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Dear doctor,
I have teenage daughters who are eligible for the HPV vaccine. But I am worried about recent negative publicity on the vaccine. Please advise me.
Answer:
The human papilloma virus (HPV) commonly affects human beings and is usually transmitted sexually. But most HPV infections are temporary and have few long term health effects. Majority of people clear the virus within two years.
It is only in cases where the virus persists that untoward health effects usually manifest. Some HPV strains are associated with cancers of the cervix, vagina, vulva, penis, anus and even cancers of the throat.
Other HPV strains can cause genital warts. There is no cure for HPV infection once it occurs, but the consequent health effects can be dealt with in various ways.
HPV vaccines have been available for several years, but their uptake has been slow. Western countries already have very effective HPV vaccination programmes, but most developing countries (Kenya included) are just catching up. The vaccines are best given to young girls at the ages of 11 to 12 years, but can be commenced as early as 9 years.
The timing of vaccination prior to sexual exposure is crucial as it allows the body to mount an immune response long before exposure to the virus. The consequent effect is lower rates of harboring HPV in the genital tract, and reduced rates of gynaecological cancers associated with HPV. Boys can also be vaccinated, boosting protection against genital warts and anal cancer.
Three doses of the HPV vaccine were initially recommended, even though two doses have also been shown to be effective. The schedule of vaccination should be discussed with your healthcare provider. Protection against HPV infection is long-lasting, and booster doses are not recommended.
Catch-up vaccination can be given up to the age of 26 years. There may also be a protective effect in older women. But vaccination does not completely negate screening for cervical cancer with regular pap smears and HPV testing.
There have been occasional media reports about untoward effects of HPV vaccines. The vaccines have already been tried and tested, and their safety is supported by various regulatory authorities. Most reported side effects are rare and transient. They include some pain and redness at the injection site, mild fever, headache and, nausea or vomiting.
Life-threatening allergic reactions are very rare, and if suspected, should warrant immediate medical attention. Like all other vaccines, monitoring for unusual problems is always ongoing.
Countries with effective HPV vaccination programmes are already projecting cervical cancer eradication in the foreseeable future. All our eligible adolescents should get vaccinated, and be protected from cervical cancer.
Don’t believe those who mistakenly publicise unsubstantiated objections on the HPV vaccine. Such individuals may not fully comprehend the burden of cervical cancer in our part of the world, which can only be reduced by effective vaccination and screening programmes.
Dr Alfred Murage is a Consultant Gynaecologist and Fertility Specialist;
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