Two
vaccines are available to prevent the human papillomavirus (HPV) types that
cause most cervical cancers. These vaccines are bivalent vaccine (Cervarix) and
quadrivalent vaccine (Gardasil). One of the HPV vaccines, Gardasil, also
prevents HPV types that cause most genital warts. Gardasil also has been shown
to prevent some cancers of the anus, vulva (area around the opening of the
vagina), and vagina. Both vaccines are given in 3 shots over 6 months.
Why is
the HPV vaccine important?
Genital
HPV is a common virus that is passed from one person to another through direct
skin-to-skin contact during sexual activity. Most sexually active people will
get HPV at some time in their lives, though most will never even know it. HPV
infection is most common in people in their late teens and early 20s. There are
about 40 types of HPV that can infect the genital areas of men and women. Most
HPV types cause no symptoms and go away on their own. But some types can cause
cervical cancer in women and other less common cancers— like cancers of the
anus, penis, vagina, and vulva and oropharynx (back of throat including base of
tongue and tonsils). Other types of HPV can cause warts in the genital areas of
men and women, called genital warts. Genital warts are not life-threatening.
But they can cause emotional stress and their treatment can be very uncomfortable.
Which
girls/women should receive HPV vaccination?
HPV
vaccination is recommended with either vaccine for 11 and 12 year-old girls. It
is also recommended for girls and women age 13 through 26 years of age who have
not yet been vaccinated or completed the vaccine series; HPV vaccine can also
be given to girls beginning at age 9 years.
Will
sexually active females benefit from the vaccine?
Ideally
females should get the vaccine before they become sexually active and exposed
to HPV. Females who are sexually active may also benefit from vaccination, but
they may get less benefit. This is because they may have already been exposed
to one or more of the HPV types targeted by the vaccines. However, few sexually
active young women are infected with all HPV types prevented by the vaccines,
so most young women could still get protection by getting vaccinated.
Can
pregnant women get the vaccine?
The
vaccines are not recommended for pregnant women. Studies show that HPV vaccines
do not cause problems for babies born to women who were vaccinated while
pregnant, but more research is still needed. A pregnant woman should not get
any doses of either HPV vaccine until her pregnancy is completed.
Getting
the HPV vaccine when pregnant is not a reason to consider ending a pregnancy.
If a woman realizes that she got one or more shots of an HPV vaccine while
pregnant, she should do two things:
-
Wait
until after her pregnancy to finish the remaining HPV vaccine doses.
-
Talk to
your doctor.
Should
girls and women be screened for cervical cancer before getting vaccinated?
Girls
and women do not need to get an HPV test or Pap test to find out if they should
get the vaccine. However it is important that women continue to be screened for
cervical cancer, even after getting all 3 shots of either HPV vaccine. This is
because neither vaccine protects against ALL types of cervical cancer.
How
effective are the HPV Vaccines?
The
vaccines target the HPV types that most commonly cause cervical cancer. One of
the vaccines (Gardasil) also protects against the HPV types that cause most
genital warts. Both vaccines are highly effective in preventing the targeted
HPV types, as well as the most common health problems caused by them.
The
vaccines are less effective in preventing HPV-related disease in young women
who have already been exposed to one or more HPV types. That is because the
vaccines prevent HPV before a person is exposed to it. HPV vaccines do not treat existing HPV infections
or HPV-associated diseases.
How
long does vaccine protection last?
Research
suggests that vaccine protection is long-lasting. Current studies have followed
vaccinated individuals for six years, and show that there is no evidence of
weakened protection over time.
What
does the vaccine not protect against?
The
vaccines do not protect against all HPV types— so they will not prevent all
cases of cervical cancer. About 30% of cervical cancers will not be prevented
by the vaccines, so it will be important for women to continue getting screened
for cervical cancer (regular Pap tests). Also, the vaccines do not prevent
other sexually transmitted infections (STIs). So it will still be important for
sexually active persons to lower their risk for other STIs.
Will
girls and women be protected against HPV and related diseases, even if they
don’t get all 3 doses?
It is
not yet known how much protection girls and women get from receiving only one
or two doses of an HPV vaccine. So it is very important that girls and women
get all 3 doses.
How
safe are the HPV vaccines?
Both
vaccines have been licensed by the Food and Drug Administration (FDA). The CDC
has approved these vaccines as safe and effective. Both vaccines were studied
in thousands of people around the world, and these studies showed no serious
safety concerns. Side effects reported in these studies were mild, including
pain where the shot was given, fever, dizziness, and nausea. Vaccine safety
continues to be monitored by CDC and the FDA.
Fainting,
which can occur after any medical procedure, has also been noted after HPV
vaccination. Fainting after any vaccination is more common in adolescents.
Because fainting can cause falls and injuries, adolescents and adults should be
seated or lying down during HPV vaccination. Sitting or lying down for about 15
minutes after a vaccination can help prevent fainting and injuries.
Why is
HPV vaccination only recommended for women through age 26?
HPV
vaccination is not currently recommended for women over age 26 years. Clinical
trials showed that, overall, HPV vaccination offered women limited or no
protection against HPV-related diseases. For women over age 26 years, the best
way to prevent cervical cancer is to get routine cervical cancer screening, as
recommended.
What
about vaccinating boys and men?
Gardasil
was found to be safe and effective for males 9 -26 years. The vaccination series
can be started beginning at age 9 years. Vaccination is recommended for males
aged 13 through 21 years who have not already been vaccinated or who have not
received all 3 doses. The vaccine is most effective when given at younger ages;
males aged 22 through 26 years may be vaccinated.
Is HPV
vaccine covered by insurance plans?
Most
health insurance plans cover the cost of vaccines, but you may want to check
with your insurance provider before going to the doctor. If you don't have
insurance, or if it does not cover vaccines, the Vaccines for Children (VFC)
program may be able to help.
What
vaccinated girls/women need to know: will girls/women who have been vaccinated
still need cervical cancer screening?
Yes,
vaccinated women will still need regular cervical cancer screening (Pap tests)
because the vaccines protect against most but not all HPV types that cause
cervical cancer. Also, women who got the vaccine after becoming sexually active
may not get the full benefit of the vaccine if they had already been exposed to
HPV.
Are
there other ways to prevent cervical cancer?
Regular
cervical cancer screening and follow-up can prevent most cases of cervical
cancer. The Pap test can detect cell changes in the cervix before they turn
into cancer. Pap tests can also detect most, but not all, cervical cancers at
an early, treatable stage. Most women diagnosed with cervical cancer in the
U.S. have either never had a Pap test, or have not had a Pap test in the last 5
years. There are HPV tests that can tell if a woman has HPV on her cervix, but
the HPV tests on the market should only be used to help screen women at certain
ages and to help health care providers assess women with certain Pap test
findings for cervical cancer. These tests can be used with the Pap test to help
determine next steps in cervical cancer screening.
Are
there other ways to prevent HPV?
For
those who are sexually active, condoms may lower the chances of getting HPV, if
used with every sex act, from start to finish. Condoms may also lower the risk
of developing HPV-related diseases (genital warts and cervical cancer). But HPV
can infect areas that are not covered by a condom—so condoms may not fully
protect against HPV.
People
can also lower their chances of getting HPV by being in a faithful relationship
with one partner; limiting their number of sex partners; and choosing a partner
who has had no or few prior sex partners. But even people with only one
lifetime sex partner can get HPV. And it may not be possible to determine if a
partner who has been sexually active in the past is currently infected. That's
why the only sure way to prevent HPV is to avoid all sexual activity.
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