Human Papilloma Virus (HPV) is a sexually transmitted infection and is the initiating factor of a chain of events that may lead to cervical cancer (please read our cervical cancer blog here). HPV also causes anal, oropharyngeal, vulval, vaginal and penile cancers. Vaccination with the Human Papilloma Virus vaccine can prevent infection and the consequences that can lead to these cancers.
High risk HPV strains 16 and 18 cause about 70% of cervical cancer and 10 other strains account for the other 30% of cervical cancer.
HPV infection with the non-high-risk strains such as 6 and 11 causes 90 % of benign anogenital warts.
What Human Papilloma Virus vaccines are available?
There are currently 3 vaccines available.
The first protects against strains 16 and 18.
The next against 6, 11, 16 and 18.
The last which is currently not available in South Africa protects against 6,11,16,18 and 5 additional high risk strains 31, 33, 45, 52 and 58.
Is it safe?
There has been a lot of controversy about the safety of the vaccine, with claims that the vaccine can cause neurological problems and may even result in death. These claims unfortunately have not been substantiated and there is no proof that this is the case.
The vaccine is at least as safe, if not safer, than the measles vaccine, which is one of the most commonly used vaccines, and a follow up of about 1 million girls aged 10 -17 found no serious adverse effects of the vaccine. The vaccine is globally accepted as safe and is part of international recommendations for its implementation. This includes the WHO global advisory committee for vaccine safety and the European and American centres for disease control.
The only side effects that have been documented as occurring more often than placebo are pain, swelling and redness at the injection sight and a mild fever.
Who should get it?
Data from the USA and Europe show that 1/3 of all HPV cancer affects men. Therefore, considering the benefits not only for cervical cancer and the fact the HPV is sexually transmitted both girls and boys should receive the vaccine.
When should it be given?
The HPV vaccine can be given from 9 years old. It is a two or three stage schedule depending how old you are. If the first injection is given before 15 years of age then two injections 6 months apart is what is recommended. If the vaccine is given after 15 years then 3 doses at 0, 1 and 6 months are given. However, the older the individual the less effective the vaccine, and it is generally not recommended over the age of 26. Vaccination prior to 15 years is the most effective option.
How effective is it?
The more people that are vaccinated the more effective it will be. With a good uptake in a population it can decrease risk of an individual getting cervical cancer by 63% and death from cervical cancer by 64%.
What about pregnancy?
It is not recommended to be given in pregnancy because there have been no trials in pregnant women, but in those pregnant woman who have inadvertently received it there has been no evidence that it causes congenital malformations.
Take home message
Please ensure that you (if appropriate) or your children when they are the correct age receive the HPV vaccination.
If you want some more information on HPV vaccination here is another great webpage to have look at http://www.hpv.co.za/