HPV VACCINES

HPV virus is considered as a necessary cause of cervical cancer and is found in more than 99% of the cases. It is a fairly common virus and infects skin and inner lining of genital and respiratory tracts. An average woman has a lifetime risk of 80% of acquiring HPV infection. Although 90% of these infections do not require treatment and go away on their own- 10% persist and this persistent infection has been consistently associated with increased risk of various genital cancers in women and men. It can take upto 10-15 years for changes to become cancerous.

HPV is a DNA virus and more than 120 types are known. Few types are high risk and are responsible for more than 90% of cervical cancers.

PRVENTING CERVICAL CANCER: A MAJOR BREAKTHROUGH FOR MANKIND

We now have HPV vaccines available which have been proven to be extremely effective in preventing HPV infection. These vaccines have been available since 2006 and many countries like Australia are on the verge of eliminating cervical cancer from their population through robust vaccination programs.

There are three types of vaccines available- depending upon the number of HPV types they cover:

1. Bivalent : Work against HPV 16 and 18 e.g Cervarix
2. Quadrivalent: Work against HPV 6, 11, 16, 18 i.e. Gardasil
3. Nonavalent: Work against HPV 6, 11, 16, 18, 31, 33, 45, 52, 58 e.g Gardasil 9

A recent addition to the group is Cervavac- a quadrivalent vaccine by Serum Institute of India and Cecolin- a bivalent vaccine by China.

HOW TO TAKE HPV VACCINE?

9-14 years: Two doses (At 0 and 6 months)

15 years onwards: Three doses (At 0, 1-2 and 6 months)

In 2022, WHO published its new recommendations for HPV vaccination

WHO now recommends:

• A one or two-dose schedule for girls aged 9-14 years
• A one or two-dose schedule for girls and women aged 15-20 years
• Two doses with a 6-month interval for women older than 21 years

The primary target of vaccination is girls aged 9-14, prior to the start of sexual activity. The vaccination of secondary targets such as boys and older females is recommended where feasible and affordable.

BENEFITS OF HPV VACCINE

• Cancer prevention- cervical, anal, vulvar, vaginal and oropharyngeal (throat)
• Prevention of genital warts
• Herd immunity against HPV viruses leading to reduced transmission
• The vaccines are highly efficacious and protection remains high for the next 10-15 years
• WHO has officially stated that these vaccines are extremely safe

SPECIAL CONSIDERATIONS

Do not take the vaccine in pregnancy- however, if taken unknowingly- termination of pregnancy is not required.

Do not take vaccine if there was an allergic reaction to the first dose

WHAT ARE THE SIDE EFFECTS OF HPV VACCINE?

1. Can lead to pain, redness, swelling at the injection site like most shots
2. Dizziness and fainting- more common in teens- vaccine should be taken in sitting or lying down position and one should wait for 15 minutes before getting up after the shot
3. Nausea, feeling tired, muscle pain or joint pain

IDEAL AGE

The HPV vaccine is best administered to girls and boys aged 9–14 years. For Adults- ages 27–45 years if not vaccinated earlier (Catch up age)

DOSAGE

Age 9–14: Two doses are needed. The 2nd dose is given 6–12 months after the first. Age 15–26: Three doses are required at 0, 1–2, and 6 months

SAFETY

It is safe, effective, and significantly reduces the risk of HPV-related cancers, including cervical, anal, and throat cancers.The vaccine is not recommended in pregnancy

* Reviewed by Dr. Nikita Chauhan

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