Improving Human Papillomavirus (HPV) Vaccine Uptake in Canada: A Call for Equity and Inclusivity.

Human Papillomavirus (HPV) is the most common sexually transmitted infection worldwide. Specifically, HPV is responsible for a large proportion of anal, cervical, vaginal, vulvar, penile and oropharyngeal cancers, highlighting the importance of optimizing the prevention of this public health issue. To date, vaccination is the most effective method for preventing HPV-related infections and associated diseases; however, vaccine uptake remains well below national targets. In Canada, gender-neutral HPV vaccination is recommended for all individuals between nine and 26 years, but can also be administered to adults until the age of 45. Despite widespread adoption of publicly-funded school-based vaccination programs, some populations report disproportionately lower rates of HPV vaccine uptake, including young adults, transgender peoples and men who have sex with men (MSM), rendering them vulnerable to morbidity and mortality. Addressing HPV-related disparities requires a coordinated, multi-level call to action involving collaboration between academic and community partners to normalize inclusive, gender-neutral vaccination. This paper explores opportunities for optimizing HPV vaccine uptake in Canada by emphasizing the importance of healthcare provider recommendation, improved access to community-based vaccination services, and representation of diverse populations (e.g., young adults, transgender peoples, MSM) in the development and delivery of vaccine communication/messaging. The time is now to normalize inclusive HPV vaccination in order to mitigate the persistence of vaccine-related disparities and strive toward global initiatives of health equity.