HPV occurs in both men and women. It is very common to be infected with one or more types of HPV shortly after sexual activity starts. Most HPV infections cause no symptoms and are cleared from the body in less than a year without the person knowing they are infected. Some types of HPV can cause genital warts and some cancers. These cancers include cervical cancer in women, and cancers of the genital area, mouth and throat in men and women.
Two types of human papilloma virus (HPV) cause most cases of cervical cancer. A vaccine has been developed to help prevent cervical cancer by reducing the risk of infection with types 16 and 18 of HPV. Approximately 70 per cent of cervical cancers contain type 16 HPV and 16 per cent have type 18 HPV.
The vaccine is most effective when given to all young people before they become sexually active and are exposed to HPV. The recommended age for vaccination is around 12 to 13 years, as this is when the body produces the greatest immune response.
HPV and cervical cancer
Different types of HPV can either be low risk or high risk, depending on the ability of the virus to cause cancer.
Some of the low-risk HPV types can cause minor changes to the cells of the cervix or cause genital warts that do not usually lead to cancer. Infections caused by low-risk HPV types are usually cleared naturally from the body within one to two years.
Some high-risk types of HPV (especially types 16 and 18) can take longer to clear from the body. In some women, infection with these HPV types remains for a long time. In these cases, there is a high risk of developing significant cell changes (dysplasia) in the cervix and these can progress to invasive cervical cancer.
A pap test can detect changes in the cervical cells. This is a test where a doctor (or other health specialist) scrapes cells from the cervix, and checks for abnormal changes or growth. A doctor can usually easily treat someone with these early changes. If these cell changes are left undetected and untreated, there is a greater risk of developing cervical cancer.
Immunisation against HPV
Since the introduction of the HPV vaccination for girls in 2007, the number of young women with HPV has decreased. Interestingly, the number of young men with HPV has also decreased. The vaccine against HPV is also sometimes called the cervical cancer vaccine.
Men can also be infected with HPV and spread it to women during sexual activity. Vaccinating boys helps to decrease the number of cases of HPV in women and this will help to decrease the number of women with cervical cancer in the future.
Immunisation against HPV involves a course of three injections over a six-month period. In Victoria, the HPV vaccine is available free of charge under the National Immunisation Program for all adolescents in year seven of secondary school (or age-equivalent 12-13 years old) – the three dose course of vaccine is given at school. It can also be given by a doctor or at a council immunisation session.
Contact your state or territory health department for more information about HPV vaccination at your school.
People not eligible for vaccination through the National Immunisation Program will have to pay for the vaccine.
Immunisation is also recommended, but not free, for people who are at increased risk including:
- men who have sex with men – recommended if men have not received a full course of the vaccine against HPV
- adults with weakened immune systems – the decision to immunise will take into account the likelihood of past HPV infection and future risk.
A video has been produced showing young people discussing the vaccine.
Pregnancy and HPV immunisation
Immunisation against HPV is not recommended for women who are pregnant. Women who become pregnant after starting the HPV vaccination course should not receive any doses of vaccine while pregnant. They can complete the course of vaccination after the birth of their baby. HPV vaccine can be given to women who are breastfeeding.
Pap tests after immunisation
The vaccine against HPV will not prevent all cervical cancers caused by HPV. Changes to cervical cells can still occur even if you have been vaccinated and so you should continue to have regular pap tests. Of course, women who were not vaccinated as part of the National Immunisation Program should continue to have pap tests to reduce their risk of cervical cancer.
The pap test is a quick and simple test that checks for changes to the cells of the cervix that may lead to cancer. Regular pap tests help with early detection so that treatment can begin. You can have a sample taken by your doctor, gynaecologist (doctors who specialise in female reproductive health) or a nurse trained to collect cervical samples.
Women between the ages of 18 and 70 years who have been sexually active (even if they are no longer sexually active) are advised to have pap tests every two years, on a regular basis. This should occur even if you have been vaccinated.
If you are over 70 years of age and have had two normal pap tests in the previous five years, you do not need to continue to have the test (unless you wish to do so). Contact your doctor to discuss what is suitable for you.
Before receiving the vaccine, tell your doctor or nurse if you (or your child):
- are unwell (temperature over 38.5 ˚c)
- have allergies to any other medications or substances
- have had a serious reaction to any vaccine
- have had a serious reaction to any component of the vaccine
- have had a severe allergy to anything
- have a disease, or having treatment, that causes low immunity
- are taking any prescription or over-the-counter medication
- are pregnant or intend to become pregnant.
Side effects of the vaccine against HPV
Immunisation against HPV is effective and safe, although all medication can have unwanted side effects. Common side effects following immunisation are usually mild and temporary (occurring in the first few days after vaccination). Specific treatment is not usually required.
Side effects may include:
- localised pain, redness and swelling at the injection site
- low-grade temperature (fever)
- mild headache
- mild nausea.
Managing fever after immunisation
There are a number of treatment options that can reduce the common side effect of fever after the vaccine including:
- giving extra fluids to drink and not overdressing if there is a fever
- although routine use of paracetamol after vaccination is not recommended, if fever is present, paracetamol can be given – check the label for the correct dose or speak with your pharmacist, (especially when giving paracetamol to children).
Managing injection site discomfort
Many vaccine injections may result in soreness, redness, itching, swelling or burning at the injection site for one to two days. Paracetamol might be required to ease the discomfort.
Concerns about side effects
If the side effect following immunisation is unexpected, persistent or severe, or if you are worried about yourself or your child’s condition after a vaccination, see your doctor or immunisation nurse as soon as possible or go directly to a hospital. Immunisation side effects may be reported to SAFEVIC, the Victorian vaccine safety and central reporting service.
In other states or territories, you can discuss with your immunisation provider how to report adverse events. It is also important to seek medical advice if you (or your child) are unwell, as this may be due to other illness rather than because of the vaccination.
Rare side effects
There is a very small risk of a serious allergic reaction (anaphylaxis) to any vaccine. This is why you are advised to stay at the clinic or medical surgery for at least 15 minutes following immunisation, in case further treatment is required.
Immunisation and HALO
The immunisations you may need are decided by your health, age, lifestyle and occupation. Together, these factors are referred to as HALO.
Talk to your doctor or immunisation provider if you think you or someone in your care has health, age, lifestyle or occupation factors that could mean immunisation is necessary. You can check your immunisation HALO using the Immunisation for Life infographic (pdf)
Where to get help
- Your doctor
- Your local community health centre
- Your local government immunisation service
- NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
- National Immunisation Information Line Tel. 1800 671 811
- Melbourne Sexual Health Centre Tel. (03) 9341 6200 or 1800 032 017 (toll free from outside Melbourne metropolitan area only)
- Cancer Council Helpline Tel. 13 11 20
- HPV Register Tel. 1800 HPV REG (1800 478 374)
- SAEFVIC Tel. (03) 9345 4143 – the line is attended between 10 am and 3.30 pm and you can leave a message at all other times
Things to remember
- The cervical cancer vaccine helps prevent the types of human papilloma virus (HPV) most commonly linked with cervical cancer.
- The vaccine is most effective when given to adolescent boys and girls before they become sexually active (the recommended age is around 12 to 13 years).
- All women aged between 18 and 70 years should have regular pap tests every two years (whether they have been vaccinated or not).