Who needs it, why and how it works
By Dr. Megha Gupta, Specialist in Obstetrics & Gynecology
Human papillomavirus (HPV) is a sexually transmitted pathogen that causes disease both in females and males. It is a group of more than 150 related viruses which are grouped as high- and low-risk, depending upon the disease they cause in humans.
The high-risk HPV types cause 90% of cervical cancers. HPV types 16 and 18 also cause nearly 90 percent of anal cancers and a significant proportion of oropharyngeal cancer, vulvar and vaginal cancer, and penile cancer. HPV types 6 and 11 cause approximately 90 percent of anogenital warts.
Mucosal (genital) HPV is spread mainly by direct skin-to-skin contact during vaginal, oral, or anal sexual activity. It’s not spread through blood or body fluids. It can be spread even when an infected person has no visible signs or symptoms.
Anyone who has had sexual contact can get HPV, even if it was with only one person, but infections are more likely in people who have had many sex partners.
In most people, the body clears the infection on its own. But sometimes, the infection doesn’t go away. Chronic, or long-lasting infection, especially when it’s caused by certain high-risk HPV types, can cause cancer over time.
There are two types of the HPV vaccine are available:
Gardasil 9 (9vHPV), active against 9 HPV types, 2 low-risk (6, 11) and 7 high-risk (16, 18, 31, 33, 45, 52, 58) types, and
Gardasil, active against 2 high-risk and 2 low-risk HPV types.
Both can prevent most cases of cervical cancer, vaginal and vulvar cancer in women, genital warts and anal cancer in women and men if given before a girl or boy is exposed to the virus. Certain types of HPV have also been linked to cancers in the mouth and throat, so the HPV vaccine likely offers some protection against these cancers, too.
The HPV vaccine is routinely recommended for girls and boys ages 11 or 12, although it can be given as early as age 9. It’s ideal for girls and boys to receive the vaccine before they have sexual contact and are exposed to HPV.
Once someone is infected with HPV, the vaccine might not be as effective or might not work at all. Also, the response to the vaccine is better at younger ages than it is at older ages.
Individuals initiating the vaccine series 9 to 15 years of age receive two doses of HPV vaccine at 0 and 6–12 months.
Individuals initiating the vaccine series at 15 years of age to 26 years – three doses of HPV vaccine should be given at 0, 1 to 2 (typically 2), and 6 months.
For adults 27 years and older: although the vaccine is approved for individuals up to 45 years of age, the decision about the vaccination is made on an individual basis.
- Pregnant women
- People who are moderately or severely ill
- People with severe allergies, including an allergy to yeast or latex
- If you’ve had a life-threatening allergic reaction to any component of the vaccine, or a previous dose of the vaccine
Yes. Even if you already have one strain of HPV, you could still benefit from the vaccine because it can protect you from other strains that you don’t yet have. However, none of the vaccines can treat an existing HPV infection. The vaccines protect you only from specific strains of HPV you haven’t been exposed to already.
If someone has received a complete course with Gardasil, a second course with Gardasil 9 is not needed.
However, if the course is not completed and the 2nd/3rd doses are remaining, consider switching to Gardasil 9 for wider coverage.
Overall, the effects are usually mild. The most common side effects of HPV vaccines include soreness, swelling or redness at the injection site.
Sometimes dizziness or fainting occurs after the injection. Remaining seated for 15 minutes after the injection can reduce the risk of fainting. Headaches, nausea, vomiting, fatigue or weakness also may occur.
Yes. The HPV vaccine isn’t intended to replace Pap tests. As per recent recommendations, routine screening for cervical cancer through regular HPV genotyping and Pap tests remains an essential part of a woman’s preventive health care.
After 25 years of age, HPV testing alone or with a Pap smear is recommended every 5 years. If for some reason, HPV testing cannot be done, a Pap smear alone is recommended every 3 years.
HPV spreads through sexual contact — oral, vaginal or anal. To protect yourself from HPV, use a condom every time you have sex. Also, don’t smoke. Smoking raises the risk of cervical cancer.
To detect cervical cancer in the earliest stages, see your health care provider for cervical screening. Seek prompt medical attention if you notice any signs or symptoms of cervical cancer — vaginal bleeding after sex, between periods or after menopause, pelvic pain, foul-smelling discharge, or pain during sex.