Eliminating cervical cancer in Canada
Solutions to increase HPV vaccination rates
Urgent action is needed for Canada to reach its target of 90 per cent of 17-year-olds fully vaccinated with the HPV vaccine. To ensure equitable access to vaccination for all people in Canada, barriers and solutions to reaching under-vaccinated populations and individuals need to be identified, understood and addressed. Many solutions will have a broader benefit to public health by improving public access to and acceptability of health services like vaccines.
- low awareness and knowledge of HPV and the HPV vaccine and low confidence in the vaccine, particularly among parents and caregivers;
- unique and distinct barriers to getting the vaccine among rural and remote communities; people with low income; recent immigrants; First Nations, Inuit and Métis; people of certain races or ethnicities; and 2SLGBTQIA+ people:
- low trust in healthcare providers and the public health system due to historical and ongoing medical racism and discrimination;
- lack of religious and cultural safety in the health system;
- limited diversity and representation in the health workforce.
- limited standardized data, including Peoples-specific and self-governed data for First Nations, Inuit and Métis populations, that describes who is and is not vaccinated for HPV across Canada;
- limited and inconsistent access to the publicly funded HPV vaccine, compounded by the high cost to privately purchase the vaccine;
- inconsistent knowledge sharing across regions about HPV vaccination strategies that work well and those that don’t.
- standardizing information about HPV, HPV vaccination and its role in cancer prevention across provinces and territories while promoting it in a community-specific and culturally competent way;
- prioritizing trust-building between people and providers and between communities and public health (e.g., by partnering with community-based organizations, working with local leaders and community champions, and providing anti-racism education for healthcare providers);
- regularly collecting and reporting vaccination rates at local and provincial/territorial levels, including race-disaggregated and Peoples-specific data to ensure health equity remains a focus;
- increasing eligibility for and access to HPV vaccination such as by adopting a “once eligible, always eligible” policy, providing alternative access points to the HPV vaccine outside of schools, and offering a single dose to all individuals 9 to 20 years of age, unless immunocompromised;
- evaluating interventions to improve HPV vaccination rates and sharing lessons learned across regions, provinces and territories to inform best practices.
One-dose HPV vaccination coverage supports cervical cancer elimination
National Advisory Committee on Immunizations (NACI) updated guidance recommends one dose of the HPV vaccine for all individuals 9 to 20 years of age, unless immunocompromised. As of 2025, Quebec, Yukon, Nova Scotia, and British Columbia all offer a publicly funded one-dose HPV vaccination schedule.
HPV vaccination guidance by province/territory, by dose (2025)
Hover over each province and territory for HPV vaccination dose details.
Legend
● 1 dose ● 2 doses
All provinces and territories administer GARDASIL®9 on a one-, two- or three-dose schedule according to the National Advisory Committee on Immunization recommended vaccination schedule for HPV vaccines.
Data tables and footnotes
Across all provinces and territories, approximately 84 per cent of 14-year-old girls and 81 per cent of 14-year-old boys have received at least one dose of the HPV vaccine.(1) The reduction in required HPV vaccine doses and associated resources can instead support expanded eligibility or vaccination program enhancement to better support coverage rates among historically under-immunized populations.
Case example
A single dose of the HPV vaccine is effective and protects against HPV infection. By moving to a one-dose vaccination program, substantially fewer doses of the HPV vaccine will be needed to achieve cervical cancer elimination. For example, in the 2023-2024 school year in Ontario, 52.3 per cent of 12-year-olds had received two doses of the HPV vaccine. However, an additional 15.4 per cent per cent of 12-year-olds had received one dose of the HPV vaccine.(2) By moving to a one-dose vaccination system, Ontario could have full coverage among 67.7 per cent of eligible students, bringing the province closer to the goal of 90 per cent coverage and the elimination of cervical cancer.
Immunization coverage for human papillomavirus (HPV) among 12-year olds by number of doses, Ontario 2019-20 to 2023-24 school years
Legend
● 0 doses ● 1 dose ● 2 doses ● 3 or more doses
Data tables and footnotes
HPV immunization is a safe and effective public health measure for reducing the spread of HPV. One of the best things we can do for women’s health is to boost immunization rates to ensure the next generation of Canadian women are cervical cancer-free."
Anne Pham-Huy, MD, Chair, Immunize Canada
Stories of progress
Increasing HPV vaccination rates among under-vaccinated people across Canada
The Urban Public Health Network is leading work with partners across Canada, including working with First Nations, Inuit and Métis organizations and equity-denied populations to uncover barriers to human papillomavirus (HPV) vaccination and implement community-specific solutions to increase uptake.
Hear from Dr. Thilina Bandara, Assistant Professor at the University of Saskatchewan’s School of Public Health, about UPHN’s work:
Building trust to improve HPV vaccine uptake in Alberta Métis Settlement communities
Alberta Health Services engaged Métis Settlement communities to explore the barriers and facilitators to HPV vaccine uptake. The findings revealed that there is a:
- lack of awareness and knowledge about HPV and the HPV vaccine;
- lack of culturally safe engagement by public health staff to foster trust in the healthcare system and HPV vaccine programming;
- need to increase education regarding HPV and HPV vaccines for parents, care providers and youth.
Community Elders and Knowledge Holders noted that establishing trusting partnerships with communities is critical to improving HPV knowledge and awareness in support of vaccine uptake. There is a need for tailored strategies and resources to ensure increased education and resources to support parents, grandparents, youth and teachers. These engagements also highlighted the benefits of providing healthcare providers with knowledge and awareness of Métis communities.
- Public Health Agency of Canada. Highlights from the 2021 childhood National Immunization Coverage Survey (cNICS) [Internet]. 2023. Available from: https://www.canada.ca/en/public-health/services/immunization-vaccines/vaccination-coverage/2021-highlights-childhood-national-immunization-coverage-survey.html.
- Public Health Ontario. Immunization Coverage Report for School-Based Programs in Ontario: 2019-20, 2020-21 and 2021-22 School Years with Impact of Catch-up Programs [Internet]. 2023. Available from: https://www.publichealthontario.ca/-/media/Documents/I/2023/immunization-coverage-2019-2022.pdf.