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.

A doctor talks about the HPV vaccine, who is eligible for it, and its aims.

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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.

Paula talks about the health messages she got from the Catch Up Programme and how she felt about it.

Age at interview 15

Gender Female

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Delilah says the nurse provided an introduction to the HPV vaccination programme and talked about certain health circumstances that made it unsafe to have the vaccine.

Age at interview 15

Gender Female

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In Lara’s school there was no assembly to talk about the HPV vaccination Programme just the information leaflet.

Lara thinks that the leaflet gave all the information she needed about what the HPV vaccine is for. She thinks it’s difficult to organise an assembly in mixed gender schools.

Age at interview 13

Gender Female

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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.

Lara is aware that the HPV vaccine, Gardasil, protects against cervical cancer and genital warts.

Age at interview 13

Gender Female

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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.

Isabella feels that she was given enough information about why it was important to get the HPV jab but incorrectly thinks the vaccine provides protection for life.

Age at interview 16

Gender Female

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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.

Lara talks about what nurses do during an HPV vaccination session and how she felt.

Age at interview 13

Gender Female

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Amelia says the vaccination at her school was straightforward but she felt worried about possible side-effects.

Age at interview 15

Gender Female

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Delilah talks about having the jabs, how she felt afterwards and the advice she got from the nurses.

Age at interview 15

Gender Female

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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.

Lara’s arm went numb for a short period after the HPV injection

Age at interview 13

Gender Female

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Paula says she got given a card that nurses signed each time she got her jabs. Her arm usually hurt for a day or so after each jab. Keywords: HPV vaccine, school, side-effects

Age at interview 15

Gender Female

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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.

Paula thinks that more information is needed about STIs (sexually transmitted infections), HPV and cervical cancer before they leave school.

Age at interview 15

Gender Female

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Amelia thinks that Citizenship lessons should have included discussions about HPV and cervical cancer while the vaccination programme was taking place.

Age at interview 15

Gender Female

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Delilah says there was not enough information for her to understand how the HPV vaccine would protect her from cervical cancer.

Age at interview 15

Gender Female

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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.

Isabella feels that more needs to be done to make sure young women understand that the HPV vaccine doesn’t prevent STIs or unwanted pregnancy.

Age at interview 16

Gender Female

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Lara says that, if you are going to have sex, you need to use a condom.

Age at interview 13

Gender Female

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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.

Some of Isabella’s friends didn’t get the HPV vaccine at school due to parents’ concerns, including fearing that daughters may become sexually active after being protected from HPV.

Age at interview 16

Gender Female

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Amelia thinks that parents shouldn’t worry because HPV vaccination happens when girls are very young. She says that girls her age are sensible, cautious and know about safe sex.

Age at interview 15

Gender Female

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