What is Human Papilloma Virus (HPV)?

HPV is a common virus. Three out of four Canadians will have at least one HPV infection in their lifetime. HPV is usually spread during sexual activity by skin-to-skin contact with an infected person. There are many different types of HPV. Some types of HPV can cause cancer of the cervix in women, and other types can lead to genital warts and other cancers (genitals, head and neck) in both men and women.

Symptoms

Most HPV infections do not have any symptoms. Genital warts are the most common symptoms. They are usually painless but may be itchy and uncomfortable. Symptoms may occur months after being infected.

Treatment

There are no antibiotics to treat HPV infection. Most people will fight the infection with their own body’s immune system. However, in some, the infection does not clear on its own and can progress to cancer. Warts and changes on the cervix that do not go away can be treated with chemical preparation, liquid nitrogen, laser, or surgery. Treatments will remove the warts, but do not remove the virus from the body so the warts can return.

Protection

Get vaccinated. Three doses of the vaccine are required for complete protection. It is best to get the HPV vaccine before becoming sexually active and coming in contact with HPV, but you are likely to benefit from the vaccine even if you are already sexually active. The vaccine does not cure HPV infections that have already occurred.

Avoid contact with an infected person; there is always some risk during intimate skin-to-skin contact.

HPV Vaccines Available:

Gardasil – Protects against four types of HPV-types 16 and 18 (cause over 70% of cervical cancers), and types 6 and 11 (cause over 90% of genital warts). It can be given to males (9-26 years old) and females (9-45 years old).

Cervarix – Prevents the type types (16, 18) that cause cervical cancer; it can be given to females (10-26 years old).

Side Effects

The HPV vaccine is safe, and has few side effects. You cannot become infected with HPV from the vaccine. The most common reactions include soreness, redness, and swelling in the arm where the shot was given. Less common reactions include dizziness, nausea, headache, fever, and muscle or joint aches. These last one or a few days. Severe allergic reactions are rare. This may include hives or rashes, difficulty breathing, or swelling of the throat, tongue, lips or eyes. Get medical attention immediately if a serious reaction develops after receiving the vaccine.

Who should not get the HPV vaccine?

The HPV vaccine should not be given to anyone who:

• Has been fully immunized with the HPV vaccine
• Has had a serious reaction to a previous dose of the HPV vaccine
• Has an allergy or hypersensitivity to any ingredient of the vaccine
• Is pregnant
• Has a high fever or an infection worse than a cold

What is Hepatitis A?

Hepatitis A virus results in a temporary infection in the liver. Hepatitis A is found in the stool (bowel movements) of persons infected with the virus. It is spread from person to person by putting anything in the mouth that has been contaminated with the stool of a person with hepatitis A. Hepatitis A cannot spread through sneezing, coughing, hugging, or sitting next to an infected person. Once you have had a hepatitis A infection, you cannot get it again.

Symptoms

Symptoms can include fever, loss of appetite, tiredness, nausea, vomiting, and jaundice (yellowing of skin or eyes).

Prevention

To prevent a hepatitis A infection always wash your hands with soap and warm water after using the toilet, changing diapers, and before and after eating or making food. Make sure to wash uncooked food before use, especially fruits, vegetables, and shellfish. Cook all foods thoroughly.

Protection

One shot of hepatitis A vaccine will provide protection against the infection for 1 year. With an additional dose of hepatitis A vaccine 6 to 12 months after the initial shot, it provides a lifetime protection against the virus.

Side Effects

Most people do not experience any side effects. Some may experience some pain and redness at the site of injection. A few may have a mild fever and headache following the shot. Rarely, someone may have an allergic reaction to the vaccine, which can result in difficulty breathing, swelling in the mouth, or hives.

When should I call a doctor?

Call your doctor if you experience a severe allergic reaction or if any side effects last for more than 2 days.

Who should not get the Hepatitis A vaccine?

You should not receive the Hepatitis A vaccine if you:

• Have had a hepatitis A infection before or received 2 shots of hepatitis A vaccine
• Had a severe reaction to the hepatitis A vaccine previously
• Have allergies to neomycin (antibiotic)
• Have a severe allergy to any other components of the vaccine

Infants less than 12 months of age should not receive this vaccine.

For individuals who cannot get the vaccine, a “shot” called an immune globulin can be given. Immune globulin is a sterile preparation of antibodies that can lower the risk of infection for about 3 to 5 months.

What is Hepatitis B?

Hepatitis B is a virus that infects the liver. It can result in liver failure, liver cancer, and even death. Hepatitis B can be passed from person to person. You can get hepatitis B through contact with blood or other body fluids from an infected person. It can be spread through sex, sharing needles or razors, and body/ear piercing or tattooing with dirty equipment. An infected mother can pass it to her child during birth. Health care and emergency service workers can get it from needle stick injuries and blood splashes in the eyes, nose and mouth, or on broken skin. You cannot get hepatitis B from coughing, hugging, or using the same dishes as an infected person.

Symptoms

Half of the infected people do not show any symptoms but can still pass it on to others. Symptoms can include feeling tired, fever, loss of appetite, and sometimes yellow eyes and skin, and dark coloured urine. Hepatitis B can only be diagnosed with a blood test.

Treatment

There is not cure for acute infection of hepatitis B. Most people get better but about 10% carry the virus for life, and can continue to infect others. Some may have liver problems for the rest of their life. There are some medications that may help a person who has a chronic infection but is not always successful.

Prevention

Getting the hepatitis B vaccine will prevent you from becoming infected should you come into contact with someone with hepatitis B. For complete protection, hepatitis B vaccine requires two shots, if you are between 11 and 15 years of age, or three doses for all other age groups. People who are travelling can get 3 doses within 21 days, but need to receive another dose 12 months later for full protection.

You can also prevent being infected by using clean equipment when getting piercing or tattoos. Do not share any personal care products like razors or toothbrushes, and do not have unprotected sexual activity.

Everyone should be protected against hepatitis B, especially family members of an infected person, injection drug users, people with multiple sexual partners, health care workers, babies born to mothers with hepatitis B, and people on dialysis for kidney failure.

Side Effects

The hepatitis B vaccine is safe but it may cause minor side effects. The side effects can include redness or soreness at the injected site. Some might feel tired or have a slight fever, but this usually goes away within 24 hours.

Call your health care provider if you have a more serious reaction – breathing trouble, swelling of the face or mouth, a fever over 39C, hives, or rashes occurring within 15 days.

Can this vaccine be given with other vaccines?

Yes, it is safe to receive the hepatitis B vaccine with any other vaccines.

Who should not get the hepatitis B vaccine?

You should not receive the hepatitis B vaccine if you:

• Have already been vaccinated against the virus
• Have had a serious reaction to any part of the hepatitis B vaccine
• have already been infected with the virus and have had a blood test that shows you are immune
• Have a fever or anything more serious than a minor cold

Tell your health care provider if you have had a past allergic reaction to a vaccine.

What is Polio?

Polio is a rare but serious disease that results from drinking water or ingesting food with polio germ in it. The infection can be found in the throat and stool of an infected person. It can spread through direct contact from person to person. It can spread through coughing, sneezing, and kissing. It can also spread through the stool by contamination of hands, food, or water. Polio can cause nerve damage and as a result, paralyze a person. It can also result in death.

Due to the success of vaccination, wild poliovirus has been eliminated in Canada. Poliovirus is still found in other parts of the world and could be re-introduced to Canada through travel or migration.

Protection

The polio vaccine protects 99% of people against the infection, if they receive the complete series of shots. Fully immunized children and adults do not require a booster dose. Polio vaccine should be given to anyone who has not completed the series recommended for their age. Polio vaccine is not administered routinely to adults. Only adults who are likely to come in contact with the polio germ need to receive the polio vaccine. These adults include:

• Unimmunized adults (including those with unknown polio immunization history) who are planning to travel to countries where there are polio outbreaks. They should receive a series of 3 doses.
• Adults who are planning to travel to countries where a poliovirus outbreak is occurring. They should receive a dose of vaccine if their last polio immunization was 10 or more years ago.
• Laboratory workers who handle specimens that may contain the polio germ.
• Health care workers who take care of patients who may have the polio germ.

Side Effects

The polio vaccine is safe. Side effects of the vaccine are mild and should only be present for a few days after getting the shot. Swelling, redness, or mild pain at the site of injection is common. A few people may get mild fever, however, allergic reactions are very rare.

When should I call a doctor?

Call your doctor if you experience any of the following symptoms within three days of receiving the vaccine:

• Hives
• Swelling of the face or mouth
• Trouble breathing
• Very pale colour and serious drowsiness
• High fever (over 40C)
• Convulsions or seizures
• Other serious problems

Who should not get the Polio vaccine?

You should not receive the polio vaccine if you have:

• A high fever or a serious infection worse than a cold
• A serious allergic reaction to the antibiotics neomycin or polymyxin B for IPV
• A serious allergic reaction to the antibiotics neomycin, polymyxin B, or streptomycin for Imovax
• Had a serious allergic reaction (anaphylaxis) to this vaccine previously
• A severe allergy or other serious reaction to any other component of the vaccine

What is Measles?

Measles is a serious infection that can result in high fever, cough, rash, runny nose, and watery eyes. It lasts for one to two weeks, and can be complicated by ear infections, pneumonia, an infection of the brain, and death. Measles can cause pregnant women to have a miscarriage or give premature birth. It spreads easily from person to person through virus droplets in the air via coughing, sneezing, and even talking.

What is Mumps?

Mumps is an infection in the salivary glands, which can result in fever, headaches, and swelling of the cheeks and jaws. One in 10 infected people can also get meningitis, an infection of the fluid and lining covering the brain and spinal cord. It can cause deafness in some persons. Mumps can cause very painful, swollen testicles in about one of 4 teenage boys or adult men. Mumps can cause a painful infection of the ovaries in one out of 20 women, and during the first 3 months of pregnancy may increase the risk of miscarriage. It can spread from person to person by contact with an infected person’s droplets through coughing, sneezing, talking, and through contact with saliva of an infected person (sharing drinks, food, or kissing).

What is Rubella?

Rubella, also known as German measles, is a disease that can result in fever, sore throat, swollen glands in the neck, and a rash on the face and neck. Rubella can lead to chronic arthritis, and can cause temporary blood clotting problems and encephalitis (swelling of the brain). Rubella is very dangerous in early pregnancy as it can cause miscarriage, stillbirth, or severe birth defects such as cataracts, deafness, heart defects, and mental retardation. It is spread through droplets when an infected person coughs or sneezes, or through contact with saliva of an infected person.

Protection

Two doses of MMR vaccine gives protection of 95% against all three diseases. Vaccination also makes these diseases milder for those who may catch them. Everyone should be protected against these diseases. It is given to children after their first birthday and then a follow up second dose is given before starting school. The vaccine should be administered to adults who are not protected against measles, mumps, and rubella. Pregnant women should be given this vaccine after their pregnancy.

Side Effects

The MMR vaccine is safe. Most people will have no side effects. Serious side effects are rare. Possible side effects include:

• Swelling, redness, or mild pain at the site of injection is common.
• A rash may occur 5 to 12 days after the injection and may last for 1 to 3 days.
• Fever may develop in the first 24 hours or 5-12 days after receiving the shot.
• Swelling in the glands of the neck, temporary joint pain and swelling, or muscle aches may also occur within 1 to 3 weeks after vaccination. Usually lasts only a few days.
• It is very rare, but 1 in 800,000 people vaccinated may develop meningitis.
• Rarely, some may experience a temporary mild blood clotting problem during the month following immunization, which will get better on its own.

Is it a problem to get pregnant after receiving this vaccine?

Wait a month after you receive the MMR vaccine before you try to get pregnant.

Who should not get the MMR vaccine?

You should not receive the MMR vaccine if you:

• Have a high fever or an infection worse than a cold
• Are pregnant, trying to get pregnant, or think you are pregnant
• Have had a severe allergic reaction (anaphylaxis) to a previous dose of MMR
• Have a severe allergy to any components of the vaccine
• Have had another live vaccine (ex. chickenpox vaccine) within the last 28 days
• Have received a gamma globulin shot within the past 3 to 12 months – depending on the dose and method of administration
• Are taking medication that lowers the body’s ability to fight infections

The MMR vaccine may be given to people who are allergic to eggs even if they have hives, wheezing, difficulty breathing, or swelling of the face or mouth after eating eggs, as long as they are observed after the vaccine for signs of a reaction.

What is Meningococcal Disease or Meningitis?

Meningococcal disease is an infection of the blood or lining of the brain and spinal cord caused by a bacteria (Neisseria meningitides) carried in the throat and nose of up to 30% of healthy people. In rare instances, the bacteria can overcome the body’s natural defenses and cause serious diseases, including meningitis (infection of the lining of the brain) and septicemia (widespread infection involving the blood and multiple organs). Meningococcal disease is fatal in 8-15% of cases. There are many different types of Neisseria bacteria. Five types, including A, B, C, Y, and W-135, cause almost all the infections.

How can someone get Meningococcal Disease?

The disease spreads through saliva by close face-to-face contact, usually by kissing or sharing food, drink, musical instruments, water bottles, cigarettes, or other things that have been in the mouth of a person with the disease.

Symptoms

Symptoms can come on very fast and make someone very sick. Symptoms include sudden onset of fever, a severe headache, feeling sick to the stomach, vomiting, and feeling tried, followed by a stiff neck, sensitivity to light, dizziness, and a red/purple blotchy rash. It can be treated with timely medical care and antibiotics.

Protection

There are a number of vaccines that protect against some of the various strains that cause meningococcal disease. Infants, children, adolescents, and young adults should receive this type of vaccine as part of their routine vaccinations. The following groups of people benefit from protection:

• People in close or direct contact with a person who has meningitis
• One year old children
• Youth between 15 and 25 years of age
• Individuals at increased risk of serious illness from invasive meningococcal disease due to certain chronic conditions

Side Effects

Some people may get redness and swelling where the needle was given. A few may have a sore arm that lasts about a day, or get headaches and feel tired or unwell for a short time after receiving the vaccine. Rarely, side effects include trouble breathing, a rash, or swelling in the throat or face. See a health care provider immediately if a serious reaction occurs following vaccination. 

Who should not get the meningococcal vaccine?

Individuals who:

• Are allergic to the vaccine (Men A, C, W, Y), or any of its components
• Have previously had a neurological condition called Guillian-Barre Syndrome
• Have been vaccinated in the last 6 months with another Neisseria meningitides polysaccharide vaccine
• Have been vaccinated within the last 1 month with another Neisseria meningitides conjugate vaccine
• Are on high dose corticosteroids or immunosuppressive agents, or who have immunosuppressive illness should delay vaccination until condition/treatment has resolved wherever possible
• Are pregnant or breastfeeding should consult with their health care practitioner
• Has a high fever or a serious infection worse than a cold

What is Tetanus?

Tetanus is a disease caused when dirt with the tetanus germ gets into a cut in the skin. Tetanus germs are found everywehre, usually in soil, dust, and manure. It does not spread from person to person. Tetanus leads to severe muscle cramps in the neck, arms, legs and stomach, and painful convulsions. Even with early treatment, tetanus kills two out of every 10 people diagnosed.

What is Diphtheria?

Diphtheria is a serious, but rare disease of the nose, throat, and skin. It causes sore throat, fever and chills, and can be complicated by breathing problems, heart failure, and nerve damage. It is spread through sneezing and coughing. Diphtheria kills one out of every 10 people diagnosed.

What is Pertussis?

Pertussis, or whooping cough, is a common disease that causes prolonged cough illness in children, adolescents, and adults. It may cause spells of violent coughs that can result in vomiting or cause breathing to stop for short periods of time. The cough can continue for many weeks, and therefore may cause difficulties in eating, drinking, sleeping, and breathing. Pertussis can cause serious complications such as pneumonia. It can also result in brain damage, seizures, and death, especially in babies. It spreads very easily to others through coughing or sneezing.

What is Polio?

Polio is a dangerous disease that people can get from drinking water or eating food with the polio germ in it. It is also spread from person to person. This disease can cause nerve damage and paralyze a person for life. It can paralyze muscles used for breathing, talking, eating, and walking. It can also cause death. There is no treatment for polio.

Treatment

Treatment options for tetanus and diphtheria include antibiotics and medications that protect aginst toxins produced by bacteria. Treatment is not always successful even with early detection.

See below for information on each of the vaccines:

• Td vaccine
• Tdap vaccine
• Td Polio vaccine

TD VACCINE

Protection

The Td vaccine, when given in the recommended number of shots, gives protection of 100% against tetanus and 95% against diphtheria. Vaccination also makes these diseases milder for those who may catch them. Everyone should be immunized with the Td vaccine. Most people get vaccinated against tetanus and diphtheria at early ages. It is recommended for these people to be vaccinated with a booster dose between the ages of 14 and 16. Adults who have been vaccinated with Td before, should receive a booster dose every 10 years. Anyone age 7 or above who has never received this vaccination, should receive three shots of the Td vaccination. The Td vaccine is also given when someone has a deep cut to protect them against tetanus and prevent tetanus bacteria from entering the body.

Side Effects

The Td vaccine is safe. Side effects of the Td vaccine are mild and should only be present for a couple of days. Swelling, redness, or mild pain at the site of injection is common. A few people may get mild fever, headache, muscle aches, or lose their appetite for a day or two after the shot.

When should I call a doctor?

Call your health care provider, or go to the nearest emergency department if you experience any of the following symptoms within three days of receiving the vaccine:

• Hives
• Swelling of the face or mouth
• Trouble breathing
• Very pale colour and serious drowsiness
• High fever (over 40C or 104F)
• Convulsions or seizures

Who should not get the Td vaccine?

You should not receive the Td vaccine if you:

• Have a high fever or a serious infection worse than a cold
• Have had a serious allergic reaction (anaphylaxis) to this vaccine, or any vaccine that contains tetanus or diphtheria in the past
• Have had a severe allergic reaction to any component of the vaccine
• Received a tetanus shot within the last 5 years

Can this vaccine be given with other vaccines?

Yes, it is safe to receive the Td vaccine with any other vaccines.

TDAP VACCINE

Protection

The Tdap vaccine, when given as a booster dose in adolescence, gives protection of 100% against tetanus, 95% against diphtheria, and 85% against pertussis. Vaccination also makes these diseases milder for those who may catch them. In Ontario, a booster shot of Tdap vaccine is given between 14 to 16 years of age (with eligibility until 18 years of age). This is approximately 10 years after the initial Tdap plus IPV received between 4 to 6 years of age. All adults 19 to 64 years of age who have never received the Tdap vaccine in adolescence are now eligible to receive one lifetime (publicly funded) dose of the vaccine. This lifetime dose replaces one of the Td booster doses given every 10 years.

Side Effects

Side effects of the Tdap vaccine are usually mild and should only be present for a couple of days. People may experience swelling, redness, or pain at the site of injection. Some less common side effects include headaches, decreased energy, body aches, nausea, chills, diarrhea, fever, sore joints, and vomiting. Allergic and other severe reactions (nervous system inflammation) are very rare.

When should I call a doctor?

Call your doctor, or go to the nearest emergency department if you experience any of the following symptoms within three days of receiving the vaccine:

• Hives
• Swelling of the face or mouth
• Trouble breathing
• Very pale colour and serious drowsiness
• High fever (over 40C)
• Convulsions or seizures
• Other serious problems, e.g. paresthesia (tingling, burning, prickling skin sensations)

Who should not get the Tdap vaccine? 

You should not receive the Tdap vaccine if you:

• Have a high fever or a serious infection worse than a cold
• Have had a serious allergic reaction to a previous dose of vaccine containing diphtheria, tetanus, or pertussis
• Have a history of an allergic reaction to any component of the vaccine
• Have a history of encephalopathy (disease of the brain) of undetermined cause within 7 days of receiving a vaccine with pertussis components
• Have a history of progressive or unstable neurological conditions
• Have a history of Guillian-Barre syndrome (inflammation of the nerves in the arms and the legs that can lead to temporary paralysis) within 8 weeks of getting a tetanus vaccine dose

TD POLIO

Protection

When the Td Polio vaccine is given in the recommended number of shots, it protects virtually 100% of people against tetanus, over 95% of people against diphtheria, and 99% of people against polio. Vaccination also makes these diseases milder for those who may catch them. The Td Polio vaccine may be given to people over the age of seven. However, vaccination against tetanus, diphtheria, and polio usually begins in infancy. Booster doses against diphtheria and tetanus are required every 10 years for continued protections. Adult travelers to parts of the world where polio disease is a risk may need a booster of polio vaccine if they have not been immunized since childhood.

Side Effects

Side effects of the Td Polio vaccine are mild and last for only a few days after getting the needle. Mild pain, swelling, and redness are common at the spot where the needle was given. A few people may get mild fever, lose their appetite, or feel tired for a day or two after the needle.

When should I call a doctor?

Call your doctor if any of the following symptoms develop within 3 days of getting the needle:

• Hives
• Swelling of the face or mouth
• Trouble breathing
• Very pale colour and serious drowsiness
• High fever (over 40C)
• Convulsions or seizures
• Other serious problems

Who should not get the Td Polio vaccine?

The Td Polio vaccine should not be given to people if they have:

• A high fever or serious infections worse than a cold
• A severe allergy to antibiotics called neomycin or polymixin B
• A serious allergic reaction (anaphylaxis) to the Td Polio vaccine
• A severe allergic reaction to any of the components of the vaccine

What is Varicella?

Varicella is also referred to as chickenpox. Chickenpox is induced by varicella zoster virus and commonly occurs during childhood. It typically gets better without any medicine. However, the virus can reappear in adults and can result in shingles, which are painful rashes. Chickenpox can be severe or even life threatening to newborn babies and anyone with a weak immune system. In rare cases, chickenpox can cause severe complications such as pneumonia, blood infections, severe skin infection, encephalitis (brain swelling), and birth defects in pregnant women.

What are the symptoms of chickenpox?

Chickenpox initiates with a fever, cough, sore throat, and general aches and pain. Within 2 days, itchy red spots can be seen on the skin, which develop into small fluid-filled blisters.

How can chickenpox be treated?

Chickenpox heals by itself over time. For rashes, creams can be applied to prevent the itching. Extreme chickenpox can be treated with specific medication that is used to fight against viruses.

How can someone get chickenpox?

Chickenpox can spread directly via air through coughing and sneezing, or directly through touching rashes. Chickenpox is very contagious within 1 to 2 days prior to the development of rashes. It continues to be contagious until all the rashes (blisters) have scabbed over, which occurs within 5 days. People who grow up in tropical countries have a higher chance of getting chickenpox as an adult.

Protection

If you have had chickenpox before, you are protected for the rest of your life. For people who have never had chickenpox, 2 doses of vaccine offers 98 to 99.9% protection against chickenpox. These vaccines include Varilrix®, VarivaxIII®, and Priorix-Tetra®.

Side Effects

• Redness, soreness, and swelling are common at the point of injection
• Fever is less common
• Sometimes a mild chickenpox-like rash may occur 1-2 weeks following the injection. The rash gets better on its own and should be covered. If the rash cannot be covered, stay away from pregnant women, newborns, and people with weak immune systems
• Serious allergic reactions are rare, and include trouble breathing, a rash, or swelling in the throat and face

See a health care provider immediately if a serious reaction occurs.

Who should not get the chickenpox vaccine?

You should not get the chickenpox vaccine if you:

• Are a pregnant woman (wait a month following the vaccine to get pregnant)
• Have acute febrile illness with fever
• Have a weak immune system. this includes patients with primary or secondary immunodeficiencies
• Are receiving immunosuppressive therapy (including high dose of corticosteroids)
• Have a blood dyscrasia, leukemia, lymphoma, or other malignant neoplasms affecting the bone marrow or lymphatic system
• Have had a live vaccine (e.g. MMR, yellow fever) in the last 28 days
• Have untreated tuberculosis (VarivaxIII only)
• Have received blood or blood products up to 5 months ago
• Had allergic reactions to varicella vaccine in the past (For Priorix-Tetra – no hypersensitivity to prior MMR or varicella vaccines)
• Have allergies to the vaccine or any component of the vaccine