
- Best practice is to record immunization as soon as it is administered. By law, immunizations must be reported within 7 days of administration
- An Adverse Event Following Immunization (AEFI) must be reported to Alberta Health Services
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- Must be reported within three days
- Online form must be submitted
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Ordering the Vaccine
- Create an LSU account
- Email LSU directly to submit an order – vaccines@lsu3pl.ca
- Shipped and delivered with 3-5 days
- Shipments contain cold chain storage indicators which allows assessment of whether storage temperature parameters were exceeded. Vaccine received with a failed temperature indicator should not be administered.
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Vaccine Fridge Requirements
- Fridge must be approved by AHS for vaccine storage
- It is not mandatory to have a vaccine fridge. You can use a standard sized fridge with a vaccine thermometer inside. An under-counter bar-type fridge is not acceptable as the temperature variations within these devices is too great. In practice, the cost of a full-sized fridge does not differ significantly from a smaller pharmaceutical grade fridge.
- The fridge must be dedicated to medication storage – no food may be stored in the fridge. It is recommended to store only vaccine in the fridge or give consideration to how often the fridge might be opened if other medications are also stored.
- Yearly maintenance of the fridge is required
- Temperature Recording:
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- Readings must be within 2 – 8 degrees which is the optimal storage temperature, ideal is between 4-5 degrees
- Ensure temperature gauge is in the middle of fridge
- Must use VHR thermometer purchased through a Medical Supply Company
- Best practice is to check and log the temperature twice daily (AM & PM)
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- Once temperature is recorded, ensure that the min/max readings are cleared so that you will be able to see any variance in range between readings
- Check Friday PM and Monday AM – temperature should stay within range as the door to the fridge will not be opened over the weekend
- Designate one person for daily documentation and an alternate
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Storage of Vaccine
- Upon arrival, vaccine is shipped in temperature regulated container. Immediately place the contents of the container in fridge upon receipt.
- Have Styrofoam containers and ice packs on-hand if the vaccine is needed to be moved, or temperature in fridge drops suddenly
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Continuing Education
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Emergency Preparedness
- Dentists are exceptionally prepared for management of adverse events related to vaccination administration. Specifically, protocols for management of anaphylaxis and medications for management of anaphylaxis such as epinephrine must be on site.
