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This is a chronology of devevelopments around the HPV virus and vaccines against it, with a specific focus on Calgary, Alberta, and Canada.
The discovery of DNA from a new type of human papillomavirus (HPV) more than three decades ago provided our first glimpse at the agent that causes cervical cancer and served as a catalyst for the explosive growth in HPV-related research that followed. Vaccines are authorized for sale in Canada after rigorous scientific review and testing for their quality, safety and effectiveness.
In the 2007 Federal Budget, Canada set aside $300 for a national vaccination program against HPV. A multidisciplinary joint CIC-NACI HPV Vaccine Expert Working Group was established in May 2006 to develop comprehensive recommendations for HPV vaccine programs using the analytical framework(1). The provincial government announced it will begin a voluntary HPV vaccination program for girls entering grade 5.
Alberta becomes the sixth province to do this, joining Quebec, New Brunsick, British Columbia, Ontario and Manitoba. Merck announced that Health Canada has approved GARDASIL(R) (Human Papillomavirus Quadrivalent (Types 6, 11, 16, and 18) Recombinant Vaccine) for boys and men nine through 26 years of age for the prevention of infection caused by HPV types 6, 11, 16, and 18 and genital warts caused by HPV types 6 and 11. In a move keeping with their counterparts across the province, trustees at the Toronto Catholic District School Board overwhelmingly voted in favour of allowing public health nurses to administer the controversial HPV vaccine in its schools. After a discussion that lasted more than 90 minutes, trustees voted 9-3 in favour of the motion, rightly putting the health of their daughters over morality, one trustee said. The Honourable Ron Liepert, Minister or Health and Wellness, has recently announced that Alberta will introduce a human papillomavirus (HPV) vaccination program for girls in Grade 5 to begin in the 2008-2009 school year. Calgary Catholic School Board Trustees voted to prevent vaccination in schools under their juridisction.
At an in camera meeting of the CSSD Board of Trustees three physicians stressed the vaccinea€™s importance because they see the ravages of HPV in their clinics. They are a pediatrician (who treats babies born with HPV infection in the throat), an obstetrician and gynecologist (who diagnoses it in the vulva, vagina and cervix) and a surgical oncologist (who has performed operations to treat infected mouths, throats, penises and anuses). Alberta's Health minister expressed frustration Friday with Catholic leaders for refusing to participate in a school-based program to prevent cervical cancer, saying the decision puts students at risk and makes it expensive to deliver vaccines outside the facilities. The National Advisory Committee published a report recommending that males between the age of 9 and 26 be vaccinated with Gardasil to prevent HPV Infection. Spokesperson Franziska Baltzer, of the Canadian Association of Adolescent Health noted that "both genders contribute to the spread of HPV and develop diseases as a result of HPV infection. HPV IMAGE # 5: Human Papilloma Virus particles on a black background with female anatomical figure.
In this computer graphic, the translucent bluish outer layer represents the viral pentamer proteins (arranged as an icosahedral capsid).


After successful infection of a basal cell, the virus expresses E1 and E2 proteins, which are for replicating and maintaining the viral DNA as a circular episome. Basal stem cells in the epithelial basement layer can maintain papillomavirus genomes for decades. The viral oncogenes E6 and E7 promote cell growth by inactivating the tumor suppressor proteins p53 and pRb. A single viral protein, known as L1, is necessary and sufficient for formation of a 60 nanometer capsid composed of 72 star-shaped capsomers. The papillomavirus capsid also contains a viral protein known as L2, which is less abundant. Genital human papillomavirus (HPV) infection is the most common sexually transmitted disease (STD) in the United States.HPV is a papillomavirus that infects the skin and mucous membranes of humans. Human papillomaviruses are a small group of DNA viruses that are non-enveloped, meaning that the outer shell or capsid of the virus is not covered by a lipid membrane. Since then, dozens of new HPV types have been discovered, routes of transmission have been delineated, estimates of prevalence and incidence have been described, carcinogenic properties have been demonstrated, and prophylactic HPV vaccines have been developed and deployed.
Health Canada, the federal regulator, approved the first HPV vaccine on 10 July, 2006, for females 9 through 26 years of age.
It included members from the CIC and NACI, as well as disease experts and representatives from the Cervical Cancer Prevention and Control Network, College of Family Physicians of Canada, Society of Obstetricians and Gynaecologists of Canada, Society of Gynecologic Oncologists of Canada, First Nations and Inuit Health Branch of Health Canada, and Biologics and Genetic Therapies Directorate of Health Canada.
In addition, HPV vaccination for Grade 9 girls will begin in the 2009-2010 school year and will continue for three years. Certain species have been implicated in cervical cancer and a vaccine has now been developed against these viruses. HPV can remain in the infected person's cells for an indefinite time--most often in a latent state, but occasionally producing symptoms or disease if the immune system weakens. The expression of the viral late genes, L1 and L2, is exclusively restricted to the host basal cells as they begin to divide and become increasingly differentiated in the upper layers of the epithelium. It is thought that the HPV virion infects the basal cells of epithelial tissues through micro-abrasions. Although not clear how L2 is arranged within the virion, it is known to perform several important functions, including facilitating the packaging of the viral genome into nascent virions as well as the infectious entry of the virus into new host cells.
It represents about 10% of all cancers of women with 70% of these cancers being caused by HPV-16 and HPV-18.
Like most non-enveloped viruses, the capsid is geometrically regular and presents icosahedral symmetry. It is now well-established that certain HPV types, prominently HPV-16 and HPV-18, cause cancers of the uterine cervix, vagina, vulva, penis, anus, oral cavity, and oro-pharynx; cancers that are responsible for significant morbidity and mortality worldwide.


In February 2007, the National Advisory Committee on Immunization (NACI) published its recommendations on HPV vaccines taking into account the burden of disease and vaccine characteristics.
Broad representation from public health, vaccinology, sexual health, gynecology, cancer, aboriginal health, nursing and family medicine ensured that multiple perspectives were discussed and that the groupa€™s mandate was met. This initiative will lead to a significant reduction in cervical cancer over the long term. Virions can then be sloughed off in the dead squames of the host epithelium and the viral lifecycle continues. Interactions between L1 and sulfated sugars on the cell surface promote initial attachment of the virus.
The virus is able to get inside from the cell surface via interaction with a specific receptor, likely via the alpha-6 beta-4 integrin and transported to membrane-enclosed vesicles called endosomes. Each T cell is uniquely equipped to deal with all types of pathogens such as a virus, bacteria or toxin. More recent findings indicate that widespread adolescent HPV vaccination could substantially reduce the global burden of such HPV-related cancers. The resulting analysis and recommendations were forwarded to the CIC for consideration in the development of their recommendations on the HPV vaccine program and options. The papillomavirus genome is a double-stranded circular DNA molecule 8,000 base pairs in length.
The capsid protein L2 disrupts the membrane of the endosome, allowing the viral genome to escape and traffic, along with L2, to the cell nucleus. Presented below is one epidemiologist's perspective on events that contributed to these scientific achievements. It is packaged within the L1 shell along with cellular histone proteins, which serve to wrap and condense DNA.
There are three types of professional APCs which include: B cells, macrophages and dendritic cells. Professional APCs are able to activate helper T cells that have not been exposed to that particular antigen before. Examples of non-professional APCs include: fibroblast, thymic epithelial cells, thyroid epithelial cells, glial cells, pancreatic beta cells and vascular endothelial cells.



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