The Importance Of Hpv Vaccines In Practice
When I do genetic counseling and extract a family history, often one or more individuals are affected with a cervical cancer diagnosis. Many of these are because of HPV infection, not genetic transmission. I try to educate families that many of the cervical cancersas well as many other cancerscould be prevented with the HPV vaccine. If my patients have children or grandchildren in the age groups for which HPV vaccination is recommended, I take it a step further to educate them about the immunization schedule, insurance and coverage options to pay for the vaccines, and, most importantly, that its a step these families can take to reduce the risk of developing cancer.
Patients often mention their children arent sexually active, so they dont feel a need to vaccinate. Parents should be educated that the HPV vaccine is recommended for preteen boys and girls to protect them before theyre exposed to the virus. HPV vaccine also produces a higher immune response in preteens than in older adolescents. Beyond that, If children start earlier, theyll only need two immunizations instead of three. The conversation only takes minutes, but the benefits could prevent cancer in future generations.
What If You Aren’t Sure If You Got The Hpv Vaccine
Those who started, but never finished the HPV vaccine series when they were younger should see their doctor for their last shots. “If you’re not sure how many doses of the HPV vaccine you’ve received, it’s better to err on the side of getting an extra dose,” Dr. White says.
You also don’t have to worry about the timing herewhile it’s best to get the shots at the recommended intervals, you won’t need to start the immunization process over again. “Even if the doses are off schedule, you can just finish the recommended number of doses. The series does not need to be restarted,” says Dr. Perkins.
For those who don’t remember whether or not they got the HPV vaccine as a child, the first step is to try and access your old medical records. If you can’t do that for whatever reason, Dr. White recommends re-starting the series. Even if you received an older version of the HPV vaccine while you were younger, it is safe to get the newer vaccine at a later date, Dr. Perkins says.
Hpv Vaccine Information For Young Women
CDC recommends HPV vaccination at age 11 or 12 years and for everyone through age 26 years, if not vaccinated already. For more information on the updated recommendations, see Human Papillomavirus Vaccination for Adults: Updated Recommendations of the Advisory Committee on Immunization Practices.
A vaccines is available to prevent the human papillomavirus types that cause most cervical cancers as well as some cancers of the anus, vulva , vagina, and oropharynx . The vaccine also prevents HPV types that cause most genital warts.
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Human Papillomavirus Vaccine: Canadian Immunization Guide
For health professionals
Last complete chapter revision: May 2017
New recommendation: HPV9 vaccine may be administered to immunocompetent males and females 9 to 14 years of age according to a 2-dose or 3-dose immunization schedule. The second dose of HPV9 vaccine in a 2-dose schedule should not be administered earlier than 24 weeks following the first dose. Immunocompromised individuals should continue to receive a 3-dose immunization schedule, as previously recommended.
The Fda Recently Expanded Approval For The Hpv Vaccine To Include Men And Women Ages 27 To 45 How Can This New Group Of Eligible Patients Get Vaccinated Against Hpv
Patients up to age 45 can request the vaccine but would have to check with insurance plans for coverage. Three doses of the vaccine may be $600-800 out of pocket. Importantly, providers can feel safe in prescribing and promoting for interested patients. Next steps to expand coverage under preventative benefits will be for the ACIP and CDC to review and support the extended vaccine age. Though we know the best time to vaccinate is at a younger age, the expansion of the HPV vaccine is an important step in cancer prevention because it will reach those who missed their adolescent vaccines and accelerate our ability to eliminate HPV-related cancers.
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Carrons Story Cervical Cancer And The Hpv Vaccine
In this short film Carron Hulme talks about her experience of surviving cervical cancer, and her daughters Charlotte and Mollie talk about the HPV vaccine. Charlotte talks about receiving three doses of the HPV vaccine, but in 2014 the schedule changed. Girls and boys now receive two doses, as long as they get the first dose when they are under 15. Thanks to Jos Cervical Cancer Trust for their help in making this film.
Who Should Be Vaccinated For Hpv
Females between 9 and 45 years of age can be vaccinated with Cervarix, Gardasil or Gardasil 9 to prevent cervical cancer and precancerous cervical changes. Gardasil and Gardasil 9 may also prevent vaginal, vulvar and anal cancers and their precancers, as well as anogenital warts.
Its important to know that HPV vaccines do not replace cervical cancer screening. Your doctor will still. HPV vaccines prevent infection from the most common types of HPV related to cancer, but not all.
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Should Hpv Vaccines Be Given To People Who Are Already Infected With Hpv Or Have Cervical Cell Changes
ACIP recommends that people who have an HPV infection and/or an abnormal Pap test result that may indicate an HPV infection should still receive the HPV vaccine if they are in the appropriate age group because the vaccine may protect them against high-risk HPV types that they have not yet acquired. However, these people should be told that the vaccination will not cure them of current HPV infections or treat the abnormal results of their Pap test .
Although HPV vaccines have been found to be safe when given to people who are already infected with HPV, the vaccines provide maximum benefit if a person receives them before he or she is sexually active .
It is likely that someone previously infected with HPV will still get some residual benefit from vaccination, even if he or she has already been infected with one or more of the HPV types included in the vaccines.
Who Should Get Hpv Vaccination
The Centers for Disease Control and Preventions Advisory Committee on Immunization Practices develops recommendations regarding all vaccination in the United States, including HPV vaccination. The current ACIP recommendations for HPV vaccination are :
- Children and adults ages 9 through 26 years. HPV vaccination is routinely recommended at age 11 or 12 years vaccination can be started at age 9 years. HPV vaccination is recommended for all persons through age 26 years who were not adequately vaccinated earlier.
- Adults ages 27 through 45 years. Although the HPV vaccine is Food and Drug Administration approved to be given through age 45 years, HPV vaccination is not recommended for all adults ages 27 through 45 years. Instead, ACIP recommends that clinicians consider discussing with their patients in this age group who were not adequately vaccinated earlier whether HPV vaccination is right for them. HPV vaccination in this age range provides less benefit because more people have already been exposed to the virus.
- Persons who are pregnant. HPV vaccination should be delayed until after pregnancy, but pregnancy testing is not required before vaccination. There is no evidence that vaccination will affect a pregnancy or harm a fetus.
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Mechanism Of Cervical Cancer
Normal cervical cells => The body is exposed to high-risk HPV and the immune system cannot fully eliminate viruses within 2 years, inducing pre-cancer changes. Pre-cancerous cervical cells can turn to be cervical cancer in the next 10 years => Pre-cancerous stage => Cancer of Cervix
Besides cervical cancer, some cancers of the vulva, vagina, penis, anus and oropharynx are also caused by certain strains of HPV. However, molecular mechanism of developing cancers after being exposed to HPV widely varies among individual patients, depending on their immune systems. For instance, immunocomprimised patients with HIV infection or SLE are more susceptible to develop cancerous stage quicker than 10 years.
As a normal mechanism of the body after being infected with HPV, an immune system can usually get rid of viruses . While most HPV infections are characterized by spontaneous viral clearance, some HPV strains are highly persistent. The median time to clearance of high-risk HPV infection in most cases with proper immune function is approximately 8 months. 70% of viruses can be eliminated from the body within a year. Nonetheless, clearance requires an effective cell-mediated immune response. In case that high-risk HPV group has been persistently detected longer than 2 years, the risk of further developing to cervical cancer drastically increases 200-400 times while detection of other strains in high-risk HPV group increases the chance of cervical cancer 30-40 times.
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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People Who Are Transgender
If you are a trans woman , you can get the vaccine for free through sexual health and HIV clinics if your risk is the same as men who have sex with men, and you are aged 45 or under.
Trans men who have sex with other men and are aged 45 or under can also get the vaccine for free. But if you are a trans man who has already had all doses of the vaccine as part of the vaccination programme at school, there is no need to have the vaccine again.
The Hpv Vaccine And Men Who Have Sex With Men
The longstanding HPV vaccination programme for girls indirectly protected boys against cancers and genital warts linked to infection with HPV because girls would not pass HPV on to them.
MSM have not benefited in the same way from the HPV vaccination programme for girls.
But MSM are at increased risk of cancers linked to infection with HPV types 16 and 18, such as cancer of the anus, penis, mouth or throat.
MSM are also at risk of genital warts caused by HPV types 6 and 11.
MSM up to and including the age of 45 are eligible for free HPV vaccination on the NHS when they visit a specialist sexual health service or HIV clinic.
From 1 April 2022, MSM need 2 doses of the vaccine, given 6 months apart. It’s important to have both doses to be properly protected.
MSM who are HIV positive or have a weakened immune system need to have 3 doses of the HPV vaccine.
Ask the doctor or nurse at the clinic for more details.
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Is The Hpv Vaccine Safe
HPV vaccines used in Australia are very safe. All HPV vaccines available in Australia have been thoroughly tested and more than 270 million doses have been given around the world.
The HPV vaccine has been provided through school based programs in Australia since 2007 for females and 2013 for males. In Australia, as in other countries, there is ongoing monitoring of vaccine safety.
Are There Any Adults Who Should Not Receive The Hpv Vaccine
Certain people should not get the HPV vaccine or should wait before getting it:
- Anyone who has had a life-threatening allergic reaction to a previous dose of the HPV vaccine
- Anyone who has had a previous life-threatening allergic reaction to an ingredient in the HPV vaccine
- Pregnant women
- Anyone with a moderate or severe illness people who feel mildly ill may still receive the HPV vaccine.
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Who Can Get The Hpv Vaccine
The groups listed below can get the HPV vaccine for free. If you dont fall into one of these groups, you can pay to have the vaccine privately. But the vaccine wont be as effective if you have already been exposed to HPV. And as HPV is a very common virus, most adults will have already been exposed to it.
Other people at higher risk may be offered the vaccine for free on a case by case basis. If youre not sure whether you are eligible, speak to your doctor.
Benefits Of Hpv Vaccination
There is ongoing, active scientific inquiry and clinical trials to extend the vaccine to include activity against more of the oncogenic viral subtypes for cancers invading the oropharyngeal and anogenital regions. Merck has a 9-valent vaccine including 5 additional cancer-causing subtypes to increase activity against these types of cancer . Sales for the Gardasil vaccine have increased over the past 3 years . This measure serves as a surrogate for total vaccine doses produced by the pharmaceutical company. Numbers of patients actually vaccinated are difficult to extrapolate. The current data regarding estimated HPV vaccination coverage among adolescent boys and girls aged 13-17 details an increase in completed vaccine series from 5.9% in 2007 to 37.6% in 2013 for girls and 1.3% to 13.9% in boys from 2011 to 2013 .
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What Is The Hpv Vaccine
The HPV vaccine currently available in the US, Gardasil 9, is the newest iteration of the vaccine. It’s a two-to-three dose vaccine regimen approved for use in all children that protects against HPV infection and HPV-related conditions, according to the CDC. Those conditions include:
- Genital warts
- Cervical precancers
- Cancers of the cervix, vagina, and vulva
- Penile cancer
- Anal cancer
- Oropharyngeal cancer
Of the more than 150 different strains of HPV, 40 are known to cause cancer. The HPV vaccine approved for use in the US protects against the nine strains responsible for about 90% of cervical cancers, Rebecca Perkins, MD, an associate professor of obstetrics and gynecology at the Boston University School of Medicine, tells Health.
Something to note: Gardasil was not the HPV vaccine used in the most recent UK study. That was, again, a first-generation HPV vaccine called Cervarix. Because Cervarix was one of the first iterations of the HPV vaccine, it didn’t protect against as many HPV strains. The HPV vaccines in circulation now protect against more strains of HPV, which means they offer more protection, says Dr. Perkins.
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Hpv Vaccination For Transgender People
Trans women are eligible in the same way as MSM if their risk of getting HPV is similar to the risk of MSM who are eligible for the HPV vaccine.
Trans men are eligible if they have sex with other men and are aged 45 or under.
If trans men have previously completed a course of HPV vaccination as part of the girls’ HPV vaccine programme, no further doses are needed.
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Who Is Eligible For The Free Hpv Vaccine
In Victoria, the HPV vaccine is available for free to all adolescents in year seven of secondaryschool under the National Immunisation Program. The two-dose course of the vaccineis given at school. It can also be given by a local doctor or at a council immunisation session. Contactyour state or territory health department for more information about HPV vaccination at your school.
People under 20 years of age who missed the vaccine at secondary school can access free catch-updoses at their local doctor or at a community immunisation session. From 15 years of age theGardasil®9 vaccine is given as a three-dose course.
- Find my local council
- Find my nearest immunisationprovider
People from 20 years of age are not eligible for free vaccination through the National Immunisation Program, so they will have to pay for thevaccine. The HPV vaccine is licensed for males aged 9 to 26 years and females aged 9 to 45 years.
Do I Need To Go To Cervical Screening If Ive Had My Hpv Vaccination
Yes, you should still consider going to cervical screening if youve had the HPV vaccine. The HPV vaccine doesnt protect against all types of HPV. And cervical screening is another effective way to reduce the risk of developing cervical cancer.
Cervical screening is for people without symptoms and helps to spot early cell changes caused by HPV. This means any abnormal cells can be removed before they have a chance to become cancer.
But dont wait for your next screening appointment if youve noticed anything thats unusual for you or wont go away. If somethings not normal for you speak to your doctor.
Cervical screening is for women aged between 25 and 64, and anyone else within this age range who has a cervix. This can include transgender men and people who are non-binary.
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