HPV Vaccine

Questions and Answers

WHAT IS HUMAN PAPILLOMAVIRUS (HPV)?

HPV is a virus that can lead to cervical cancer; vulvar and vaginal cancers; penile cancer; anal cancer and genital warts (warts in the genital areas). More than 1 vaccine is available to help you or your child with protection against HPV. Your caregiver can talk to you about which one might give you the best protection.

WHO SHOULD GET THIS VACCINE?

The HPV vaccine is most effective when given before the onset of sexual activity.

  • This vaccine is recommended for girls 11 or 12 years of age. It can be given to girls as young as 9 years old.

  • HPV vaccine can be given to males, 9 through 26 years of age, to reduce the likelihood of acquiring genital warts.

  • HPV vaccine can be given to males and females aged 9 through 26 years to prevent anal cancer.

HPV vaccine is not generally recommended after age 26, because most individuals have been exposed to the HPV virus by that age.

HOW EFFECTIVE IS THIS VACCINE?

The vaccine is generally effective in preventing cervical; vulvar and vaginal cancers; penile cancer; anal cancer and genital warts caused by 4 types of HPV. The vaccine is less effective in those individuals who are already infected with HPV. This vaccine does not treat existing HPV, genital warts, pre-cancers or cancers.

WILL SEXUALLY ACTIVE INDIVIDUALS BENEFIT FROM THE VACCINE?

Sexually active individuals may still benefit from the vaccine but may get less benefit due to previous HPV exposure.

HOW AND WHEN IS THE VACCINE ADMINISTERED?

The vaccine is given in a series of 3 injections (shots) over a 6 month period in both males and females. The exact timing depends on which specific vaccine your caregiver recommends for you.

IS THE HPV VACCINE SAFE?

The federal government has approved the HPV vaccine as safe and effective. This vaccine was tested in both males and females in many countries around the world. The most common side effect is soreness at the injection site. Since the drug became approved, there has been some concern about patients passing out after being vaccinated, which has led to a recommendation of a 15 minute waiting period following vaccination. This practice may decrease the small risk of passing out.

Additionally there is a rare risk of anaphylaxis (an allergic reaction) to the vaccine and a risk of a blood clot among individuals with specific risk factors for a blood clot.

DOES THIS VACCINE CONTAIN THIMEROSAL OR MERCURY?

No. There is no thimerosal or mercury in the HPV vaccine. It is made of proteins from the outer coat of the virus (HPV). There is no infectious material in this vaccine.

WILL GIRLS/WOMEN WHO HAVE BEEN VACCINATED STILL NEED CERVICAL CANCER SCREENING?

Yes. There are 3 reasons why women will still need regular cervical cancer screening. First, the vaccine will NOT provide protection against all types of HPV that cause cervical cancer. Vaccinated women will still be at risk for some cancers. Second, some women may not get all required doses of the vaccine (or they may not get them at the recommended times). Therefore, they may not get the vaccine's full benefits. Third, women may not get the full benefit of the vaccine if they receive it after they have already acquired any of the 4 types of HPV.

WILL THE HPV VACCINE BE COVERED BY INSURANCE PLANS?

While some insurance companies may cover the vaccine, others may not. Most large group insurance plans cover the costs of recommended vaccines.

WHAT KIND OF GOVERNMENT PROGRAMS MAY BE AVAILABLE TO COVER HPV VACCINE?

Federal health programs such as Vaccines for Children (VFC) will cover the HPV vaccine. The VFC program provides free vaccines to children and adolescents under 19 years of age, who are either uninsured, Medicaid-eligible, American Indian or Alaska Native. There are over 45,000 sites that provide VFC vaccines including hospital, private and public clinics. The VFC program also allows children and adolescents to get VFC vaccines through Federally Qualified Health Centers or Rural Health Centers if their private health insurance does not cover the vaccine. Some states also provide free or low-cost vaccines, at public health clinics, to people without health insurance coverage for vaccines.

GENITAL HPV: WHY IS HPV IMPORTANT?

Genital HPV is the most common virus transmitted through genital contact, most often during vaginal and anal sex. About 40 types of HPV can infect the genital areas of men and women. While most HPV types cause no symptoms and go away on their own, some types can cause cervical cancer in women. These types also cause other less common genital cancers, including cancers of the penis, anus, vagina (birth canal), and vulva (area around the opening of the vagina). Other types of HPV can cause genital warts in men and women.

HOW COMMON IS HPV?

  • At least 50% of sexually active people will get HPV at some time in their lives. HPV is most common in young women and men who are in their late teens and early 20s.

  • Anyone who has ever had genital contact with another person can get HPV. Both men and women can get it and pass it on to their sex partners without realizing it.

IS HPV THE SAME THING AS HIV OR HERPES?

HPV is NOT the same as HIV or Herpes (Herpes simplex virus or HSV). While these are all viruses that can be sexually transmitted, HIV and HSV do not cause the same symptoms or health problems as HPV.

CAN HPV AND ITS ASSOCIATED DISEASES BE TREATED?

There is no treatment for HPV. There are treatments for the health problems that HPV can cause, such as genital warts, cervical cell changes, and cancers of the cervix (lower part of the womb), vulva, vagina and anus.

HOW IS HPV RELATED TO CERVICAL CANCER?

Some types of HPV can infect a woman's cervix and cause the cells to change in an abnormal way. Most of the time, HPV goes away on its own. When HPV is gone, the cervical cells go back to normal. Sometimes, HPV does not go away. Instead, it lingers (persists) and continues to change the cells on a woman's cervix. These cell changes can lead to cancer over time if they are not treated.

ARE THERE OTHER WAYS TO PREVENT CERVICAL CANCER?

Regular Pap tests and follow-up can prevent most, but not all, cases of cervical cancer. Pap tests can detect cell changes (or pre-cancers) in the cervix before they turn into cancer. Pap tests can also detect most, but not all, cervical cancers at an early, curable stage. Most women diagnosed with cervical cancer have either never had a Pap test, or not had a Pap test in the last 5 years.

There is also an HPV DNA test available for use with the Pap test as part of cervical cancer screening. This test may be ordered for women over 30 or for women who get an unclear (borderline) Pap test result. While this test can tell if a woman has HPV on her cervix, it cannot tell which types of HPV she has.

If the HPV DNA test is negative for HPV DNA, then screening may be done every 3 years. If the HPV DNA test is positive for HPV DNA, then screening should be done every 6 to 12 months.

OTHER QUESTIONS ABOUT THE HPV VACCINE

WHAT HPV TYPES DOES THE VACCINE PROTECT AGAINST?

The HPV vaccine protects against the HPV types that cause most (70%) cervical cancers (types 16 and 18), most (78%) anal cancers (types 16 and 18) and the two HPV types that cause most (90%) genital warts (types 6 and 11).

WHAT DOES THE VACCINE NOT PROTECT AGAINST?

Because the vaccine does not protect against all types of HPV, it will not prevent all cases of cervical cancer, anal cancer, other genital cancers or genital warts. About 30% of cervical cancers are not prevented with vaccination, so it will be important for women to continue screening for cervical cancer (regular Pap tests). Also, the vaccine does not prevent about 10% of genital warts nor will it prevent other sexually transmitted infections (STIs), including HIV. Therefore, it will still be important for sexually active adults to practice safe sex to reduce exposure to HPV and other STI's.

HOW LONG DOES VACCINE PROTECTION LAST? WILL A BOOSTER SHOT BE NEEDED?

So far, studies have followed women for 5 years and found that they are still protected. Currently, additional (booster) doses are not recommended. More research is being done to find out how long protection will last, and if a booster vaccine is needed years later.

WHY IS THE HPV VACCINE RECOMMENDED AT SUCH A YOUNG AGE?

Ideally, males and females should get the vaccine before they are sexually active since this vaccine is most effective in individuals who have not yet acquired any of the HPV vaccine types. Individuals who have not been infected with any of the 4 types of HPV will get the full benefits of the vaccine.

SHOULD PREGNANT WOMEN BE VACCINATED?

The vaccine is not recommended for pregnant women. There has been limited research looking at vaccine safety for pregnant women and their developing fetus. Studies suggest that the vaccine has not caused health problems during pregnancy, nor has it caused health problems for the infant. Pregnant women should complete their pregnancy before getting the vaccine. If a woman finds out she is pregnant after she has started getting the vaccine series, she should complete her pregnancy before finishing the 3 doses.

SHOULD BREASTFEEDING MOTHERS BE VACCINATED?

Mothers nursing their babies may get the vaccine because the virus is inactivated and will not harm the mother or baby.

WILL INDIVIDUALS BE PROTECTED AGAINST HPV AND RELATED DISEASES, EVEN IF THEY DO NOT GET ALL 3 DOSES?

It is not yet known how much protection individuals will get from receiving only 1 or 2 doses of the vaccine. For this reason, it is very important that individuals get all 3 doses of the vaccine.

WILL CHILDREN BE REQUIRED TO BE VACCINATED TO ENTER SCHOOL?

There are no federal laws that require children or adolescents to get vaccinated. All school entry laws are state laws so they vary from state to state. To find out what vaccines are needed for children or adolescents to enter school in your state, check with your state health department or board of education.

ARE THERE OTHER WAYS TO PREVENT HPV?

The only sure way to prevent HPV is to abstain from all sexual activity. Sexually active adults can reduce their risk by being in a mutually monogamous relationship with someone who has had no other sex partners. But even individuals with only 1 lifetime sex partner can get HPV, if their partner has had a previous partner with HPV.

It is unknown how much protection condoms provide against HPV, since areas that are not covered by a condom can be exposed to the virus. However, condoms may reduce the risk of genital warts and cervical cancer. They can also reduce the risk of HIV and some other sexually transmitted infections (STIs), when used consistently and correctly (all the time and the right way).