Immunisation HPV Vaccination Questions and Answers
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What is HPV (human papillomavirus)? What causes cervical cancer? Can HPV infection be treated or prevented? What is the GARDASIL® vaccine? How safe is the vaccine? How effective is the vaccine, and how long does it last? When does the HPV Immunisation Programme start? Why should girls be vaccinated at 12 to 13 years of age? Should a young woman be vaccinated if she has already had sexual contact? Is vaccination compulsory? How is the vaccine given? Will young women be protected against HPV and related diseases, even if they don’t get all three doses? If young women receive the HPV vaccine, will they still need cervical smear tests when they’re older? Can girls younger than 12 or older than 18 get the vaccine? Will information about a young woman be collected if she is vaccinated with the HPV vaccine? Can boys be vaccinated? What is HPV (human papillomavirus)? HPVs are common viruses spread through skin to skin contact. Some high-risk types of HPV cause cell changes that, if not detected through cervical screening and treated, can lead to cervical cancer. Other low-risk types of HPV can cause genital warts but those strains do not generally 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. Back to top What causes cervical cancer? 99% of all cervical cancer is caused by genital infection with human papillomavirus (HPV). HPVs are common viruses that are spread through skin to skin contact. Some types of high-risk HPV can cause cell changes in the cervix which, if not detected through cervical screening and treated, over many years can lead to cervical cancer. These high-risk types of HPV are spread through sexual contact. Other factors increase the risk of cervical cancer including genetics, smoking and number of sexual partners. Back to top 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 genital warts, abnormal changes to cervical cells, and cancers). Back to top 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. Back to top How safe is the vaccine? The vaccine was shown to have a good safety profile during large clinical trials involving more than 20,000 people from 30 countries, including clinical trials in New Zealand. Gardasil® has been licensed for use in more than 100 countries, including New Zealand, Australia, the United States, Canada and countries in the European Union. 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 HPV immunisation are similar to other immunisations. The most common are injection site pain, redness, and swelling. Nausea and fainting have also been reported. The only known severe reaction is serious allergic reactions, like a peanut allergy (called anaphylaxis) usually within minutes of the immunisation being given. Anaphylaxis is rare – about 3 anaphylaxic reactions per 1 million doses of vaccine administered. Every vaccinator is trained and equipped to deal with an anaphylaxic reaction if one occurs Back to top How effective is the immunisation, and how long does protection from it last? The Gardasil® vaccine targets the types of HPV responsible for 70% of cervical cancer and 90% of genital warts. Clinical trials show it is highly effective in preventing these types of HPV in young women who have not previously been exposed to them. So far, ongoing clinical studies show three doses of the vaccine protects against HPV infection for at least five years after immunisation, and suggest protection will be long lasting. The vaccine is effective at preventing persistent infection with HPV in 96 per cent of women. Back to top When did the HPV Immunisation Programme start? The HPV Immunisation Programme started in September 2008, and was initially offered only to young women born in 1990 and 1991. In 2009 the programme was extended to girls born from 1992 onwards. In 2009 and 2010, HPV immunisation is offered through most participating schools to girls in school years 8 to 13. From 2011 onwards, the HPV immunisation will only be offered in participating schools to girls in school year 8. HPV immunisation is also available through family doctors, local health centres and most Family Planning clinics for girls and young women who do not attend a participating school or who do not want to have it at school. Details on each District Health Board’s plans are available from them.. Back to top Why should girls be immunised 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 immunised before they are likely to be exposed to HPV, which means before they start having any sexual contact. There is also good evidence that younger girls develop a stronger immune response from the vaccine compared to older girls. Most countries who have introduced publicly funded HPV immunisation programmes offer the immunisation to girls of a similar age. Back to top Should a young woman be immunised 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. Back to top Is immunisation compulsory? No. We reccomend that young women and their parents to discuss the HPV immunisation information and make a decision together. If they have further questions, they should discuss these with their family doctor or the public health nurse at school. Back to top How is the vaccine given? The vaccine is given by injection in the upper arm. Three injections are usually 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. Back to top 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. Back to top If young women receive the HPV vaccine, will they still need cervical smear tests when they’re older? Yes. The vaccine does not protect against HPV types that can cause 30 percent of cervical cancers and 10 per cent of genital warts. Regular cervical smear tests are recommend for women aged 20 to 70 if they have ever been sexually active. Together, HPV immunisation and cervical screening offers women the best protection against cervical cancer. 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 an earlier dose or any component of the vaccine pregnant women. Anyone who has a bleeding disorder or an immune disorder should talk to their doctor or nurse before having the HPV vaccine. People with moderate or severe illnesses should wait until they recover to receive their HPV immunisation. People who are mildly ill can still get their immunisation as scheduled. Back to top Can girls younger than 12 or older than 18 get the vaccine? The vaccine is licensed for use for females aged between 9 and 45 years of age, but it is only free for girls and young women born on or after 1 January 1990. Women wanting the vaccine, who are not funded by the HPV Immunisation Programme should talk to their family doctor. The vaccine is also licensed for males aged between 9 and 15. Back to top Will information about a young woman be collected if she is has the HPV immunisation? Yes. Information from school-based consent forms and details of each immunisation offered, given or declined at school or in primary care will be recorded on either the School-Based Vaccination System (or similar) or the General Practice Management System and some of it will be passed on the National Immunisation Register. You can choose not to have immunisations recorded on the National Immunisation Register. Within the school-based programme, participating schools may provide the district health board or public health nurse with specific information about their female students (such as names, dates of birth, addesses etc) to help with the administration of the HPV Immunisation Programme. Schools must notify parents of their intention to share this information before doing so. For more information about the use of information, privacy and data-sharing, download our fact sheet (PDF, 41 KB) Back to top 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. Back to top Back to the Human Papillomavirus (HPV) Immunisation Programme page Website feedback We welcome your feedback on this page. Page last updated: 11 February 2010