Human papilloma virus (HPV) vaccination is now given routinely to children in many countries. Here, Dr Neil Forrest from Osler Health International discusses the vaccine, and what protection it can offer:
Many parents I speak to still consider HPV vaccines to be something new. Perhaps this is because our generation did not receive them when we were younger, but they have actually been approved for more than 15 years now. The most commonly used vaccine is called Gardasil 9 which protects against 9 different strains of HPV.
What is HPV?
HPV is an incredibly common virus of which there are approximately 100 different strains that can infect humans. Of these, there are around 14 different types which can infect the genital region, and we know that around 80% of sexually active people come into contact with at least one type of HPV. Most people get no symptoms and would not know that they had the virus but, in some people, HPV causes warts.
What is the link between HPV and cancer?
HPV infection of the cervix is responsible for practically all cases of cervical cancer. This can be a devastating disease and tends to affect younger women. We try to prevent cervical cancer by screening for it with PAP smear tests. HPV is also linked to anal/penile cancers as well as some neck and throat cancers. Fortunately, most people who come into contact with HPV clear the virus naturally and even in those who don’t, not all of them will go on to develop cancer.
Who should be vaccinated against HPV?
I recommend HPV vaccination for all girls and boys. This is normally done between the ages of 10 and 14 (to be most effective, the vaccine should be given before someone becomes sexually active). The vaccine consists of two doses done 6 months apart in children age 15 and under, but in those over 15 an extra dose is required. Gardasil 9 protects against the main cancer-causing variants of HPV, as well as those that cause genital warts. Research data suggest that the vaccines provide near 100% protection for many years.
Why do you recommend vaccination for boys?
Although boys can’t get cervical cancer themselves, they can develop other HPV-related cancers, as well as genital warts. By vaccinating boys, we are also offering added protection to their future partners.
Can adults be vaccinated?
Yes! Although adults who are already sexually active will have already come into contact with HPV, it is unlikely that they will have contracted all 9 subtypes covered by the vaccine, so there is still some protection. Of course, in adults who are not sexually active or are in a stable relationship with a single partner, the risk of new exposure is low and so there is less of a case for vaccinating. The vaccine is licensed up to age 45 in Australia.
Are there any side-effects?
Side effects are rare and include those which are common to most vaccines – pain and redness at the injection site, fever and aches. We do see a higher rate of fainting after Gardasil vaccination (this may be related to the fact that fainting is generally more common in adolescent girls anyway), so the vaccine is given with the patient sitting or lying down, and we observe everyone for 15 minutes following the injection to make sure they feel OK.
Does the vaccine interact with COVID vaccines?
We don’t think so but as a precaution I advised leaving at least a two-week gap between COVID-19 vaccination and other vaccine doses. HPV vaccine can be given at the same time as a tetanus booster and is often done so, as these vaccines are often due to be given 1 round 12–14-years old.
If your child is between 10 – 15 years old you may wish to book in for their HPV vaccine.
Dr Neil Forrest is a British GP based at Osler Health International at Star Vista.
Call 6339 2727.
