Vaccine against Papilloma Virus - HPV
The vaccine against papilloma may prevent a significant portion of various types of cancer:
- Cervical cancer, cancer of the vulva and of the vagina in women;
- Penile cancer in men;
- Anal cancer and oral and throat cancer in men and women.
The vaccine also prevents genital warts and warts in the throat that appear shortly after becoming infected.
Questions and Answers about the Vaccine against Papilloma Virus - HPV
- What is the papilloma virus (HPV)?
Human papilloma virus (HPV) is the name of a family of viruses that contains over 100 strains.
Papilloma viruses are among the most common viruses in the world. Papilloma virus is the main cause of cervical cancer. Certain strains of the virus cause approximately 99% of cases of cervical cancer.
The papilloma virus causes additional cancers in women and men:
- Approximately 90% of cases of anal cancer in men and women
- Approximately 70% of cases of cancer of the mouth and pharynx
- Approximately 65-70% of cases of vaginal and vulvar cancer
- Approximately 50% of cases of cancer of the penis
The papilloma virus causes additional diseases in women and men:
- Genital warts and various skin warts
- Warts of the vocal cords
- How does one become infected with papilloma virus (HPV)?
Papilloma virus (HPV) is common, and is readily transmitted by direct contact during sexual relations. The infection usually has no symptoms and the person who has become infected is unaware that he could transmit the virus to someone else.
- How common are the medical problems caused by the papilloma virus (HPV)?
The papilloma virus (HPV) is the main cause of cervical cancer in women.
In Israel, approximately 1,200-2,000 women are diagnosed every year with pre-cancerous changes to the cervix.
Approximately 200 women are diagnosed every year with cervical cancer, and approximately 100 women die every year from this cancer.
Approximately 60 persons every year in Israel are diagnosed with anal cancer.
Approximately 100 persons every year in Israel are diagnosed with cancer of the mouth and the pharynx.
At any given time, approximately 20,000 sexually active adults in Israel have genital warts.
- Does a condom protect against becoming infected with the papilloma virus (HPV)?
Use of a condom during sexual relations can help prevent HPV infection. However, since condoms do not cover the entire area of the genitals, and they are usually worn after sexual contact has already commenced, a condom does not constitute a guarantee against becoming infected with HPV. It is nevertheless recommended to use condoms in order to also prevent other sexually transmitted diseases.
- What vaccines are there in Israel against papilloma virus (HPV)?
Two vaccines are currently registered in Israel that are intended as a vaccine against HPV and are recommended by the Ministry of Health. These vaccines are: Cervarix (manufactured by GSK) and Gardasil (manufactured by Merck).
- What are vaccines against the papilloma virus composed of?
Both vaccines contain only the virus’ empty envelope.
The vaccines do not contain the virus’ genetic material (DNA), so that it is not possible to be infected with the virus when the vaccine is administered.
- What are the similarities between the two vaccines against papilloma virus (HPV)?
Both vaccines, Cervarix and Gardasil, protect against infections caused by strains 16 and 18. These strains cause most of the cases of cervical and anal cancer, and approximately half of the cases of cancer of the vulva, vagina, penis and hypopharynx.
- Both vaccines have been demonstrated to prevent pre-cancerous lesions of the cervix.
- Both vaccines are very safe.
- Both vaccines are made from the external envelope of the virus, and cannot cause infection.
- Both vaccines are given as an intramuscular injection in 2-3 doses over a period of half a year.
- What are the differences between the two vaccines against papilloma virus (HPV)?
- The Gardasil vaccine also protects against HPV strains 6 and 11, which cause most of the cases of genital warts. The vaccine may be given to girls and women aged 9 to 45, and to boys and men aged 9 to 26. Only the Gardasil vaccine is registered for vaccinating boys and men.
- The Gardasil vaccine has been tested and proven as a vaccine that protects against pre-cancer of the vulva, vagina and anus.
- The Cervarix vaccine is registered for women, with no upper age limit.
- For whom is the vaccine against papilloma virus (HPV) recommended?
Every person between the ages of 13 and 26 is recommended to receive the vaccine against papilloma virus. The vaccine should be considered in special cases for women over the age of 26.
- Why has the Ministry of Health begun to also vaccinate boys in the 2015-2016 academic year?
The recommendation to vaccinate boys stems from the same reasons for which girls are vaccinated:a.
- In order to protect girls and boys from malignant diseases and from genital warts caused by the virus.
- In order to prevent transmission of the virus from one person to another.
With this decision, Israel has joined Western countries that vaccinate boys in addition to girls.
- Starting from the 2015-2016 academic year, 8th grade students will receive 2 doses of vaccine, not 3 as was the case until now. Why?
- As a rule, we give vaccines in the smallest dosage and number of doses that yields the desired immune response. Current studies show that vaccination of children up to the age of 14 years with 2 doses yields a good immune response, providing protection that lasts for years that is comparable to vaccination with 3 doses of vaccine. The recommendation for 8th grade students, most of whom are 13 years old, is 2 doses. From 9th grade onwards, 3 doses of vaccine are recommended.
- Why is it recommended to receive the vaccine against the papilloma virus (HPV) at ages 13-14?
The two reasons for recommending administration of the vaccine at a young age are:
- It is very important to receive the vaccine prior to the commencement of sexual activity. It is possible to become infected with HPV the first time that one has sexual contact with another person.
- The immune response to the vaccine is better when given at this age as compared to older ages.
- For how long does the vaccine protect against becoming infected with the virus?
The vaccine is effective for at least 15 years, which is the time that has elapsed since its use was commenced. Studies show that women who were vaccinated 15 years ago still have a level of antibodies that protects against the virus. Experts expect that the duration of the protection provided by the vaccine will be for many additional years, apparently lifelong.
- Who may receive the vaccine?
The Cervarix vaccine may be given to girls and women from age 9.
The Gardasil vaccine may be given to girls and women from age 9 to 45 years.
The Gardasil vaccine may be given to boys aged 9 to 26 years.
The Ministry of Health recommends that all boys and girls aged 13–14 years receive the Gardasil vaccine as part of the planned routine vaccines given in 8th grade, in order to protect them against cervical cancer and additional cancers and against warts.
- What is the recommended timetable for receiving the doses of the vaccine against papilloma virus (HPV)?
Children commencing the series of vaccinations in 8th grade receive two doses of vaccine, with an interval of 6 months between the doses.
Children and adults commencing the series of vaccinations in 9th grade or later receive three doses of vaccine within a six month period: the first dose, the second dose one to two months later, and the third dose approximately 6 months after the first dose.
It is recommended to receive all the doses at the set times in order to ensure full protection against the virus.
- Are the vaccines against papilloma virus (HPV) safe and effective?
Vaccines are approved in Israel only if the meet extremely strict standards and only if they are safe. The HPV vaccine has been investigated for over 15 years, with careful monitoring of side effects. Both vaccines have been tested on thousands of people throughout the world, and over 175 million doses have been administered throughout the world so far. The studies have proved that there were no serious side effects. The safety studies of these vaccines are continuing to demonstrate that the vaccines against HPV are safe. In the past two years, over 200,000 doses have been given in Israel to girls in 8th grade.
- Do the vaccines against HPV cause chronic pain syndrome or a syndrome of fainting and weakness from decreased blood pressure upon standing up or sitting?
The European Medicines Agency, which is responsible for the licensing of medicines in European Union countries, has investigated the claim that the vaccines against HPV can cause these syndromes. The Agency’s investigation included a survey of studies in scientific journals and data from clinical trials performed by pharmaceutical companies, an assessment of the rate of the syndromes among vaccinated and non-vaccinated persons in the reporting countries, receipt of information from patients’ associations and consultation with experts. In November 2015, after several months of investigation, the Agency publicized the findings of the investigation, according to which no causal relation was found between receiving the vaccine and the said syndromes. The rate of these syndromes is approximately 150 per 1,000,000 girls aged 10-19 years, and was not higher among females who received the vaccine than it was among girls and women who did not receive the vaccine. In contrast, proof of the benefit of the vaccine in preventing various types of cancer has remained unchallenged. The Agency has seen fit to not change the guidelines for administration of the vaccine, but is aware of the need to continue to monitor effects following the vaccine just as for any other medicine and vaccine. For further information >
- What effects occur after the vaccine?
The effects that occur after this vaccine are similar to those that occur after all vaccines that children receive.
There may be local effects such as pain, redness and swelling at the injection site. More rarely, from the day of the vaccine until the 15th day after the vaccine, vaccine recipients experience headaches, dizziness, a general unwell feeling, muscle pain, joint pain, and there may be abdominal pain, nausea, diarrhea and vomiting, and a feeling of weakness.
Most are mild and resolve a short time after the vaccine.
- Do people faint after receiving vaccines against papilloma virus (HPV)?
There are children who faint after receiving a vaccine. People faint for many reasons, including due to injection with a needle. Children and adolescents could faint after medical procedures, including when receiving vaccines. Sitting or lying down when the vaccine is administered and for 15 minutes after receiving the vaccine can prevent falling and injury from falling.
- Do vaccines against papilloma virus (HPV) treat infections, cancer or warts?
Vaccines against papilloma virus (HPV) do not treat existing infections and do not heal them. Vaccines against papilloma virus (HPV) do not treat and do not heal health problems (such as cancer or warts) caused by HPV infection that occurred prior to administration of the vaccine. It is important that adult women perform a test for cervical cancer (PAP) even if they have received the complete series of vaccines against papilloma virus.
- How important is it to receive a vaccine against papilloma virus (HPV)?
The vaccines against papilloma virus (HPV) are important for the prevention of cancer and genital warts in men and women.
- Do pregnant women need to be vaccinated?
Pregnant women are not included in the recommendations for receiving the vaccine against papilloma virus (HPV). Studies show that receiving the vaccine during pregnancy does not cause damage to the embryo / fetus. Receiving a vaccine against papilloma virus (HPV) during pregnancy is therefore not a reason to consider termination of the pregnancy. Nonetheless, in order to be certain, until more information is available, a pregnant woman is not recommended to receive doses of the vaccine against papilloma virus until after the pregnancy.
- What should a women do if she discovers that she received a vaccine against papilloma virus (HPV) while pregnant?
If a women discovers that she received vaccination shots against papilloma virus (HPV) while she was pregnant, she should do two things:
- Wait until after the pregnancy to complete the remaining doses of the vaccine.
- Report receipt of the vaccine to the Ministry of Health during pregnancy.
- Who is entitled to receive the vaccine in the framework of the health services basket?
The Gardasil vaccine is given to boys and girls aged 13–14 years as part of the planned routine vaccines given in 8th grade, in order to protect them against cervical cancer and additional cancers and against warts.
- Gardasil is in the basket of health services for male youths and men up to the age of 26 who are at high risk of becoming infected with HPV.
- Will the vaccine against HPV be covered by supplementary health insurance?
Most of the supplementary health insurance programs subsidize vaccines against papilloma virus (HPV) for residents who are not eligible for the vaccine as part of the school vaccine program.
Check with you insurance provider as to whether the cost of the vaccine is covered.