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Encyclopaedia


HPV vaccination

Introduction

HPV vaccination

All girls aged aged 12 to 13 ared offered HPV (human papilloma virus) vaccination as part of the NHS childhood vaccination programme. The vaccine is usually given in year eight at schools in Wales.

Some types of HPV can cause cervical cancer, and the HPV vaccine helps to protect girls from getting cervical cancer in the future. It's also known as the cervical cancer jab.

According to Cancer Research UK, cervical cancer is the second most common cancer in women under the age of 35. In the UK, 2,900 women a year are diagnosed with cervical cancer.

Combined with cervical screening, the HPV vaccination is an important step towards preventing cervical cancer. It is estimated that about 400 lives could be saved every year in the UK as a result of vaccinating girls before they are infected with HPV.

The HPV vaccine is delivered largely through secondary schools, and consists of two injections over a period of between 6 and 24 months.

Research has shown that a full course of HPV vaccine provides effective protection for at least 10 years. It is not known yet how long protection will last beyond this time.

What is HPV?

The human papilloma virus (HPV) is the name given to a family of viruses.

Different types of HPV are classed as either high-risk or low-risk, depending on the conditions they can cause. For instance, some types of HPV can cause warts or verrucas. Other types are associated with cervical cancer.

In 99% of cases, cervical cancer occurs as a result of a history of infection with high-risk types of HPV. Often, infection with the HPV causes no symptoms.

How is HPV infection spread?

The HPV virus is very common and is easily spread by sexual activity. As much as half the population will be infected at some time in their life. In most cases, the virus doesn't do any harm because your immune system gets rid of the infection. But in some cases, the infection persists and can lead to health problems.

Although most girls don't start having sex until after they're 16 years of age, it's important that they get this protection early enough and a good time is in the teenage years - getting the vaccine as early as possible will protect them in the future.

Using a condom during sex can help to prevent HPV infection. However, as condoms do not cover the entire genital area and are often put on after sexual contact has begun, a condom is no guarantee against the spread of HPV.

Different types of HPV and what they do

There are over 100 different types of HPV, with around 40 types that affect the genital area.

Infection with some high-risk types of HPV can cause abnormal tissue growth as well as other cell changes that can lead to cervical cancer.

Infection with other types of HPV may cause:

For more information see Why is the HPV vaccine needed?

How the HPV vaccine helps

A vaccine called Gardasil vaccine is used in the national NHS cervical cancer vaccination programme. Gardasil protects against the two types of HPV responsible for more than 70% of cervical cancers in the UK.

A bonus of using Gardasil to prevent cervical cancer is that it prevents genital warts too.

Which girls should have the HPV vaccination?

The HPV vaccine is part of the NHS childhood vaccination programme and is routinely offered to secondary school girls aged 12 and 13.

It's a safe vaccine and there are very few girls who aren't suitable for HPV vaccination. However, special precautions may need to be taken if the girl being vaccinated has certain health conditions, or has ever had a severe allergic reaction (anaphylaxis).

Read more about who should have the HPV vaccine.

For most girls who receive their first dose of HPV before their 15th birthday the HPV vaccine is given as a series of two injections over a 6-24 month period. Girls who receive their first dose of HPV vaccine on or after their 15th birthday or any girls who are HIV infected or immunocompromised at time of immunisation should receive a 3 dose schedule at 0, 1 and 4-6 months.

Learn more about how the HPV vaccine is given.

Cervical screening and the HPV vaccine

Cervical screening is a way of picking up abnormal cells in the cervix before they progress to cancer. It's been shown that early detection and treatment of cervical abnormalities picked up by screening can prevent three-quarters of cervical cancers.

The NHS cervical screening programme involves checking women between the ages of 25 and 64 every three to five years for early cervical abnormalities.

Regular cervical screening is the best way to identify abnormal cell changes in the cervix. So it's important that all girls who receive the HPV vaccine also have regular cervical screening once they reach the age of 25.

Now, read why it's so important for 12-13 year-old girls to receive the HPV vaccination and find out more about the safety of the HPV vaccine.

Following the introduction of the national HPV vaccination programme, Cervical Screening Wales will continue to play an important part in checking women, who are between 25-64 years of age, for early-stage cell changes.

HPV Helpline

Phone the NHS Direct Wales HPV helpline for impartial advice and information on 0845 602 3303 open 8.00am to 8.00pm  Monday to Friday.

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Why should it be done?

Gardasil protects against two strains of HPV (HPV-16 and HPV-18) which together are responsible for about 70% of cervical cancer cases.

Clinical trials show that the HPV vaccine is effective in protecting against these two types of HPV virus and should therefore substantially reduce the cases of cervical cancer in future.

In addition, the Gardasil vaccine can also protect against HPV-6 and HPV-11, the two strains of HPV that cause most cases of genital warts

How HPV causes cervical cancer

If you become infected with one of the high-risk strains of HPV, and your immune system does not deal with it, the infection can lead to cell changes and the growth of pre-cancerous cells in your cervix. This is known as cervical intraepithelial neoplasia (CIN).

CIN is not cancer but, if left untreated, it can develop into cancer in some women. This can take up to 10 years.

Why cervical screening is important

The HPV vaccine does not protect against all types of HPV, so it is not guaranteed to prevent cervical cancer.

This is why regular cervical screening continues to play an important role in detecting potentially cancerous cell changes in the cervix.

Protecting against other health conditions

While the Gardasil vaccine protects against genital warts, it does not:

  • treat an HPV infection already present
  • protect against illnesses or conditions, including cancers, not caused by infection with HPV-6, HPV-11, HPV-16 or HPV-18
  • protect against other sexually transmitted infections (STIs). Using condoms offers the best protection against STIs
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Who can use it?

The HPV vaccine is given in secondary schools to girls aged 12 to 13. In Wales, this age-group is typically in year eight.

Health conditions and HPV vaccination

Most girls are able to have the vaccine, but there are a few who need to take some precautions. Before the vaccination, tell your GP if your daughter has:

  • a condition that makes them bleed more than normal, such as thrombocytopenia; it may be possible to use a different type of injection 
  • a weakened immune system, as the vaccine may not be as effective

If these health conditions affect her, it doesn't necessarily mean that she cannot have the HPV vaccine, it simply means that extra care should be taken.

Other medications and the HPV vaccine

Before the vaccination, tell your GP if your daughter is taking, or has recently taken, any other medicines, including:

  • prescription medicines
  • over-the-counter medicines
  • other vaccinations

Research shows that taking hormonal contraceptives, such as the Pill, do not appear to reduce the protection the vaccine provides.

Which girls should not be vaccinated?

As with any medicine or vaccine, the HPV vaccine should not be used in girls who:

  • have had a confirmed anaphylactic reaction (severe allergic reaction) to a previous dose of the HPV vaccine or any of its ingredients
  • are pregnant  

Which girls should delay vaccination?

The HPV vaccination should be postponed if your daughter has:

  • a severe illness with a high temperature (fever)

This is because symptoms of the illness may be confused with side effects from the vaccine, and this could result in the wrong diagnosis being made.

However, there is no reason to delay vaccination for a mild illness, such as the common cold.  

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How is it performed?

The HPV vaccine is usually given as a series of two injections over a period of 6-24 months.. A full HPV Course is needed for the vaccine to work effectively.

Do I have to consent to the HPV vaccine?

The HPV vaccine is given to girls at secondary school aged 12 and 13 as part of the NHS childhood vaccination programme.

If your daughter is in year 8 at school, you will usually receive a letter about the vaccine and a consent form before she is due to have the vaccine. Although, as a parent, you're asked to sign a consent form, it is up to your daughter whether she has the vaccine or not.

Girls are offered the vaccine to protect them against cervical cancer. Around 1,000 women die from cervical cancer in the UK each year.

Read the Department of Health's guide to the HPV vaccination (PDF, 210kb).

Why will my daughter be offered the HPV vaccination before she’s 16?

The virus that causes cervical cancer, called human papilloma virus (HPV), is spread by having sex or being sexually intimate with another person who has the virus. So it’s natural that, as a parent, you may question why the HPV vaccine will be given to your daughter before she reaches the age of consent at 16.

While most girls don’t start having sex until they’re 16 or older, it’s best for them to be vaccinated a few years earlier so they get the most benefit from the vaccine.

If the HPV vaccine is given after a young woman has become sexually active, it’s possible she may already be infected with the virus, and it’s therefore too late for the vaccine to fully protect her.

What if my daughter doesn’t want the HPV vaccination?

Your daughter has to sign a consent form before she can be vaccinated. So she doesn’t have to have the HPV vaccine if she doesn’t want to. However, it’s worth making sure she’s thought things through. The HPV vaccine has a good safety record and will protect her against cervical cancer for many years.

Suggest she speaks to the nurse or doctor if she wants more information, on her own, or with you if she’d prefer.

What if my daughter wants the vaccination, but I’d rather she didn’t have it?

The decision to have the vaccine is legally your daughter's, as long as she understands the issues in giving consent. Discuss this with your daughter, the doctor or nurse to get more information.

The HPV vaccination schedule

The HPV vaccine is given as an injection into the muscle of the upper arm.

The vaccination consists of two doses for most girls, and both injections are needed to ensure your daughter is fully protected against the virus.

Girls who receive their first dose of HPV vaccine on or after their 15th birthday or any girls who are HIV infected or immunocompromised at time of immunisation should receive a 3 dose schedule at 0, 1 and 4-6 months.

Girls given the HPV vaccine as part of the national vaccination programme are given a vaccine called Gardasil.

The schedule for girls receiving their first dose of Gardasil before their 15th Birthday is as follows:

  • the first dose is given
  • the second dose is given usually 12 months (although can be given anytime from 6 to 24 months) following the first dose.

The schedule for Gardasil for girls who receive their first dose on or after their 15th birthday, or any girls who are HIV infected or who are immunocompromised at time of vaccination is as follows:

  • the first dose is given
  • the second dose is given at least once month after the first dose
  • a third, final dose, is given at least three months after the second dose
  • All three doses should be given within a 12-month period.

In some circumstances it may be possible for the vaccination schedule to be more flexible. For example, if a third dose of the HPV vaccine falls during the exam period, it may be possible to have the vaccine slightly earlier. Your GP will be able to give you more information about this.

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Safety

The vaccine used to vaccinate against the human papilloma virus (HPV) is called Gardasil, and it has been used in the national vaccination programme since September 2012. Before that, a vaccine called Cervarix was used.

Like all vaccines, the safety and effectiveness of both Cervarix and Gardasil have been rigorously tested in clinical trials.

A vaccine is only released to the public if scientific tests, called clinical trials, show the benefits outweigh the risks.

The data from these trials was reviewed by the European Medicine Agency's Committee for Medicinal Products for Human Use before a licence was granted for Gardasil's use in the UK.

Monitoring safety of HPV vaccines

The Medicines and Healthcare products Regulatory Agency (MHRA) collects information from doctors, other healthcare professionals and patients regarding suspected adverse reactions (unwanted reactions following administration of a medicine, including vaccines) through the Yellow Card scheme.

These reports, or yellow cards, are recorded and regularly reviewed. If a potential problem is identified, an investigation will be carried out and if necessary appropriate action taken.

There is also a legal requirement for pharmaceutical companies to report serious and suspected adverse events to the MHRA.

The safety record of Cervarix

Between April 2008 and July 2010, the MHRA received 4,703 yellow cards detailing around 10,410 adverse reactions relating to the administration of Cervarix. The MHRA says this number is consistent with that expected.

Most reports were to do with recognised side effects listed in the product information or due to the injection process and not the vaccine itself.

The safety record of Gardasil

Similarly, the US Food and Drug Administration (FDA) have carefully monitored the use of the Gardasil vaccine in the US where it has been widely used for many years. The FDA recently reported that ‘Gardasil continues to be safe and effective and its benefits outweigh its risk’.

For isolated cases of other medical conditions reported, the available evidence at the moment does not suggest that vaccines caused these conditions.

When risks of the HPV vaccines are weighed against the benefit of protection from cervical cancer and genital warts, for most people the benefit of the vaccine far outweighs the risk.

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The information on this page has been adapted by NHS Wales from original content supplied by NHS Choices.
Last Updated: 20/05/2015 08:22:52

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