HPV Vaccine

 

There is a vaccine that helps prevent cervical cancer and other conditions caused by certain types of Human Papillomavirus (HPV). Maybe you’ve heard about the HPV vaccine from a friend, parent, or your health care provider. So why is it such a big deal? It's the first vaccine that helps prevent a major type of cervical cancer! Not sure if the vaccine is right for you? We hope this guide will answer your questions so you can decide.

 

What is HPV?

There are many different types of HPV (Human Papillomavirus). There are about 100 different types and more than 30 are sexually transmitted. Researchers keep track of the different types of HPV by identifying them with numbers - such as 6, 11,16 and 18.

 

Some types cause genital warts, others cause pre-cancerous changes (cellular changes that can lead to cancer of the cervix later). In rare cases, the virus can cause other types of cancers to the vulva, vagina, anus in girls, and the anus and penis in guys.

 

Am I at risk to get HPV?

If you have had sexual contact or plan to have sexual contact in your lifetime, you are potentially at risk for getting HPV. Any sexually active person—no matter what color, race, gender or sexual orientation—can get HPV. In fact, at least 1 in every 2 sexually active young women has had a genital HPV infection. About 20 million Americans of all ages know they have the HPV virus because they have had genital warts, an abnormal Pap test, or have tested positive for HPV. However, most people do not know they have HPV because they have not had symptoms.

 

HPV and genital warts are usually spread by direct skin-to-skin contact during vaginal, anal, or oral sex with someone who is infected with HPV. Condoms can help protect against HPV, but they aren’t perfect because HPV can be found on skin that isn’t covered by a condom. HPV can be in the skin and genital organs without any symptoms.

 

What are the HPV vaccines?

There are now two vaccines that protect young women against different types of HPV.

 

One vaccine, called Gardasil, protects young women against four different types of HPV. The vaccine works to prevent two types of HPV-16 and 18, which have been linked to cervical cancer, and two other types—6 and 11, which cause genital warts. Gardasil can also prevent some vulvar and vaginal cancers.

 

The second vaccine, called Cervarix, protects young women against two different types of HPV. This vaccine works to prevent HPV-16 and 18, which have been linked to cervical cancer. It does not protect against HPV-6 and 11.

 

The vaccines work best in girls/young women who have not yet come in contact with these viruses. That is why the vaccine is recommended for all 11 and 12 year old girls as a routine vaccination, and for all young women 13-26 years of age who have not yet had the vaccine. Similar to the vaccine for Hepatitis B, the HPV vaccine is given in a series of 3 shots over 6 months. The first shot is given at a time of your choice. The second shot should be given two months after the first shot, and the third shot should be given about six months after the first one. It is preferred that the same HPV vaccine be use for the entire 3 shot series.

 

How does the HPV vaccine work?

The vaccine is a fluid that has very small particles in it that look like HPV. The body quickly starts making antibodies against the four types of HPV. Antibodies are necessary to fight HPV. Remember that the virus isn’t a live virus, which means you can’t get HPV from the vaccine.

 

How does a vaccine get approved?

Before the Food and Drug Administration (FDA) approves any medicine or vaccine, scientists and doctors must study it. After researching the vaccine for a long time, the pharmaceutical company that created the vaccine must show that the vaccine will improve the health of people who receive it. In June of 2006, the FDA found the Gardasil vaccine to be an excellent way to lower the chances of getting HPV for girls and young women between the ages of 9-26. The Cervarix vaccine was approved by the FDA in October of 2009 for girls and young women between the ages of 10-25.

 

Is the HPV vaccine effective?

When tested in girls who had not yet been exposed to HPV types 6, 11, 16 and 18, Gardasil was 100% effective in preventing infection. When Cervarix was tested in girls not yet exposed to HPV types 16 and 18, it was 93% effective in preventing infection.

 

Both vaccines are less effective in young women who have already come in contact with the HPV types in the vaccine. However, if a girl has been exposed only to one of the types, the vaccines still gives protection against the remaining types. So, even girls who have had sexual contact should get immunized.

 

It is important to plan on returning to your healthcare provider for the second and third shots because the vaccine will not be completely effective if you don’t have all three doses.

 

When is the best time to get vaccinated?

The best time to get vaccinated is before you come in contact with the HPV virus. In fact, the government organization that decides when kids should be immunized recommends that all 11 and 12 year old girls get it. Health care providers can also offer the vaccine to younger girls (9 and 10 year olds). Gardasil is approved for young women from 9 years of age up to 26 years, while Cervarix is approved for young women from 10 years of age up to 25 years.

 

Are there any side effects with the HPV vaccine?

Side effects are rare; however, some young women who get the vaccine may complain of pain, or have swelling or redness where they got the shot (arm or thigh). These discomforts are temporary but may last a couple of days. In very few cases, people may get a fever, feel dizzy, or feel sick to their stomach. Some young women have fainted after receiving the vaccine, so you may want to sit quietly for 10-15 minutes after receiving the vaccine.

 

It is very uncommon to have side-effects from vaccines. If you think you might have had a side-effect from a vaccine, talk to your health care provider. You can also call 1-800-822-7967 or log on to vaers.hhs.gov.

 

Do I have a choice about getting the HPV vaccine?

A few states require the vaccine, but most leave the choice to each family and teen. However, most health care providers will suggest that you get the vaccine if you are between the ages of 9-26 years old to reduce your risk of getting cervical cancer.

 

How do I know if I should get the HPV vaccine?

Talk it over with your health care provider. Now that the vaccine is available, it is a good idea to take advantage of it. Most people will become sexually active at some point in their lives and the vaccine is very effective in preventing the spread of HPV. Using condoms lowers your risk of HPV, but condoms are not perfect. The risk of getting HPV is far worse than getting the shot.

 

Is there any reason why I shouldn’t get the HPV vaccine?

The vaccine is not recommended if you are pregnant, have certain blood conditions, an immune disorder, or certain other medical problems. You should not receive Gardasil if you have a history of a severe allergic reaction to baker’s yeast. Let your health care provider know if you have a latex allergy, as Cervarix comes in two different preparations, and one contains latex. If you are thinking about getting the vaccine, ask your health care provider if it’s a good idea for you to get it.

 

If you find out you are pregnant after you get the first shot, tell your healthcare provider. You will be advised to get the second or third shot until after your pregnancy is over.

 

Should I get the vaccine even if I’ve already had sex and don’t know if I was exposed to HPV?

Yes. Girls and young women should receive the vaccine even if they have already had sex. It is not necessary to have an HPV test before getting the vaccine.

 

Is the HPV vaccine safe?

The vaccine is considered safe by FDA standards. It is not made with a live virus that can cause an HPV infection. It does not contain mercury or thimerosal.

 

If I’ve already tested positive for HPV, will the vaccine help?

It depends on what type of HPV you have been exposed to. The vaccine won’t cure an HPV infection that you already have, such as genital warts, pre-cancers (changes that usually happen before a cancer starts to grow), or cervical cancer. It could, however, protect you from the types of HPV that you have not come in contact with. Many people who have HPV are not infected with all the types of HPV that the vaccine targets. Since there is no test available to tell for sure if a woman has had just one or multiple types of the HPV virus, it is recommended to get the vaccine.

 

Talk to your healthcare provider to find out if you should have the vaccine. It is ALWAYS important to use condoms every time you have sex and to see your healthcare provider for regular check-ups and Pap tests.

 

If I get the HPV vaccine will I be protected for the rest of my life?

It is not known how long you will be protected after you receive the HPV vaccine, because it hasn’t been available for that long. So far, research studies have followed girls for 5 years after they received all 3 shots of the HPV vaccine and they are still protected. The levels of antibodies are very high so protection is likely to last for a long time.

 

Is there an HPV vaccine for guys too?

Gardasil was approved by the FDA in October 2009 for use in young men ages 9 through 26. Gardasil can be given to prevent genital warts caused by HPV-6 and 11, but it is not yet routinely recommended in young men. Cervarix is not approved for use in young men.

 

Will my insurance cover the HPV vaccine?

Since the HPV vaccine is relatively new, it is possible that some insurance companies may not cover the cost of it. It may be expensive if your insurance company doesn’t pay for it. If you are covered under your parent’s insurance, check with them. If you have your own policy, you can call your insurance provider directly. If you must pay for the vaccine on your own, each dose is about $120 (you need 3 doses to complete the series).

 

Will there be a vaccine someday, that prevents other types of HPV?

It would be wonderful if someday there could be a vaccine that works to prevent more types of HPV. In order for this to happen, a lot more research is needed.

 

Having a vaccine that protects against types of HPV that cause serious problems including warts (6 and 11) and cervical cancer (types 16 and 18) is a huge deal and very exciting. Remember, the HPV vaccine protects you against a few kinds of the virus, but it doesn’t protect you from all of them. It is still very important to go for regular check-ups and Pap tests. Be sure that you always use condoms if you are sexually active. Talk to your healthcare provider about whether the vaccine is right for you.

 

Resources

The Vaccine Adverse Event Reporting System (VAERS)

 

Written by the CYWH Staff at Children's Hospital Boston

 

Updated: 6/16/2010

 

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