Role of HPV? HPV help prevent cervical cancer.
How common is cervical cancer? Cervical cancer is caused by the Human Papilloma Virus (HPV). There are about 100 known types/strains of HPV. These are classified as high risk and low risk. High risk HPV types have been linked to cervical cancer. Low risk HPV types, such as HPV6 and 11 are not known to cause cancer but are responsible for genital warts.
How is HPV transmitted? Oncogenic HPV can spread via skin-to-skin genital contact and does not necessary require penetrative sexual intercourse. Men act as a reservoir of infection, Capable of passing on the virus to the female partners who are then at risk of developing cervical cancer.
Will vaccinating as early as 10 years of age protect women from cervical cancer in the future? How long does vaccine protection last? Antibodies are an important co-relate of long term protection. It is believed that antibody levels that are consistently high over a period of time and are likely to stay high, Would provide women with long term protection against cervical cancer. With some HPV , Mathematical modelling suggests that these antibodies are likely to persist for at least 50 years. Hence, Vaccination started at 10 years would confer protection against cervical cancer in the future.
Should boys/men be vaccinated as well to reduce overall incidences since they act as reservoirs for re-infection? Yes, The Centers for Disease Control and Prevention (CDC) recommends that the HPV vaccine be given to girls and boys between ages 11 and 12. 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 .As per WHO position paper 2017, Gender-neutral vaccination is always less cost-effective than vaccination of girls only.
What are the available schedule for HPV vaccines? Different companies offers different schedule, So physicians usually follow schedule given in literature (comes with each vaccine). Usual schedule is as:
What is the flexibility in vaccination schedule? Depends upon the brand/company , Usually : 2 vaccine dose schedule : If the second vaccine dose is administered before the 5th month after the 1st dose, A third dose should always be administered. The 2nd dose should be given between 5 and 13 months after the 1st dose. 3 Vaccines dose schedule: If flexibility in the vaccination schedule is necessary , The second dose can be administered between 1 month and 2.5 months after the first dose and the third dose between 5 and 12 months after the first dose.
Is screening necessary for sexually active women before vaccination? Screening women prior to vaccination is not a necessary prerequisite. Even if a woman is currently infected with an oncogenic HPV type, She will still stand to benefit from vaccination against new infection with the same or different HPV type(s). Is HPV vaccine safe to use in pregnant/Lactating women? Specific studies o the vaccine in pregnant women were not conducted. HPV vaccine is not to be used during pregnancy. Women who are pregnant or trying to become pregnant , Are advised to postpone or interrupt vaccination until completion of pregnancy. The effect on breast fed infants of the administration of HPV to their mother has not been evaluated. Better avoid HPV vaccination during lactating period.
How to choose best HPV vaccine? Different companies introduces their vaccine with different number of strains. eg Cervarix (GSK HPV Vaccine) covers 5 HPV strains. Gardasil (MSD Pharmaceuticals) introduces two vaccines covering 9 strain and 15 strain. I personally recommend to go for vaccine covering 15 or 9 strains (depend upon budget).