Q & A WITH DR. RANI BHAT
How effective is HPV vaccination in preventing cancer?
Introduction The human papillomavirus or HPV is the name given to a group of related viruses. There are more than a hundred types of HPVs and about forty of them are transmitted sexually. These viruses are generally divided into two groups known as low and high-risk types.
The low-risk virus can cause genital warts and high-risk type causes various cancers of the reproductive organs, like cervical, vaginal, penile, vulvar, and anal and oropharyngeal cancers. Of the high-risk HPV, types 16 and 18 are responsible for about 70% cases of cervical cancers globally.
What is HPV vaccination?
• Human papillomavirus (HPV) is a sexually transmitted virus that causes anogenital and oropharyngeal cancer in males and females.
Rationale for HPV vaccination Females
• These vaccines provide direct protection to female recipients against HPV infection and keep at bay cancers caused due to the virus. • This preventive outcome is most beneficial against cervical cancer, the most common cancer in females worldwide. • HPVs 16 and 18, which are covered by all three available vaccines (9-valent, quadrivalent, or bivalent HPV vaccine) and are responsible for 70% of all cervical cancers. HPV types 31, 33, 45, 52, and 58, which are targeted by the 9-valent vaccine, cause an additional 20 percent of cervical cancer cases.
Males
• Anal cancer afflicts both men and women. HPV vaccination also protects males against this form of cancer that can result from chronic HPV infection.
How do vaccines protect against HPV infection?
• The vaccines, particularly Gardasil 9, are composed of microscopic proteins that resemble the exterior of the actual humanpapilloma virus. • After the vaccines are injected, the immune system responds by making antibodies to the proteins that look like the actual HPV, so they know what to attack and kill when HPV infection actually takes place. When the person is exposed to the real HPV, the antibodies kill it and prevent the virus from entering the cells.
Who is eligible for HPV vaccination?
• Routine HPV vaccination is recommended to all children from 11 or 12 years of age and can be vaccinated though the minimum age of nine years. • Adolescents and young adults who have either not been previously vaccinated or have not completed the vaccination doses begun in the earlier age group are advised to get vaccinated or complete the series between the ages of 13 and 26 years of age.
People who are indirectly not eligible for HPV vaccination Even though you may be in the right age groups, you should not get vaccination if:
• you have a yeast allergy • you are pregnant. However, research suggests no significant hazard on you or the baby if you are vaccinated and later become pregnant • you have a bleeding disorder, though you may be eligible if your doctor thinks so • people with anaphylaxis of serious allergy to a previous vaccine or to any of the ingredients that go in its formulation
Parents should mention to their doctors about the effects of any previous vaccination or medicines in their children.
How effective are HPV vaccines? • Gardasil 9 is shown to be highly effective. This vaccine provide near-100% protection from nine types of HPV, namely types 6, 11, 16,18,31,33,45,52, and 58. But this is only when all scheduled doses are received at the right intervals, and when vaccination is given before any HPV exposure. • Individuals aged 14 or younger at the time of their first immunization need two vaccine doses at least six months apart.
Are there any side effects? The side effects of HPV vaccines in people are similar to what they experience after other vaccines. The most common side effects of any vaccination are • pain • swelling or redness at the injection site
Though these reactions occur in four out of five people, they are temporary, which also proves how fast the immune system responds to the vaccine. The reactions themselves be treated with a cold pack or a dose of paracetamol if required.
Claims of premature menopause as a side effect • Concerns were raised recently about the quadrivalent HPV vaccine causing a very rare condition of premature menopause also known as Primary Ovarian Insufficiency (POI) and Premature Ovarian Failure (POF).
• The World Health Organization, the Centers for Disease Control and Prevention of the USA, and the Australian Advisory Group on Immunization, and many other expert medical groups continue to advocate the implementation of the HPV immunization programs to prevent diseases caused by the human papilloma virus. • Thus, it is of paramount importance that parents and individuals get their information from credible sources and consult the best medical practitioners.
Do women who have already been vaccinated need to be screened for cervical cancer? • There are more than a hundred HPV types and the vaccines that we have at present can protect against only nine virus types and may give cross cover to other types of viruses. The other types may also be responsible for cancer-causing infections. • Hence, HPV vaccination today cannot be a substitute for regular cervical cancer screening.
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