Sexual Health

The HPV Vaccination Programme

Human papilloma virus (HPV) is the main cause of cervical cancer in women. There are many types of HPV and the HPV vaccine provides protection against the two high risk types (types 16 and 18) that cause 70% of all cervical cancers (NHS Choices 2014). Other low-risk types cause anal and vaginal warts. Women need to be vaccinated before they come into contact with the virus. The virus is transmitted by skin-to-skin contact, usually by sexual activity. There is currently no medical treatment for HPV but there are treatments for the problems that HPV can cause such as cervical cancer and genital warts. Being vaccinated against it and practising safe sex (penetrative or oral) by using condoms are the best ways to reduce the chance of infection.

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Routine HPV vaccination was introduced in 2008 for girls aged 12-13 (school year 8). The Catch-Up Programme also started in 2008 offering the vaccine to girls aged up to 18 and this ended in most of the UK in 2011. In 2012 by the Department of Health recommended to the routine vaccination programme for 12-13 year olds be offered in schools.
 
We talked to 12 to 16 year old girls, all in full-time education about their experience of HPV vaccination. All were vaccinated in school, some attended a school assembly where a Primary Care Trust nurse talked about the programme and they received an information leaflet and a consent form to take to their parents. Girls who had the HPV vaccine a few years ago didn’t remember much about what was said at the assembly talk and their decision to be vaccinated seemed to be based on a combination of their parents’ attitude, talking with others their age and their own understanding of HPV. 
In Lara’s school there was no assembly to talk about the HPV vaccination Programme just the information leaflet. 
Two types of HPV vaccines are available in the UK: Cervarix and Gardasil. Cervarix protects against HPV 16 and HPV 18 and aims to reduce the number of people who get cervical cancer. Cervarix was used by the vaccination programme until 2011. Gardasil protects against four strains of HPV: 16, 18, 6 and 11 and protects against cervical cancer as well as genital warts. Gardasil was used by the vaccination programme from September 2012. Cervarix and Gardasil give 99% protection against these types of HPV, for at least 6 years.

Most of the young people we talked with were vaccinated with Cervarix except for Lara who was vaccinated after September 2012 and therefore, with Gardasil. 
The information leaflet was usually talked about with friends at school and in some cases with parents. Most parents seemed to have been happy with the information given in the leaflet but, Paula remembers her mother looking for more information about the HPV vaccination programme on the internet. All the young girls we talked with thought it important to get protection and said it was their decision rather than their parents’ decision to get the HPV jab. The girls we talked with were unsure if the HPV vaccine offered protection for life, or how long the protection lasted, or if they needed to have a booster later on. The length of vaccine protection (immunity) is usually not known when a vaccine is first introduced. "Studies have already shown that the vaccine protects against HPV infection for around 10 years, although experts expect protection to be for much longer" - NHS Choices September 2014.
The vaccine is given in three doses, the second dose being 1-2 months after the first and the third at 6 months after the first. The vaccine is not given to pregnant women and very ill people should wait until feeling better. The girls we talked with said that, at every vaccination session, nurses enquired about pregnancy or illness. And nurses also asked about any allergic reactions to a previous dose of HPV vaccine. Young people were also aware that if they missed the vaccination date at school they could have it done at their GP surgery. Concerns about having the vaccine were mostly limited to whether the injection would hurt.
All the girls we talked with were told by nurses to get in touch with their doctor or a nurse if they felt unwell after having a dose of the vaccine. Some had a mild reaction after the injection. Mild problems include redness, tenderness, or swelling where the injection is given.
Young women we talked with said they would welcome more information. They felt that, at the time of getting the vaccine, they were too young to understand it all or thought that not enough information was made available to them by nurses giving the talk. School assemblies, citizenship lessons or leaflets were all thought to be good ways to provide further information. 
Lara completed the vaccination programme in 2013 and feels she had enough information to understand the health risks of the papilloma virus and the benefits of the HPV vaccine.

All of the young people we talked with understood that the HPV vaccine does not protect against unwanted pregnancy or any other sexually transmitted infection (STI). They knew that only a condom can help prevent a STI. Similarly, young people saw no relationship between having the HPV vaccine and sexual behaviour, but stressed the importance of using contraception if, and when they became sexually active. 
The parents of the young women we talked with seemed to have supported and encouraged their daughters to get vaccinated but they knew of friends whose parents felt differently and didn’t consent for their daughters to get the HPV vaccine.

Last reviewed January 2016.
Last updated January 2016.

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