HPV vaccines (to prevent cervical cancer)
This information is about vaccines to prevent a virus called the human papilloma virus (HPV), which can cause cervical cancer. We hope it answers your questions. If you have any further questions, you can ask your doctor or nurse.
Cervical cancer and vaccination
Back to top
About 2,900 women are diagnosed with cervical cancer in the UK each year.
Vaccines that help prevent cervical cancer are a major step forward in women's healthcare. It is hoped that the vaccines will prevent at least 70% (7 in 10) of the most common type of cervical cancer (squamous cell cervical cancer).
The vaccines work by preventing infection with the human papilloma virus (HPV).
The human papilloma virus is a common virus. Over 100 different types of HPV have been identified, and each is known by a number. HPV affects the skin and the mucosa (the moist membranes that line the body, for example in the mouth, throat, anus and cervix).
Some types of HPV cause harmless skin warts (papillomas) that can appear on the hands and feet. Types 6 and 11 affect the genital area and can cause genital warts, but they don't cause cervical cancer. These types are called low-risk HPV.
Other types of HPV are known to increase the risk of developing particular cancers and are referred to as high-risk HPV. Types 16 and 18 are high-risk types that can lead to abnormal changes in the cells of the cervix (known as cervical intra-epithelial neoplasia or CIN).
CIN is not cancer, but in some women it can develop into cancer over a number of years if it's left untreated. Treatment for CIN works very well and the risk of it coming back is low.
HPV infection of the cervix is mainly diagnosed in women as a result of the cervical screening programme. A woman may be told she has HPV when she receives her cervical screening result. If an HPV infection is present, changes in the appearance of the cells can sometimes be seen when they are looked at under a microscope during the screening process. In England and Northern Ireland, your sample may be tested for high-risk types of HPV as part of the screening process. And in some parts of England, testing for HPV is the first test carried out on the cervical screening sample. This is called primary HPV testing. You can find out more about this from the NHS cervical screening programme.
Women who have one or more abnormal smear test results will be referred to a colposcopy clinic. If the abnormality is very mild, they may not be referred until they have had two or three abnormal results in a row. Their cervix will be examined using an instrument like a microscope (called a colposcope). During the examination, the nurse or doctor can apply a solution to the cervix that makes cells infected with HPV turn white.
Most women have HPV at some point in their lives without it causing any harm. There is no treatment for HPV, but the immune system can usually get rid of it quickly by itself.
It’s important that women are aware of the cervical screening programme. Regular cervical smear tests can pick up any abnormal cell changes, which can be treated before they develop into cancer.
Since September 2008, there has been a UK-wide HPV vaccination programme for girls aged 12-13. Two vaccines are available to prevent infection with HPV. These are called Gardasil ® and Cervarix ®.
Gardasil protects against four types of HPV:
Types 16 and 18 (which are high-risk for cervical cancer).
Types 6 and 11 (which are low-risk for cervical cancer but cause genital warts).
Cervarix ® protects against HPV types 16 and 18.
Both vaccines are licensed in the UK, which means that doctors can prescribe them in this country. Gardasil can be prescribed for women between the ages of 9-26. Cervarix can be given to women aged between 10-25.
The vaccines don’t protect against all types of HPV, and women may be infected with more than one type, so it's not guaranteed that they'll prevent all cervical cancers. It is, however, expected that vaccination will prevent most of the more serious pre-cancerous changes (CIN 2 and 3). Gardasil is also expected to prevent most genital warts.
From September 2012, the vaccine used in the national vaccination programme has been Gardasil ®.
All 12-13 year-old girls in the UK are now routinely offered an HPV vaccination. It’s usually when they are in year 8 at school. A letter and consent form is given to parents, explaining what’s involved.
There is also a catch-up programme to vaccinate 13-18-year-old girls, which started in the autumn of 2008. It's also possible to obtain the vaccines privately.
There is some research to suggest boys and men may also benefit from the vaccine. A decision on whether to include boys in the vaccination programme will be made in 2014 when more research has been completed.
How the HPV vaccines are given
Back to top
They are given by injection into the muscle, usually the upper arm or thigh. Three separate doses are needed. The second and third doses are given two months and six months after the first dose.
Possible side effects of HPV vaccines
Back to top
Both vaccines appear to have few side effects. The main ones include:
redness at the injection site
pain and swelling at the injection site.
Other mild effects include a slightly raised temperature, itching, a rash, dizziness, sickness, diarrhoea, a headache and muscle aches.
Can the vaccines get rid of HPV if I already have it?
Back to top
No. There’s no evidence that the vaccine works in anyone who already has HPV infection or abnormal cells changes in the cervix (CIN).
Women will still need to attend their routine cervical smear tests. This is because there are other types of HPV linked with cervical cancer, which the vaccines are not active against. The vaccines are not a substitute for cervical screening.
We have detailed information about the cervical screening programme in our section on cervical screening.
What we don't yet know
Back to top
How many cases of cervical cancer will be prevented by vaccines that only protect against some types of HPV.
How long the vaccines are protective for. We need to know this to find out if and when booster vaccines will be needed. This is currently being researched.
Whether other types of HPV will take over and become more active in causing CIN.
Whether boys should eventually be immunised as well as girls. Research is looking at whether boys and men would benefit from being offered the HPV vaccination.
Whether vaccines can be developed for people who already have HPV. Research trials are currently looking into new vaccines which could be used in the future.
This information has been compiled using information from a number of reliable sources, including:
Thank you to Dr J. Richard Smith, Consultant Gynaecologist, and the people affected by cancer who reviewed this edition. Reviewing information is just one of the ways you could help when you join our Cancer Voices network.