HPV vaccine

Answer 1

Definition

The HPV vaccine protects against infection by certain strains of the human papilloma virus (HPV) that can cause Cervical cancer and genital warts.

HPV spreads mostly through sexual contact. Almost all cervical cancers are caused by HPV. HPV vaccination is expected to prevent about 70% of cervical cancer cases.

See also:

• Cervical cancer
• Genital warts

Alternative Names

Vaccine - HPV; Immunization - HPV; Gardasil; Cervarix; Vaccine to prevent cervical cancer

Information

HPV is a common virus that is spread through sexual intercourse. There are many different types of HPV, and many do not cause problems. However, certain types of HPV can lead to cervical cancer (and genital warts).

Two vaccines are currently available to prevent cervical cancer in girls and young women. These vaccines do not treat cervical cancer, however.

The vaccines are called Gardasil and Cervarix.

• Both of the vaccines protect against HPV-16 and HPV-18, the two types of HPV that cause most cases of cervical cancer.
• Gardasil also protects against HPV-6 and HPV-11, which cause most cases of genital warts.
• The vaccines do not protect against all types of cervical cancer-causing HPV.

WHO SHOULD GET THIS VACCINE

Gardasil is approved for:

• Females age 9-26 to protect against cervical cancer and prevent genital warts
• Males age 9 - 26 to prevent genital warts

Cervarix is approved for:

• Females age 10 - 26 to help protect against cervical cancer
• Cervarix does not protect against genital warts
• Cervarix has not been approved for use in boys or men

CURRENT IMMUNIZATION RECOMMENDATIONS:

Routine HPV immunization is recommended for 11- and 12-year-old girls. The vaccine is given in 3 shots over a 6-month period. (The second and third doses are given 2 and 6 months after the first dose.)

One brand of vaccine can be substituted for another in the 3-dose series. The HPV vaccine can be given at the same time as other vaccines.

Girls as young as 9 can receive the vaccine if their doctor recommends it.

Girls and women ages 13 - 26 who have not been previously immunized or who have not completed the full vaccine series should get vaccinated to catch up on missed doses. (Note: Some groups do not recommend women between 19 and 26 receive catch-up doses of this vaccine. Talk with your provider if you are this age group.)

Routine use of the HPV vaccine in boys and men is not recommended. However, a health care provider may still decide to use it on a specific patient.

Pregnant women should not receive this vaccine.

SIDE EFFECTS

The most common side effects are fainting, dizziness, nausea, headache, and skin reactions at the site where the shot was given.

CONSIDERATIONS

The HPV vaccine does not protect against all types of HPV that lead to cervical cancer. Girls and women should still receive regular screening (Pap tests) to look for any early signs of cervical cancer. See: Pap smear

The HPV vaccine does not protect against other sexually transmitted infections.

CALL YOUR HEALTH CARE PROVIDER IF

• You aren't sure whether you or your child should receive the HPV vaccine
• You or your child develops complications or severe symptoms after getting an HPV vaccine
• You have other questions or concerns about the HPV vaccine

References

Kahn JA. HPV vaccination for the prevention of cervical intraepithelial neoplasia. N Engl J Med. 2009 Jul 16;361(3):271-8.

Slade BA, Leidel L, Vellozzi C, Woo EJ, Hua W, Sutherland A, et al. Postlicensure safety surveillance for quadrivalent human papillomavirus recombinant vaccine. JAMA. 2009 Aug 19;302(7):750-7.

Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States, 2009. Ann Intern Med. January 6, 2009;150(1):40-4.

Centers for Disease Control and Prevention (CDC). Recommended adult immunization schedule -- United States, 2009. MMWR Recomm Rep. January 9, 2009;57(53):Q-1-4.

Answer 2

Definition

The HPV vaccine protects against infection by certain strains of the human papilloma virus (HPV). HPV can cause cervical cancer and genital warts.

See also:

• Cervical cancer
• Genital warts

Alternative Names

Vaccine - HPV; Immunization - HPV; Gardasil; Cervarix; Vaccine to prevent cervical cancer

Information

HPV is a common virus that is spread through sexual contact. There are many different types of HPV, and many do not cause problems. However, certain types of HPV can lead to:

• Cervical cancer in women
• Genital warts in men and women
• Cancer of the penis or anus in men

Two vaccines (called Gardasil and Cervarix) are approved:

• Both of the vaccines protect against the two types of HPV that cause most cases of cervical cancer. (Other, less common types of HPV can still cause cervical cancer.)
• Gardasil also protects against two other types of HPV that cause most cases of genital warts in women and men.
• These vaccines do not treat cervical cancer.

WHO SHOULD GET THIS VACCINE

Gardasil is approved for:

• Females ages 9-26 to protect against cervical cancer and to prevent genital warts
• Males ages 9 - 26 to prevent genital warts

Cervarix is approved for:

• Females age 10 - 26 to help protect against cervical cancer

Girls ages 11 and 12 should receive the HPV vaccine series:

• The vaccine is given in three shots over a 6-month period. (The second and third doses are given 2 and 6 months after the first dose.)
• One brand of vaccine can be substituted for another in the 3-dose series. The HPV vaccine can be given at the same time as other vaccines.
• Girls as young as age 9 can receive the vaccine if their doctor recommends it.

Girls and women ages 13 - 26:

• Those who have not received the HPV vaccine in the past should get a series of three vaccines.
• Those who have not completed the full vaccine series should catch up on missed doses. (Note: Some experts do not recommend that women between ages 19 and 26 receive catch-up doses of this vaccine. Talk with your provider if you are in this age group.)

Boys and men ages 9 - 26:

• May receive Gardasil to reduce the chance of becoming infected with genital and anal warts.
• The vaccine is not yet being recommended for all boys and men up to age 26.
• The vaccine can prevent genital warts in men and decrease the risk for cancer of the penis and anus.

Pregnant women should not receive this vaccine. However, there have been no problems found in women who received the vaccine during pregnancy, before they knew they were pregnant.

SIDE EFFECTS

The most common side effects are fainting, dizziness, nausea, headache, and skin reactions at the site where the shot was given.

To prevent injury from fainting, adolescent girls should be watched for 15 minutes after getting the vaccination.

WHAT ELSE TO THINK ABOUT

The HPV vaccine does not protect against all types of HPV that lead to cervical cancer. Girls and women should still receive regular screening (Pap tests) to look for any early signs of cervical cancer. See: Pap smear

The HPV vaccine does not protect against other infections that can be spread during sexual contact.

CALL YOUR HEALTH CARE PROVIDER IF

• You aren't sure whether you or your child should receive the HPV vaccine
• You or your child develops complications or severe symptoms after getting an HPV vaccine
• You have other questions or concerns about the HPV vaccine

References

Kahn JA. HPV vaccination for the prevention of cervical intraepithelial neoplasia. N Engl J Med. 2009 Jul 16;361(3):271-8.

Slade BA, Leidel L, Vellozzi C, Woo EJ, Hua W, Sutherland A, et al. Postlicensure safety surveillance for quadrivalent human papillomavirus recombinant vaccine. JAMA. 2009 Aug 19;302(7):750-7.

Centers for Disease Control and Prevention. FDA licensure of bivalent human papillomavirus vaccine (HPV2, Cervarix) for use in females and updated HPV vaccination recommendations fromt he Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2010;59(20):626-629.

Reviewed By

Review Date: 02/28/2011

Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; and Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.