HPV vaccine: about cervical cancer prevention vaccines

Giving immunization to children is very important to prevent disease transmission, one of which is cervical cancer. The cause of this disease is human papillomavirus (HPV) and can be prevented by using a vaccine. This is an explanation of the HPV vaccine in children starting from the immunization schedule, benefits, and side effects.

What is the HPV vaccine?

The HPV vaccine is a type of vaccine that aims to prevent disease caused by human papillomavirus.

In women, this virus can cause cervical cancer, vaginal cancer, vulvar cancer, genital warts, and anus. Meanwhile, in men, the HPV virus can cause genital warts, anal cancer and penile cancer.

However, HPV immunization cannot prevent other types of sexually transmitted diseases caused by bacteria (chlamydia, gonorrhea, and syphilis), parasites (trichomoniasis), and other viruses (hepatitis B, genital herpes, HIV, zika).

HPV immunization only serves to prevent HPV infection, which can be cervical cancer or genital warts. To prevent the risk of various venereal diseases from other causes, other ways are still needed.

Several types of HPV have also been linked to cancer of the mouth and throat. So immunization for HPV may also protect you from mouth and throat cancer.

This virus can attack the epithelial cells in the skin and mucous membranes, one of which is located in the genital area.

The cells that are attacked will become damaged and begin to grow abnormally. As a result, the development of the HPV virus is at risk of causing cancer.

How does the HPV vaccine work?

Quoting from the page of the Indonesian Pediatrician Association (IDAI), there are 2 types of cervical cancer vaccines in Indonesia to help prevent cervical cancer. The first is bivalent, and the second is tetravalent.

The bivalent vaccine contains 2 types of HPV virus, namely types 16 and 18, which can prevent cervical cancer. While the tetravalent type contains 4 types of HPV viruses, namely 6, 11, 16, and 18.

The four types of viruses in the HPV vaccine are useful for preventing cervical or cervical cancer, as well as genital warts or genital wart.

The HPV vaccine needs to be given 3 times over a period of 6 months. The second HPV vaccine is given 1-2 months after the first HPV vaccine. The third HPV vaccine is given 6 months after the first vaccine.

For example, if you got your first HPV vaccine on June 1, your schedule for the second HPV vaccine is at least July 1 or August 1. While the schedule for the third HPV vaccine is at least on December 1.

For the price, HPV immunization does not receive subsidies from the government so it is quite high. The price of this vaccine is around Rp. 760 thousand to Rp. 920 thousand.

Who needs the HPV vaccine?

In Indonesia, giving cervical cancer is generally recommended for girls, at least starting from the age of 10 years and over. It's just that, the Indonesian Ministry of Health hopes that the HPV vaccine can be extended to boys later.

The reason is, giving vaccinations to men can help protect and reduce transmission of the HPV virus that causes cervical cancer to sexual partners at a later date.

It is ideal for girls and boys to receive vaccines to prevent the spread of viruses and diseases before they have sexual contact and are exposed to HPV.

This is because once infected, the vaccine for cervical cancer prevention will not work effectively, maybe even not work at all.

Schedule of HPV vaccine

According to the CDC, the HPV vaccine as an effort to prevent cervical cancer is routinely given to girls and boys aged 11 or 12 years. However, there are also some organizations that recommend starting vaccines from the age of 9 or 10.

The immune response will be stronger if the vaccine is given at a young age, than at an older age. The level of effectiveness of this vaccine will be even higher.

Vaccination given to young girls at the age of 9-13 years is considered to be the most effective even though they have not had sexual intercourse.

This age range is considered effective because it is at this time that the body provides better immune response protection than the above age.

In particular, the Indonesian Pediatrician Association (IDAI) schedules that HPV immunization should be carried out between the ages of 10-18 years.

The number of HPV immunizations can be given as much as 2-3 times. The second dose of vaccine can be given one or two months after the first vaccine administration, depending on the type of vaccine given, whether bivalent or tetravalent.

For bivalent HPV immunization, it is given three times with a schedule of 0, 1, 6 months, the HPV tetravalent vaccine with a schedule of 0.2, 6 months.

If given to adolescents aged 10-13 years, 2 doses are sufficient at intervals of 6-12 months because the antibody response is equivalent to 3 doses.

The last vaccine schedule is about 6 months after the first injection. In general, giving HPV immunization is carried out in terms of:

First dose: At this time
Second dose: 2 months after the first dose
Third dose: 6 months after the first dose

If you miss the vaccine schedule, you don't need to start over. It is enough to complete the previously missed vaccine doses for cervical cancer.

Who should not receive the HPV immunization?

HPV immunization is not recommended for pregnant women or people who are seriously ill. Launching from the CDC, women who are pregnant are only allowed to get this vaccine after giving birth.

If you find yourself pregnant after receiving the first injection of the HPV vaccine, it is recommended that you postpone the next injection until delivery.

Although generally a mother who does not know that she is pregnant when the vaccine does not need to worry, try to still consult a doctor.

Inform all types of allergies you have before the vaccine is carried out. If you also have an allergic reaction to any ingredients or components of the vaccine or previous vaccine doses, you should not be allowed to get this vaccine.

What are the side effects of HPV immunization?

The side effects of HPV immunization are usually mild. In fact, there are also those who don't feel any side effects after getting it.

The most common side effects of immunization after injection are pain, swelling or redness at the injection site. Dizziness or fainting may also occur after vaccination.

Very common side effects

More than one per hundred women who get HPV immunization experience:

Fever
Nausea (not feeling well)
Pain in the arms, fingers, feet and toes
Redness, bruising, itching, swelling, pain, or cellulitis
Headache

Rare side effects

About one in ten thousand women who get the HPV vaccine develop an itchy red rash (urticaria or hives).

Very rare side effects

Less than one in ten thousand women who get the cervical cancer vaccine experience problems and difficulty breathing (bronchospasm).

In rare cases, you may experience serious allergic reactions after getting the vaccine. This reaction is also known as anaphylactic shock. Signs of anaphylactic shock include:

Difficulty breathing
Swollen eyes, lips, genitals, hands, feet and other areas (angioedema)
Itchy
The mouth feels like iron
Sore, red, itchy eyes
Change in heart rate
Loss of consciousness

Again, severe reactions like this are extremely rare. The ratio is one per one million people. If you have a severe allergic reaction, contact your doctor immediately.

It is better to still give vaccines to your little one because children who are not immunized or children who are late in immunization have a greater risk of contracting the disease.

Does the HPV vaccine affect female fertility?

Research entitled The Effect of Vaccination Against Human Papillomavirus on Fecundability shows that the HPV vaccine is a way to improve the likelihood of fertility in some women.

This study uses data from Pregnancy Study Online (PRESTO), a group working on pregnancy from pregnancy planners in North America.

Research published in the journal Pediatric and Perinatal Epidemiology this involved 3,483 women and 1,022 men aged 21 to 45 who were actively trying to conceive.

The partners were followed for 12 months or until pregnancy. At the time of enrollment, 33.9 percent of women and 5.2 percent of men had received the HPV immunization.

The results show an association between the HPV vaccine and women who have a history of venereal disease. A person who has a history or symptoms of venereal disease is often associated with low fertility rates.

However, women with a history of venereal disease who are vaccinated will have the same chance of pregnancy as women who have not been vaccinated and do not have a history of venereal disease.

In other words, the HPV vaccine can protect the fertility of women who have venereal diseases.

Researchers hope that with this research, there will be no more doubts about doing HPV immunization for fear of infertility.

Already have the HPV vaccine, do you still need to do a pap smear test?

The HPV vaccine is a measure to prevent cervical cancer and cannot replace a pap smear test. Routine cervical cancer screening through a pap smear test is an important part of a woman's health care.

Pap smear is a test to detect cervical cancer early in the condition of cells in the cervix (cervix) and vagina. With routine checks, doctors can immediately detect if there are cell changes that may develop into cancer.

Pap smear tests should start when a woman is 21 years old or has been sexually active. This examination can be done every 3 years.

Do you need the HPV vaccine if you have genital warts?

The HPV vaccine is basically meant to prevent infection. However, in some cases this vaccine can actually function as a treatment that aims to help clear the genital wart virus in people who have been infected.

So, doing a vaccine even though you have been infected is a wise choice you can take. The reason is, there are about 30 to 40 types of HPV viruses that are sexually transmitted.

That way, doing the HPV vaccine after infection can also help protect you from other types of HPV that lurk in the body.

Quoted from the old Health Harvard Edu, the HPV vaccine can provide promising protection. This vaccine helps reduce sores and inflammation of genital warts by 35 percent.

In addition, the vaccine not only prevented infection of the four targeted HPV strains but also reduced 38 percent of the risk of precancerous lesions caused by 10 other strains.

However, you also need to realize that doing the vaccine once you have an infection does not mean completely eliminating the infection you have.

Vaccines also don't protect you from all types of HPV. Experts also do not know exactly how long the HPV vaccine can run effectively. However, vaccines can help protect you in about five years.

Therefore, even if you have had your vaccinations it is a good idea to keep having regular Pap smear tests and pelvic exams.

The reason is, people who have been infected with the HPV virus such as genital warts are still at risk of contracting other types of HPV viruses, including those that cause cervical cancer.