HPV Vaccination Uptake: Identifying Gaps, Barriers and Disparities in Canadian Population

Human papillomavirus (HPV) causes the most common viral infection of the reproductive tract worldwide. It is implicated in cervical, anal, oropharyngeal cancers and genital warts in males and females. Infections with HPV are common, it is estimated that 550,000 Canadians are infected yearly. Without prevention measures, it is projected that 75% of the population will contract HPV infection at one point in their lifetime. The World Health Organization recognizes vaccination as a strategic approach in the prevention of HPV-related diseases. In Canada, the HPV vaccine was approved in 2006. In spite of proven benefits, HPV vaccine uptake is suspected to be low and variable across Canada. To maximize obtainable benefits from HPV vaccination, it is crucial to understand the dynamics and interplay of factors underpinning HPV vaccine uptake in Canada. Using systematic literature review, meta-analysis and analysis of reliable secondary data; this thesis examined rates of HPV vaccine uptake, identified determinants of uptake and HPV vaccination gaps among different sub-populations in Canada. From the pooled result of meta-analysis; the proportion of HPV vaccination uptake was 47.0% (male) and 57.0% (female). Using the American College Health Assessment-National College Health Assessment (ACHA-NCHA), proportion of HPV vaccine uptake was 56.1% (female) and 22.2% (male). Furthermore, using the Childhood National Immunization Coverage Survey (CNICS) 2015; proportion of HPV vaccine uptake is 73.7% in girls. In terms of HPV vaccination trend; proportion of HPV vaccine uptake is 41.1%, 68.6% and 73.7% for CNICS 2011, 2013 and 2015 respectively. The observed HPV vaccine uptake proportions across Canadian subpopulations were well below the >80% target set by the Government of Canada. Significant determinants of HPV vaccine uptake were: age, birthplace of child, province of residence, race/ethnicity, history of vaccination, history of sexually transmitted infections and marital status. There were significant gaps in the HPV vaccine uptake among different sub-populations namely: male, men-sleeping-with-men (MSM), older age individuals, international and Aboriginal students (p-value <0.05). To improve on current HPV vaccination uptake in Canada, health education programs and intentional HPV catch-up vaccination programs are required. This is crucial especially for sub-populations with evidence of gaps in HPV vaccine uptake

Name thesis:degree_name

Doctor of Philosophy (Ph.D.)

Level thesis:degree_level

Doctoral

Discipline thesis:degree_discipline

Public Health

Grantor

University of Saskatchewan

Year dc:date.issued

2020

Author dc:creator

• Obidiya, Olatunji Sunday

Advisor dc:contributor.advisor

• Mutwiri, George

Committee members dc:contributor.committeemember

• Tikoo, Suresh
• Griebel, Philip
• Feng, Cindy
• Henry, Carol

• HPV infection
• HPV vaccination uptake
• determinants
• disparities
• Canadian population

Handle dc:identifier.uri

https://hdl.handle.net/10388/12945

OAI identifier oai:identifier

oai:harvest.usask.ca:10388/12945