This vaccine gives protection against certain types of the Human Papillomavirus (HPV), including those types which cause cervical and mouth cancers. About 2,900 women are diagnosed with cervical cancer every year in the UK, and the disease kills around 1,000 women every year.
The vaccine currently used in the UK is called Gardasil. It was chosen over an alternative vaccine called Cervarix because it gives wider protection. (Cervarix was used in the UK until September 2012.) Gardasil protects against four types of HPV: type 16, which causes oral cancer and, together with type 18, is responsible for 70% of the cases of cervical cancer in Europe; and types 6 and 11, which together are responsible for around 90% of the cases of genital warts.
In clinical trials, Gardasil was over 99% effective at preventing cancer caused by HPV types 16 or 18 in young women, and it is expected that vaccination will reduced the number of cases of the most common kind of cervical cancer by at least 70%. However, it is important that girls who are vaccinated continue to take up the offer of cervical smear testing later in life, so that other kinds of cervical cancer can be picked up.
HPV vaccine programmes around the world are currently being evaluated. Evidence from these shows falling numbers of young people with pre-cancerous cells (the cells that can go on to cause cervical cancer), and protection from the HPV vaccine is expected to be long-term.
In the UK the vaccine is routinely offered to girls who are aged 12-13 years. The first dose is offered during school year 8, with the second dose either 12 months or 6 months later. There should be at least a 6 month gap between the first and second doses. Girls aged 15 or older who have not been vaccinated at 12-13 years should have three doses of the vaccine to ensure good protection.
HPV vaccination in the UK is offered through schools. If a girl is not in school or misses one or both doses of the vaccine, catch-up vaccination can be provided by the GP surgery.
In this short film Carron Hulme talks about her experience of surviving cervical cancer, and her daughters Charlotte and Mollie talk about the HPV vaccine. Thanks to Jo’s Cervical Cancer Trust for their help in making this film.
In the film Charlotte talks about receiving three doses of the HPV vaccine, but in 2014 the schedule changed. Girls now receive two doses, as long as they get the first dose when they are aged 12-13. The HPV vaccine is expected to prevent about 70% of cervical cancers. However, it is important that girls who are vaccinated continue to take up the offer of cervical smear testing later in life, so that other kinds of cervical cancer can be picked up.
The vaccine does not contain any live viruses and cannot cause HPV infection. It contains individual proteins from four types of HPV virus, which produce an immune response.
It contains a small amount of an aluminium compound which acts as an adjuvant, strengthening and lengthening the immune response to the vaccine. See more information about aluminium in vaccines.
The vaccine may contain a tiny trace (a few millionths of a gram) of sodium borate (borax), used as an acidity regulator.
The HPV vaccine used in the UK does not contain the preservative thiomersal (mercury).
Yeast is used in the production of Gardasil. However no yeast remains in the vaccine itself, so it can be given to those with yeast allergies.
Common but not serious:
It is quite common for teenagers to have panic attacks before vaccination, or to faint during vaccination. These should not be confused with reactions to the vaccination itself.
There is no evidence that the HPV vaccine leads to an increased risk of chronic fatigue syndrome, POTS (postural orthostatic tachycardia syndrome) or CRPS (Complex Regional Pain Syndrome). See 'Is the vaccine safe?' at the bottom of this page.
As with any vaccine, medicine or food, there is a very small chance of a severe allergic reaction (anaphylaxis). Anaphylaxis is different from less severe allergic reactions because it causes life-threatening breathing and/or circulation problems. It is always serious but can be treated with adrenaline. In the UK between 1997 and 2003 there were a total of 130 reports of anaphylaxis following ALL immunisations, but all of these people survived. Around 117 million doses of vaccines were given in the UK during this period, making the overall rate around 1 in 900,000. Depending on the cause of the reaction, and following expert guidance, the person may be able to have vaccinations in the future.
Reactions listed under ‘possible side effects’ or ‘adverse events’ on vaccine product information sheets may not all be directly linked to the vaccine. See Vaccine side effects and adverse reactions for more information on why this is the case.
See more information on the monitoring of vaccine safety.
In the UK in 2012, there were 3044 new cases of cervical cancer and 919 women died from cervical cancer (see cervical cancer statistics from Cancer Research UK ). Cervical cancer is the most common cancer among women who are 15 to 34 years old. Unlike the majority of cancers, it is mainly a disease of the young, with 62% of cases occurring in women who are less than 50 years old.
Before September 2014, girls in the UK were given three doses of the HPV vaccine. However, from September 2014 the number of doses was reduced from three to two for those who first receive the vaccine aged 12-13. This was because research has shown that two doses of the vaccine give a level of protection that is just as good and lasts just as long as three doses, as long as girls are aged 12-13 when they receive the first dose. For those who start the vaccination course over the age of 13, it is recommended that they continue to receive the three doses.
Although there is no evidence that the vaccine is unsafe during pregnancy, it is not routinely given to pregnant women. The three-dose course should be completed following pregnancy.
In some countries the HPV vaccine is given to teenage boys as well as to girls. The Joint Committee on Vaccination and Immunisation (JCVI) is currently assessing whether it would be cost-effective to extend the HPV vaccine programme to boys in the UK.
The JCVI has recommended that HPV vaccination should be offered to all 16-40 year old men who have sex with men, as long as the vaccination programme can operate at a cost-effective price. See our blog post for more information. In 2016 Public Health England introduced a new pilot programme in selected GUM and HIV clinics in England.
A new HPV vaccine which protects against nine types of HPV is being considered for use in the UK.
A 2015 report from Public Health England shows a significant fall in HPV infections in young women since the vaccine was introduced. In 2010-13, HPV types 16 and 18 were 66% less common in sexually active young women aged 16-18 than they were in 2008. These early findings support the view that the HPV vaccination programme will have an impact on the numbers of cases of cervical cancer in future. A 2016 study from the USA showed similar results.
The same Public Health England report also shows that the HPV vaccine has had a very high level of coverage in England. In the three years 2011/12, 2012/13 and 2013/14, 86% of girls received the full three doses of HPV vaccine. (Doses were reduced to two from September 2014; see 'More Information' above.)
In Australia, data from sexual health clinics show that cases of genital warts in younger women have fallen since vaccination was introduced. In 2007, the year HPV vaccination started, over 11% of women under 21 were diagnosed with genital warts at their first visit to a clinic. By 2014 this figure had fallen to just over 1%. There was also a decline in cases among 21-30 year old women; some of these would have been vaccinated against HPV. In the older age group (over 30 years) who did not receive HPV vaccination, there was no change between 2007 and 2014.
There is no evidence that the HPV vaccine leads to an increased risk of chronic fatigue syndrome (also called myalgic encephalomyelitis or ME). See the results of a study by the MHRA in 2013 (Medicines and Healthcare products Regulatory Authority).
There is also no evidence that the HPV vaccine leads to an increased risk of POTS (postural orthostatic tachycardia syndrome) or CRPS (Complex Regional Pain Syndrome). The European Medicines Agency (EMA) carried out a full review of the evidence in 2015. Read their November 2015 press release and the full EMA report . See also our blog piece from June 2015 about this story.
In December 2012 the MHRA (Medicines and Healthcare products Regulatory Authority) published a 4-year safety report on Cervarix, the HPV vaccine used in the UK until September 2012. This included a breakdown of all the adverse events reported after HPV vaccination. Read the MHRA report here.