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HPV vaccination


HPV vaccination

All girls aged 12 to 13 are offered HPV (human papilloma virus) vaccination as part of the NHS childhood vaccination programme. The vaccine protects against cervical cancer. It's usually given to girls in year eight at schools in Wales.

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, that's around eight women every day.

Around 970 women died from cervical cancer in 2011 in the UK. It's 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 into the upper arm spaced at least six, and not more than 24 months apart (girls who began vaccination before September 2014 receive three injections).

Research has indicated that the HPV vaccine protects against cervical cancer for at least 20 years.

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 early 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 is used in the national NHS cervical cancer vaccination programme. Gardasil protects against the two types of HPV, between them 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.

The HPV vaccine is currently given as a series of two injections within a six- to 24-month period.

Girls who began their course of HPV vaccination before September 2014 receive three injections.

Learn more about how the HPV vaccine is given.

Can girls who missed HPV vaccination still have it?

Yes, if a girl misses either of her vaccinations, for whatever reason, speak to her nurse or doctor about making another appointment, ideally as close as possible to the original one.

Girls can have the HPV vaccination on the NHS up to age of 18.

Girls who have the HPV vaccination after the age of 15 will need three doses as the response to two doses is not so good in older girls.

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.

Find out more about the safety of the HPV vaccine.

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?

The HPV vaccine protects against two types of HPV virus  (HPV-16 and HPV-18) which together are responsible for about 70% of cervical cancers.

In addition, the HPV 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 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.

Older girls and the HPV vaccine

Girls who missed HPV vaccination first time around, can receive a catch up HPV vaccination on the NHS up to age of 18.

Girls who have the HPV vaccination after the age of 15 will need three doses, however, as the response to two doses is not so good in older girls.

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How is it performed?

The HPV vaccine is given as two injections into the upper arm over a six to 24 month period. Both doses are needed for the vaccine to work.

Girls who began HPV vaccination before September 2014 receive three injections.

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 (see below).

The HPV vaccination: doses and timings

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

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

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

The schedule for Gardasil is as follows:

  • the first dose is given, usually in October of year 8 at school
  • the second dose is given no sooner than six months and no later than 24 months after the first dose

There is some variation within the schedule to give flexibility to school nurses administering the programme.

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.

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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 Gardasil

The US Food and Drug Administration (FDA) have carefully monitored the use of the Gardasil vaccine in the USA 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: 01/06/2015 14:23:31

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