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The Manitoba Human Papillomavirus vaccine surveillance and evaluation system

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by Erich V. Kliewer, Alain A. Demers, Marc Brisson, Alberto Severini, Robert Lotocki, Brenda Elias, Gregory Hammond, George Wurtak and the Manitoba HPV Research Group

Abstract
Keywords
Findings
Authors
What is already known on this subject?
What does this study add?

Abstract

Background

With the recent introduction of a human papillomavirus (HPV) vaccine in Canada, it is important to establish surveillance and evaluation programs that not only track the uptake of the vaccine, but also assess its safety and its impact on: distribution of HPV type, cervical cancer screening programs, the incidence of anogenital warts, precancerous lesions and various cancers, and sexual behaviour.

Data sources and methods

Administrative databases, registries and questionnaire information are being linked to identify people receiving the HPV vaccine and to develop an evaluation system.

Interpretation

The availability of extensive linkable databases in Manitoba allows for the development of a comprehensive HPV vaccine surveillance and evaluation system that can address many of the questions related to the HPV vaccine. Aspects of the Manitoba surveillance and evaluation system could be implemented in other provinces that have similar databases.

Keywords

human papillomavirus vaccine, surveillance, evaluation, record linkage

Findings

A quadrivalent human papillomavirus (HPV) vaccine was approved for sale in Canada in July 2006 for females aged 9 to 26 years. This vaccine protects against infection from HPV types 6, 11, 16 and 18. Types 16 and 18 are responsible for approximately 70% of all cervical cancers, while types 6 and 11 are responsible for over 90% of anogenital warts. Clinical trials have shown that the vaccine is effective in preventing anogenital warts and precancerous cervical, vulvar and vaginal lesions. A bivalent (types 16 and 18) HPV vaccine is currently going through the Canadian regulatory approval process, and other HPV vaccines that protect against an increased number of HPV genotypes are being evaluated..[Full text]

Authors

Erich V. Kliewer (1-604 675-8000, ext. 7076; Erich.Kliewer@cancercare.mb.ca) and Alain A. Demers are with CancerCare Manitoba in Winnipeg, Manitoba; Marc Brisson is with Laval University in Quebec City, Quebec; Alberto Severini is with the Public Health Agency of Canada in Winnipeg, Manitoba; Robert Lotocki, Brenda Elias and Gregory Hammond are with the University of Manitoba, and George Wurtak is with the International Centre for Infectious Diseases in Winnipeg, Manitoba.

What is already known on this subject?

  • A quadrivalent HPV vaccine was approved for sale in Canada in July 2006.
  • Most provinces and territories have implemented school‑based vaccination programs.
  • Questions remain about the vaccine’s safety and its impact on anogenital warts, cervical abnormalities, cervical cancer screening, HPV type, and sexual behaviour.

What does this study add?

  • This article explains how linkable databases and registries available in Manitoba and other Canadian provinces and territories can be used to address questions about the HPV vaccine.