What causes cervical cancer?
Cervical cancer is caused by human papillomavirus (HPV). HPV is a common virus that is spread through skin to skin contact. Some types of HPV infection can cause cell changes that may lead to cervical cancer, and these types are spread through sexual contact.
What is HPV (human papillomavirus)?
HPV is a common virus spread through skin to skin contact. Some strains of HPV cause cell changes that can lead to cervical cancer. Other strains can cause warts but those strains do not lead to cancer. Most women who develop HPV infections clear the virus naturally and do not develop cervical cancer. About four out of five people have HPV infection at some time in their lives.
Can HPV infection be treated or prevented?
There is no treatment for HPV infections, but there is treatment for the health problems that HPV can cause (such as warts, abnormal changes to cervical cells, and cancers).
What is the GARDASIL® vaccine?
Immunisation with the GARDASIL® vaccine can protect against the two HPV types that cause 7 out of 10 cervical cancers and the two HPV types that cause 9 out of 10 cases of genital warts, provided a person has not already been infected.
How safe is the vaccine?
The vaccine was shown to have an excellent safety profile during large clinical trials in which more than 20,000 people from 30 countries took part.
GARDASIL® has been licensed for use in more than 100 countries, including New Zealand, Australia, the United States, and the 27 countries in the European Union including the U.K.
In New Zealand, as in other countries, there is ongoing monitoring of vaccine safety.
All applications for consent to distribute a medicine in New Zealand are evaluated by Medsafe. This evaluation is performed to internationally defined standards and requirements. GARDASIL® was evaluated by Medsafe and formal approval of the vaccine was notified in the New Zealand Gazette on 20 July 2006.
The reactions reported from GARDASIL® are similar to other vaccinations. The most common are injection site pain, redness, and swelling. Nausea and fainting have also been reported. Very rarely people have more serious allergic reactions to vaccinations (such as anaphylaxis). All the clinical trials and ongoing safety monitoring worldwide report no deaths have been caused by the vaccine.
How effective is the vaccine, and how long does it last?
GARDASIL® vaccine targets the types of HPV responsible for most cases of cervical cancer and genital warts. Clinical trials show GARDASIL® is highly effective in preventing these types of HPV in young women who have not previously been exposed to them. So far, ongoing studies show three doses of the vaccine protects against HPV infection for five years after immunisation, and suggest protection will last much longer. The vaccine was effective at preventing persistent infection with HPV in 96 per cent of women. At present it is expected that booster doses will not be required. Research is continuing to find out how long protection will last.
When does the HPV Immunisation Programme start?
The HPV Immunisation Programme will start in September 2008, and will be initially offered to:
- Young women born in 1990 and 1991
- Younger girls who have left school
This group can get HPV vaccine from their family doctor or practice nurse.
In 2009 and 2010 the programme will be available through schools for girls in years 8-13. The vaccine will be offered each year to year 8 girls (aged 12 to 13 years), mostly through nurses in schools.
More details will be released once District Health Board plans are finalised.
Why should girls be vaccinated at 12 to 13 years of age?
The HPV vaccine only prevents against HPV infection, it does not treat infection. Therefore, for best protection girls need to be vaccinated before they are likely to be exposed to HPV, which means before they start having any sexual contact.
Should a young woman be vaccinated if she has already had sexual contact?
Yes. A young woman who has had sexual contact may still benefit from the vaccine because it is unlikely she will have been infected with the two HPV types that cause 7 out of 10 cervical cancers, and the two HPV types that cause 9 out of 10 genital warts.
Is vaccination compulsory?
No. It’s preferable for young women and their parents to discuss the immunisation information and make a decision together. If they have further questions, they should discuss these with their family doctor or nurse.
How is the vaccine given?
The vaccine is given by injection in the upper arm. Three injections are given over a 6-month period. The second dose will be given approximately 2 months after the first dose, followed by a third dose 4 months after the second dose.
Will young women be protected against HPV and related diseases, even if they don’t get all three doses?
It is not known how much protection young women would get from one or two doses of the vaccine. The Ministry of Health recommends that young women receive all three doses of the vaccine.
If young women receive the HPV vaccine, will they still need cervical smear tests when they’re older?
Yes. GARDASIL® does not protect against HPV types that can cause 30 percent of cervical cancers. And, as with any vaccine, GARDASIL® may not provide protection for everyone who is vaccinated.
Also, the vaccine does not prevent about 10 per cent of genital warts, nor will it prevent other sexually transmissable infections (STIs), or pregnancy.
Are there any groups who should not get HPV vaccine, or should wait?
There are a few people for whom the vaccine is not recommended, including:
- anyone who has ever had a life-threatening reaction to yeast, or any other component of GARDASIL®
- anyone who has any severe allergies – these people should check with their doctor first
- pregnant women. The vaccine appears to be safe for both the mother and the unborn baby, but this is still being studied. Pregnant women who inadvertently receive the vaccine do not need to consider terminating the pregnancy . They can complete the vaccine course after their baby is born.
- people with moderate or severe illnesses should wait until they recover to receive their HPV immunisation.
Women who are breastfeeding may safely get the vaccine.
People who are mildly ill can still get their immunisation as scheduled.
Can girls younger than 12 or older than 18 get the vaccine?
The vaccine is licensed for use for females aged between 9 and 26 years of age, but it is only free for girls and young women who are part of the immunisation programme. Young women wanting the vaccine, who are not part of the programme should talk to their family doctor.
Will information about a young woman be collected if she is vaccinated with the HPV vaccine?
HPV immunisations will be collected on the National Immunisation Register (NIR) so that reminders can be issued if the course is incomplete. The information will also be used to check the impact of the vaccine programme on cervical cancer rates.
If a young woman or her parents decline to have details recorded on the NIR, this would make it difficult to contact them about any missed doses. However, young women can still receive HPV immunisation even if they are not enrolled on the NIR.
Could vaccinating from age 12 promote early sexual activity?
Overseas research has found that there is no increase in sexual activity, nor any lowering in the age of initiation of sexual activity after sexual health education is given to young people. Therefore, offering girls information on vaccination about a sexually transmitted infection will not increase sexual activity.
This is an immunisation programme to protect girls and young women from developing cervical cancer later in life.
Girls need to be vaccinated before they are likely to be exposed to HPV, which means before they start having any sexual contact.
Focus groups of parents and young women supported vaccination at age 12, as did Public Health Nurses who vaccinate in schools. This age is also supported in programmes in other countries.
Health education for young people needs to support them to make responsible choices.
Can boys be vaccinated?
The vaccine is approved for use in boys, but is not funded for boys as part of the National Immunisation Programme.
Modelling studies suggest that if high immunisation coverage of females can be achieved little reduction in cervical cancer is gained by vaccinating males.
No country in the world is funding a programme for boys and men at present.
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Page last updated: 28 August 2008 |