HPV Vaccines
The human papillomavirus (HPV) is the most common STD in the world: there is a very good chance that you will get at least one type of HPV during your lifetime. Preventative measures include practicing good hygiene and safe sex, getting tested regularly, and getting vaccinated, the last of which we focus on in this article.
HPV vaccines are a safe and effective way to train your immune system to combat the HPV virus. Ideally, you would get vaccinated before becoming sexually active. You can also get vaccinated later in life, however the vaccine will not be effective against any strains you currently are infected with, nor any HPV-related disease, and less effective against any strains you may previously have been infected with.
Worldwide, HPV viruses are considered the most common sexually transmitted disease. There are more than 100 papillomaviruses that infect the skin or the genital mucosa, and it is estimated that over 70% of sexually active men and women are infected with it at some point in their lives. Although it is generally transmitted during sexual intercourse, it can also be passed on by being in close, non-sexual contact with an infected person.
There are several vaccines, each offering protection against a few select strains of HPV. They do not contain HPV virus DNA, and are therefore not infectious. Instead they contain virus-like particles that train the body’s defense mechanisms to identify it when presented with the real virus. These vaccines are highly immunogenic—in other words, highly effective.
Common symptoms
Most HPV cases present no symptoms. Many of those that do present only mild symptoms that aren’t necessarily associated with disease. HPV infections often go unnoticed due to their asymptomatic nature and when symptoms do appear, they may be written off as something else, especially since they often resolve on their own.
Symptomatic HPV viruses are generally divided into two types—cutaneous viruses that generally infect areas on the hands, feet, arms, and chest, and mucosal viruses that prefer warm, wet environments such as the genital and anal areas, as well as the mouth and throat. These viruses cause benign lesions, such as skin or genital warts—small, flesh-colored bumps, some of which may have a cauliflower-like appearance. These warts may be accompanied by itchiness and discomfort.
In women, genital warts (also called condylomas) can grow on the vulva, the walls of the vagina, the area between the external genitals and the anus, the anal canal, and the cervix. In men, they tend to occur on the tip or shaft of the penis, the scrotum, or the anus. Mucosal warts can also develop in the mouth or throat of a person who has had oral sexual contact with an infected person.
Other HPV symptoms include:
- Blood spots or light bleeding between or after periods
- Menstrual bleeding that is longer and heavier than usual
- Bleeding after sexual intercourse, douching, or a pelvic exam
- Increased vaginal discharge
- Pain during intercourse
These symptoms are not unique enough for a self-diagnosis of HPV, but are certainly cause for a visit to your doctor. HPV and related complications (as with most things) are easier to treat if caught in the early stages.
Many social factors play a significant role in your health and safety. You increase the risk of becoming infected with HPV (and other sexually transmitted diseases) if you:
- Don’t ask your sexual partner/s about their sexual history
- Don't get yourself and your partner tested for STDs when entering a new relationship
- Have an incomplete or inadequate understanding of basic sexual etiquette and/or basic human anatomy
- Have sex without a condom (birth control types that don’t include a physical barrier are designed to prevent pregnancy only and do not protect you against STDs)
- Have poor hygiene
- Have previously been infected with an STD
- Have a compromised immune system
If you wish to protect yourself and your loved ones stay informed and up-to-date. Cultivate healthy and open communication with both potential and existing sexual partners, and get tested regularly.
HPV & cancer
High–risk HPV strains (such as types 16 and 18) have a higher chance of developing into cancer. These can cause cervical cancer, along with cancers of the colon, anus, vagina, vulva, penis, and tonsils.
In most cases the HPV virus can be defeated by a healthy immune system. However, if the infection persists and isn’t treated, there is a risk of it developing into pre-cancers or cancers. Since cancer takes a long time to develop (approximately 15 to 20 years), symptoms will likely also develop over time. This is one of the reasons that regular HPV tests can make a big difference if you are infected with a high-risk HPV virus.
HPV vaccines
HPV vaccines were introduced in 2006 and are now standard procedure in some countries. All existing HPV vaccines effectively prevent infection with HPV types 16 and 18 (which cause a significant number of HPV-related cancers, including 70% of cervical cancers). Some also protect against types 6 and 11 (which cause about 90% of genital warts).
Vaccines work best as a preventative measure. If you can, get vaccinated before potential exposure to HPV, that is especially before you become sexually active. While the vaccine can be administered from age 9, the age of the recipient matters when it comes to the number recommended doses. Up until the age 15, the standard is 2 doses with an interval of 6 to 12 months. Starting from age of 15, it’s 3 doses, and the interval between them depends on the vaccine.
It is generally recommended that anyone under the age of 27 who hasn't been vaccinated should do so. After that, there is a greater need to take your circumstances into consideration, but it’s better to do it later in life than not to do it at all.
Different brands of vaccines target different types of HPV and are effective for differing amounts of time. For example, Gardasil lasts 10 + years, Gardasil 9 lasts at least 6 years, while Cervarix lasts at least 9 years.
Side effects
Side effects for the HPV vaccine are rare and usually mild, and are similar to those commonly experienced with vaccines. Generally they are a response to being pierced with a needle (often in combination with any related fears or other mental discomfort) rather than the contents of the vaccine. The most common side effects are:
- Nausea
- Headache
- Dizziness or fainting
- Pain, redness or swelling in the arm at the site of the shot
There are some exceptions. To prevent more serious adverse reactions, HPV vaccines should not be administered to people who:
- are allergic to the HPV vaccine or any of its ingredients (mild-to-moderate reactions and potential reactions must be taken into consideration and should be discussed with the recipient before administering the vaccine)
- are pregnant
How HPV vaccines work
HPV vaccines are administered by injection into the muscle of the upper arm. The process shouldn’t take more than a few seconds, although your doctor’s visit may take a little longer.
These vaccines do not contain any virus DNA—instead, they contain virus-like particles (formed by HPV surface components) that closely resemble the HPV virus strains the recipient is being inoculated against. This trains the body’s immune system to recognise the virus before actually encountering it, and can also offer some cross-protection against additional strains of the virus.
Vaccine ingredients can be divided into three categories:
- Antigens (or active ingredients), which are tiny quantities of whole (weakened) or incomplete bacteria or viruses that teach your body to identify and eliminate the disease you are being vaccinated against
- Excipients (or inactive ingredients), which help improve the immune response to the vaccine, or act as preservatives, stabilisers, or emulsifiers (depending on the ingredient)
- Water for injection
Gardasil contains proteins of HPV types 6, 11, 16, and 18, amorphous aluminum hydroxyphosphate sulfate, yeast protein, sodium chloride, L-histidine, polysorbate 80, sodium borate, and water.
Gardasil 9 contains proteins of HPV Types 6, 11, 16, 18, 31, 33, 45, 52, and 58, amorphous aluminum hydroxyphosphate sulfate, yeast protein, sodium chloride, L-histidine, polysorbate 80, sodium borate, and water.
Cervarix contains the active ingredients of HPV-16 L1 protein and HPV-18 L1 protein, as well as 3-O- desacyl-4'- monophosphoryl lipid A (MPL), aluminium hydroxide, sodium chloride, sodium phosphate- monobasic and water.
Long–term trials
As HPV vaccines were introduced relatively recently, their long-term effect is still under investigation, especially since cancer usually also develops over a long period of time. So it is important to see your doctor/gynecologist for routine health checks, including HPV tests and PAP smears, even if you’ve already been given an HPV vaccine.
The best thing we can do is to keep on educating ourselves and the younger generation about how to practice safe sex, both physically and emotionally. Talking about these issues—destigmatising any and all health problems—will result in an increase in both an informed population and the percentage of people seeking treatment.
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