Cervical cancer – HPV vaccine FAQs
There has been strong interest in the development of two human papillomavirus (HPV) vaccines, one of which (Gardasil) has been available in Ireland for several years. Gardasil has also been confirmed for future funding on the National Immunisation Schedule for 12 and 13 year old girls only. A lot of information is available, and this article is to help you answer some of the frequently asked questions (FAQs)
The HPV vaccine (Gardasil) is available at the D2 medical, the cost of the vaccine in 600 euro for 3 shots over a six month period.
Yes. The available HPV vaccine is 100% effective against disease caused by HPV types 6, 11, 16 and 18.
HPV types 16 and 18 cause around 70% of high-grade pre-cancerous changes and cervical cancers as well as vaginal and vulval cancers. HPV types 6 and 11 cause an estimated 90% of genital warts. The currently available vaccine prevents you from being infected with four different HPV types (6, 11, 16 and 18) and protects against pre-cancers, cancers and genital warts caused by these HPV types.
No. The vaccine has been developed to protect against the four most common types of HPV. Therefore, it will not prevent infection with other less common types
The vaccine does not work for a particular HPV type in the vaccine if you are already infected with that HPV type – it prevents HPV infection through sexual activity. That is why the target is a young age group (females 9-26 years; males 9-15 years). However, if you have been infected with one HPV type that is in the vaccine, the vaccine will still prevent you being infected with the other types contained in the vaccine.
It will not protect against 30% of cancers and 10% of genital warts, which are caused by other less common types of HPV not in the vaccine.
HPV is sexually transmitted. The vaccine is best given when you do not have an HPV infection from an HPV type in the vaccine. Therefore, people who receive the vaccine before sexual activity begins will receive the maximum benefit and protection against the HPV types in the vaccine. However, if you have been infected with one HPV type that is in the vaccine, the vaccine will still prevent you being infected with the other types contained in the vaccine
The safety and efficacy data from studies are well established for this age group. Further research is awaited on women older than 26
Yes. Sexually active females will also receive protection. They may not receive full protection if they are currently infected with one of the vaccine HPV types, but they will be protected against the other types covered in the vaccine.
The vaccine only works to prevent the acquisition of HPV virus. It does not work as a treatment for genital warts. However, the vaccine can still be given to protect against the other HPV types covered in the vaccine.
The vaccine only works to prevent infection with HPV virus. It does not work as a treatment for cervical smear abnormalities. The vaccine provides some (about 25%) protection against the progression of HPV infection to CIN 1 (the first pre-cancerous stage) and worse. However, the vaccine can still be given to protect against the other HPV types covered in the vaccine.
An HPV DNA test is not routinely available in general practice. It is not necessary to know whether someone already has HPV before giving them the vaccine. Those who have already acquired one HPV type that is in the vaccine will still benefit from the vaccine by protecting themselves from the other types.
The available HPV vaccine (Gardasil) is currently indicated for boys aged 9-15 years. This may change to include older males as research is completed. It makes sense to vaccinate males as this will protect them from genital warts and will have indirect benefits for partners.
It is a three-dose schedule given over six months – you receive the first dose, the second is given two months later and the third is given six months after the first one (0, 2 and 6 months).
The vaccine gives protection for at least five years. Follow-up trial data will likely show the duration of protection is even longer. It is not yet known if a booster is required, but current data show the vaccine produces a high immune response and is unlikely to need a booster.
No. The vaccine is not a live vaccine. It does not contain the complete HPV virus and cannot cause HPV infection.
It is not known yet what level of protection is provided by only one or two doses
The HPV vaccine is safe and has been studied in over 20,000 women. The most common side effects are local reactions at the injection site and fever, which are mainly mild and usually disappear in a few days
There is no evidence to suggest adverse outcomes in pregnancy. However, the vaccine is not licensed for use in pregnant women. If a woman becomes pregnant after starting the vaccination schedule, she should give birth before receiving the next dose. The vaccine is safe for breastfeeding mothers.
People with an allergy to yeast or components of the vaccine should not be vaccinated.
As cervical cancer is the second most common cause of cancer death in women on a worldwide basis, this vaccine represents a significant advance in preventive health.