What Age Is Hpv Vaccine Given To When Did Rollout Start As Study Finds Thousands Of Lives Saved
The HPV vaccine has been offered to every girl at the age of 12 since 2008 and every boy since 2019.
Its been over a decade since the human papillomavirus vaccine was introduced.
First given to girls in England in 2008, then boys 11 years later, the rollout has been wildly successful.
Professor Peter Sasieni, one of the researchers at King’s College London, said: “The impact has been huge,” and that it is “just the tip of the iceberg” as many coming generations receive the vaccine and greatly lower their risk of developing HPV.
Dr Vanessa Saliba, a consultant epidemiologist for the UK Health Security Agency, says the findings 13 years on from the jab’s introduction are ‘remarkable’ and show the jab “saves lives by dramatically reducing cervical cancer rates among women”.
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Almost all cervical cancers are caused by a virus, so vaccination is a hugely effective way of preventing them developing.
Cervical cancer is the fourth most common cancer in women around the world and kills more than 300,000 annually.
Around nine in 10 of these deaths are women from low or middle income nations, which have limited access to cervical screening. It is hoped that now over 100 countries have starting using the vaccine, the globe could soon be rid of cervical cancer if jabs continue increasing.
The History Of The Hpv Vaccine
Human papillomavirus, or HPV, is a group of over 200 viruses that are very common in humans. Most types do not cause any problems, however some can develop into diseases such as genital warts or cancer. HPV types known to cause cancer are classified as high risk. There are currently 14 known high risk HPV types, two of which, HPV16 and HPV18, are responsible for most HPV-related cancers. Thankfully we have the means to protect against these high-risk strains by way of the HPV vaccines. But how did we get to that point?
In the 1970s and 80s, Harald zur Hausen, German virologist, isolated HPV strains in cervical cancer tumours, and later the theory that HPV is a causal agent of cervical cancer was confirmed. Following zur Hausens work, HPV was found to cause other cancers including as anal, vulval, and oral. Zur Hausen proposed the idea of the HPV vaccine as a cancer prevention method in 1986, but was rejected by pharmaceutical companies as they believed the vaccine was not profitable. The HPV vaccine would not come until nearly two decades later. For his discoveries, and their impact on global health, Harald zur Hausen was awarded the 2008 Nobel Prize in Medicine. He continues to research infectious agents and their contribution to cancer.
Immunogenicity Efficacy And Effectiveness
Immunogenicity
HPV vaccine is highly immunogenic. More than 99% of vaccine recipients develop an antibody response to vaccine HPV types after completing a 3-dose series. In immunocompetent, non-HIV infected individuals 9 to 14 years of age, a 2-dose schedule of HPV2, HPV4, or HPV9 vaccine is as equally immunogenic as a 3 dose series in individuals 15 to 24 years of age. The immune correlates of protection against HPV infection are unknown.
Efficacy and effectiveness
In Canada, immunization against HPV types 16 and 18 contained in HPV2, HPV4 and HPV9 vaccine can prevent approximately 70% of anogenital cancers and 60% of high-risk precancerous cervical lesions. Immunization against HPV types 31, 33, 45, 52, and 58 contained in HPV9 vaccine could further prevent up to 14% of anogenital cancers and 30% of high-risk precancerous cervical lesions. Immunization with either HPV4 or HPV9 vaccine can prevent approximately 90% of genital warts.
HPV vaccine has no proven therapeutic effect on existing HPV infection. Prior infection with one or more vaccine HPV types does not diminish vaccine efficacy against other vaccine HPV types. The duration of protection following HPV vaccination is not known. Clinical trial subjects have been followed for approximately 10 years for HPV2 and HPV4 vaccines with no evidence of waning protection.
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The Impact Of Controversy
When the HPV vaccine was first introduced a decade ago, it was met with resistance and steeped in controversy. Despite supporting studies, this controversy rages on, impacting peoples health worldwide.
HPV vaccines work best when given to preadolescent girls , before they become sexually active this is one of the reasons for resistance. Some people claim the vaccine promotes promiscuity by sending the message to young people that there is no danger of getting a sexually transmitted infection. Even though research shows there is no increase in sexual activity as a result of the vaccine, the moral argument is still keeping US vaccination rates relatively low.
According to Dr. Bosch, this is a problem that needs to be taken seriously:
The HPV vaccine is generating some anti-vaccine reactions and vaccine hesitancy in some countries. This deserves attention the scientific and public health communities need to monitor introduction and reinforce access to vaccination in all countries worldwide. Indications need to be regularly updated in light of the latest clinical trials and the evaluation of public programs. We also need to improve our communication with the public, based on sound evidence published in journals like Papillomavirus Research.
The Hpv Vaccine 10 Years On: Where Are We Now
Read the top 5 articles from Elseviers open access journal Papillomavirus Research and commentary by the editor
Ten years ago, the first teenage girl was vaccinated against human papillomavirus , dramatically reducing her risk of cervical cancer. Despite controversy and even protests about the vaccine, its uptake has been relatively successful, with almost 90 percent of girls in England aged 12-13 being vaccinated, according to statistics cited in a 2013 Vaccine study.
However, teenage vaccination in general and HPV in particular often has low rates of uptake, particularly in developing countries. This can mean the unnecessary healthcare burden of treating preventable cancers.
Research has moved on significantly since the first vaccine second-generation vaccines are now being evaluated for protection against additional strains of the virus and a variety of other HPV-induced cancers. With an increase in research comes an increase in scientific literature: about 3,000 articles are being published on HPV every year.
In response, Elsevier created Papillomavirus Research, an open access journal that publishes research on all aspects of human papillomavirus and other related cancer-causing viruses. To mark the 10-year anniversary of the first HPV vaccine, the journals Editor-in-Chief, Dr. Xavier Bosch, invites you to read the top-cited articles published in Papillomavirus Research, and looks ahead to the future of HPV research
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How Do I Obtain The Vaccine Do I Need To Pay For The Vaccine
The provision of free medications, vaccines and health services is a decision that is made within each province and territory. Please check with your provincial/territorial public health department. If you or your child is not eligible for HPV vaccination under an immunization program, you can speak with your healthcare provider if you wish to purchase the vaccine.
What You Say And How You Say It Matters
Physicians give consistent, strong recommendations for the HPV vaccine. A physicianâs recommendation is the single best predictor of vaccination. It is recommended that physicians âbundle,â and not single out the HPV vaccine in discussions with patients on the importance of receiving vaccinations. The bundling approach has been shown to normalize and increase acceptance of the HPV vaccine, and demonstrate the importance of the HPV vaccine. The current HPV immunization schedule is provider and patient friendly, and is consistent with adolescent well visits. More talking points can be found on the CDC website.
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When Am I Going To Be Immunised
The vaccine’s offered in 2 or 3 doses over a period of 12 months, depending on the age of when you receive the first dose.
Most students will only need 2 doses of the vaccine.
If you receive your first dose before you turn 15 years old, you’ll only need 2 doses of the HPV vaccine. You’ll be offered the second dose at least 6 -12 months after the first.
If you receive your first dose after you turn 15 years old, you’ll need 3 doses of the vaccine. You’ll be offered:
- the second dose at least 1 month after the first dose
- the third dose at least 3 months after the second dose
Human Papillomavirus Vaccination: Why Is Coverage So Low In The United States
The human papillomavirus is the most common sexually transmitted infection in the United States. The Centers for Disease Control and Prevention has confirmed that at least half of all sexually active men and women will acquire HPV in their lifetime. The latest figures indicate that about 79 million Americans are currently infected with HPV, and about 14 million people are newly infected each year. HPV is associated with almost all cases of cervical and anal cancers, approximately 70% of vaginal, vulvar, and oropharyngeal cancers, and 60% of penile cancers. From 2008 to 2012, about 38,793 new cases of HPV-related cancers were diagnosed annually, which is a 16% increase over the 33,369 cases diagnosed from 2004 to 2008.
Three Vaccines With Different Availabilities
In 2014, a nine-valent vaccine, Gardasil® 9 , was approved in the United States. In addition to HPV types 6, 11, 16, and 18, Gardasil 9 protects against HPV types 31, 33, 45, 52, and 58, which account for about 15% of cervical cancers. Gardasil 9 has since been approved in Australia, Canada, and Europe. After Gardasil 9 was launched in the United States, practitioners began switching from the four-valent to the nine-valent vaccine, explains Lauri Markowitz, MD, from the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the CDC, during an interview with Medscape.
Dosing Schedules Changing
Cite this: The HPV Vaccine: Then and Now – Medscape – Aug 01, 2016.
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Summary Of Key Points
- In 2007, Australia became the first country to roll out a national HPV vaccination program.
- In 2013, boys were included in the program, too.
- 200 million doses have been distributed to date, in 130 countries.
- The current vaccines protect against about 70 per cent of cervical cancers, 90 per cent of genital warts, 70 per cent of vaginal cancer cases and up to 50 per cent of vulva cancer cases.
- In the first four to five years after the program started, HPV infections of the types that are included in the vaccine decreased by 77 per cent in 1824-year-olds.
- Precancerous abnormalities decreased by 34 per cent in in 20-24-year-olds.
- The next-generation vaccine prevents persistent infection and precancerous lesions associated with nine different HPV types. Seven of these types cause cancer and are together found in around 90 per cent of cervical cancers worldwide.
- It will further improve protection and lower rates of HPV-related cancers, especially cervical cancer.
Few Young Adult Men Have Gotten The Hpv Vaccine
But they should: A cancer found in the throat is now the leading cancer caused by HPV and 80% of those diagnosed are men.
The COVID-19 vaccine isnt having any trouble attracting suitors.
But theres another, older model thats been mostly ignored by the young men of America: the HPV vaccine.
Using data from the 2010-2018 National Health Interview Surveys, Michigan Medicine researchers found that just 16% of men who were 18 to 21 years old had received at least one dose of the HPV vaccine at any age. In comparison, 42% of women in the same age bracket had gotten at least one shot of the vaccine.
The CDCs Advisory Committee on Immunization Practices recommends two doses of the vaccine at 11 or 12 years old, but Americans can still benefit from the HPV vaccine if they receive it later, as long as they get three doses by age 26.
In the U-M study, however even among those who were vaccinated after turning 18 less than a third of men received all three vaccine doses, and about half of women did.
I dont think that a lot of people, both providers and patients, are aware that this vaccine is actually a cancer-prevention vaccine for men as well as women, Chen says. But HPV-associated oropharyngeal cancer can impact anyone and theres no good screening for it, which makes vaccination even more important.
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How Long Has Hpv Immunisation Been Available In New Zealand
The HPV Immunisation Programme started in New Zealand in September 2008, for girls and young women up to their 20th birthday. Over 200,000 girls and young women have been fully immunised against HPV in New Zealand.
HPV vaccines were first approved by the United States FDA in 2006. Over 165 million doses have been distributed worldwide since then.
If A Person Has Begun Immunisation With The Existing Gardasil Vaccine Can They Complete The Course With Gardasil 9
People who have begun immunisation with the HPV4 vaccine should complete with HPV4 while it is available, which is expected to be until early 2017.
Once stocks of HPV4 have run out, people will complete their course with Gardasil 9.
Gardasil 9 protects against nine types of HPV, whereas HPV4 protects against four types. It is not known whether a mixed schedule gives any protection against the five additional HPV types included in Gardasil 9.
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Scottish Hpv Immunisation Programme
The Scottish HPV immunisation programme started in September 2008 and vaccination is now routinely offered to all secondary school girls, from age 11 to 12 years. At the start of the programme, all 13 to 17 year old girls in Scotland were also offered HPV vaccine through a catch up campaign for a limited time. This catch up programme finished on 31 August 2011.
In September 2012, the vaccine was changed from Cervarix to Gardasil. Gardasil also protects against HPV 16 and 18 but also HPV 6 and 11.
In July 2017, a HPV vaccination programme was introduced for MSM, up to age 45 years. The vaccine is offered at sexual health clinics and administered as a three dose schedule.
Safety And Adverse Events
Common and local adverse events
Based on pre-licensure clinical trials, involving more than 15,000 subjects given HPV4 vaccine and 12,000 given HPV2 vaccine, the most common adverse events in persons receiving HPV vaccines were: injection site pain , swelling or redness . These adverse events were observed significantly more often following HPV vaccine than following active vaccine or placebo controls. In over 94% of subjects who received HPV vaccine, the reactions were mild to moderate in intensity, resolved over a few days, and did not prevent completion of the immunization schedule. Systemic adverse events, such as fatigue, myalgia, headache, fever, and nausea, generally occurred with comparable frequency in vaccine and control groups. The safety profile of HPV9 vaccine is comparable to HPV4 vaccine, although mild to moderate intensity injection site reactions are more common following receipt of HPV9 vaccine.
Since vaccine licensure, hundreds of millions of doses of HPV vaccine have been distributed worldwide. Data from post-licensure safety surveillance reporting systems have consistently mirrored the pre-licensure data with the most frequently reported adverse events following immunization being vaccination site reactions and muscle pain.
Less common and serious or severe adverse events
Other reported adverse events and conditions
Guidance on Reporting Adverse Events Following Immunization
Contraindications and precautions
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Available Vaccines And Vaccination Campaigns
The U.S. Food and Drug Administration approved Gardasil , a Merck vaccine for four types of HPV, in 2006. The FDA approved another vaccine, Cervarix from GlaxoSmithKline, which protects against two high-risk types of HPV, in 2009. A nine-valent vaccine was approved in 2014. All HPV vaccines use just a protein from the shell of certain HPV types: they contain no viral RNA or DNA and so cannot cause disease. The HPV vaccines have been shown to be effective in preventing precancerous cervical changes and precancerous anal changes in women and men caused by high-risk cancer-causing HPV strains. HPV4 and HPV9 additionally offer protection from several low-risk, wart-causing HPV types.
Current U.S. recommendations and guidelines from the Advisory Committee on Immunization Practices for HPV vaccination for females and males are below:
The recommended age for HPV vaccination of females is 11-12 years. The vaccine series can be administered as young as age 9 years. Catch-up vaccination is recommended for females age 13-26 years who have not been previously vaccinated.
ACIP recommends routine vaccination of males aged 11 or 12 years with HPV4 or HPV9. The vaccination series can be started beginning at age 9 years. Vaccination with HPV4 or HPV9 is recommended for males age 13-21 years who have not been vaccinated previously or who have not completed the series. Males age 22-26 years may be vaccinated.
How You Can Get Hpv
HPV which stands for Human Papillomavirus is a sexually transmitted virus that you can catch from an infected person through:
- sexual activity, including oral sex
- intimate skin-to-skin contact with an infected person
You don’t have to have intercourse to get HPV.
Without immunization, three out of four sexually active Canadians will be infected with HPV at some point in their lives.
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The Effects Of The National Hpv Vaccination Programme In England Uk On Cervical Cancer And Grade 3 Cervical Intraepithelial Neoplasia Incidence: A Register
- Kate SoldanAffiliationsBlood Safety, Hepatitis, Sexually Transmitted Infections and HIV Service, National Infection Service, Public Health England, London, UK
- Peter SasieniCorrespondenceCorrespondence to: Prof Peter Sasieni, Innovation Hub, Guy’s Cancer Centre, Guy’s Hospital, Great Maze Pond, London SE1 9RT, UKCancer Prevention Group, School of Cancer and Pharmaceutical Sciences, King’s College London, London, UKInnovation Hub, Guy’s Cancer Centre, Guy’s Hospital, London, UK