HPV Vaccine (Human Papillomavirus Vaccine)

HPV vaccine

The HPV vaccine is provided free by the NHS for boys and girls aged 12-13 in the UK. The vaccine protects against the Human Papillomavirus (HPV) which is linked to 90% of cervical cancers and 5% of all cancers worldwide. This page provides information about:

  • Key facts about the HPV vaccine
  • Who is eligible and how many doses are needed?
  • The effect of the HPV vaccine programme
  • Carron’s story – cervical cancer and the HPV vaccine
  • Safety and side effects
  • Vaccine ingredients

Key facts about the HPV Vaccine

 

 

This vaccine gives protection against the most high risk strains of the Human Papillomavirus (HPV), including ones which cause cervical, mouth and genital cancers. Cervical cancer is the most common cancer in women under the age of 35. About 3,200 women are diagnosed with cervical cancer in the UK every year and around 900 women die from it.

There are three HPV vaccines available which protect against two, four or nine types of the HPV virus. These are Cervarix (two types), Gardasil (four types) and Gardasil 9 (nine types). All of them protect against the two most common high-risk types of the virus: 16 and 18. These two strains are linked to over 70% of cervical cancers and 63% of penile cancers as well as most mouth, anus and throat cancers.

In the UK Gardasil and Gardasil 9 are available. Gardasil is offered for free as part of the NHS programme. In addition to types 16 and 18, it also protects against types 6 and 11, which are responsible for around 90% of genital warts. Cervarix vaccine was previously used in the UK until 2012 and is also used in other countries.

Who is eligible, and how many doses are needed?

In the UK the HPV vaccine has been routinely offered to girls aged 12-13 years since 2008. The vaccine will also be offered to boys aged 12-13 from September 2019. This means that all boys and girls in school year 8 will be offered the first and second doses of the vaccine in school. See this video from the NHS about the year 8 HPV vaccine.

Any girls or boys who have missed the vaccine in school are still eligible to receive it for free through their GP until their 25th birthday. Those who are over 15 years old when they receive the first dose of the vaccine will need three doses instead of the usual two doses if they are under 15. All doses are covered by the NHS for boys and girls who are in the eligible cohorts:

  • Girls who started year 8 in 2008 or later, up to their 25th birthday
  • Boys who started year 8 in 2019 or later, up to their 25th birthday

Since April 2018 the HPV vaccine has also been offered to all men who have sex with men that are aged 45 or younger. This follows a successful pilot programme that has run since 2016. The vaccine will be offered at routine check-ups at sexual health (GUM) clinics and HIV clinics. See the Public Health England news item.

The impact of the HPV programme

In clinical trials, the HPV vaccine was over 99% effective at preventing pre-cancer caused by HPV types 16 or 18 in young women, which are linked to 70% of cervical cancers. It is estimated that by 2058 after 50 years of this vaccination programme, 64,000 cervical cancers and 50,000 other cancers will have been prevented.

The World Health Organization have declared a global strategy to eliminate cervical cancer completely, through vaccination and cervical screening. It is important that women who have been 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 a recent study of 66 million young men and women showed an 83% reduction in high-risk HPV in teenage girls, and 66% reduction in women aged 20-24. The study also showed precancerous cervical lesions declined by 51% in teenage girls and 31% in women up to age 24 (Analysis of HPV Vaccine Effectiveness).

In the graph below, the prevalence of high-risk HPV types 16 and 18 has reduced with the increasing number of women who have received the vaccine in England. Studies have shown that protection against HPV lasts at least 10 years, and this is expected to be long-term. More information about how the vaccine works is below.

As the HPV vaccine is still new, we won’t know the effect on rates of cervical cancer until those women who have received the vaccine are older. However, studies looking at the percentage of women diagnosed with cervical abnormalities have shown a marked reduction since the introduction of the vaccination programme. The graph below shows the percentage of 20 year old women diagnosed with cervical abnormalities by their birth year. This shows that as vaccine uptake has increased with each birth year, cervical abnormalities have fallen.

Carron’s story – cervical cancer and the HPV vaccine

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. Charlotte talks about receiving three doses of the HPV vaccine, but in 2014 the schedule changed. Girls and boys now receive two doses, as long as they get the first dose when they are under 15. Thanks to Jo’s Cervical Cancer Trust for their help in making this film.

Ingredients

The HPV vaccine used in the UK is called Gardasil. This vaccine contains individual proteins from four types of HPV virus, which produce an immune response. Apart from the active ingredients (the antigens), it contains very small amounts of these ingredients:

  • Aluminium, which strengthens the immune response to the vaccine
  • polysorbate 80, used as an emulsifier (to hold other ingredients together)
  • an amino acid called histidine, used as an acidity regulator
  • sodium chloride (salt)

The vaccine may also contain traces of this product used during the manufacturing process:

Other brands of HPV vaccines used in other countries may contain different ingredients. If you are not in the UK, ask for the Patient Information leaflet for the vaccine you are offered.

Safety and Side effects

Between 2009 and 2018 more than 10 million doses of HPV vaccine were given in the UK, which means over 80% of women aged 15-24 have received the vaccination. There have been no examples of the vaccine causing serious side effects during this period. The side effects associated with the vaccine are listed below:

Very common (affecting more than 1 in 10 people at each dose):

  • Pain, swelling and redness at the injection site
  • Headache

Common (affecting up to 1 in 10 people at each dose):

  • Bruising or itching at the injection site
  • Raised temperature (fever)
  • Feeling sick (nausea)

Rare (affecting up to 1 in 1000 people at each dose):

  • Hives (urticaria)

Very rare (affecting fewer than 1 in 10,000 people at each dose):

  • Difficulty breathing (bronchospasm) 

If you are concerned about any reactions that occur after vaccination, please consult your doctor.

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 is linked to serious side effects such as chronic fatigue syndrome, POTS (postural orthostatic tachycardia syndrome) or CRPS (Complex Regional Pain Syndrome). More information about this is available here: results of a study by the MHRA in 2013 

In the UK, the Yellow Card Scheme is used to report adverse events after medication or treatment to the Medicines and Healthcare products Regulatory Authority (MHRA). It is important that these events are monitored to identify any very rare side effects that were not detected during the clinical studies. All adverse events reported through the Yellow Card Scheme are investigated to check if they have occurred at a higher rate than would be expected for the general population. So far, the HPV vaccine has not been associated with a higher incidence of any serious adverse events than the expected general occurrence of such events.

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.

Page last updated: 
Monday, November 18, 2019

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